The journal of spinal cord medicine
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The Subaxial Injury Classification (SLIC) system has been developed to improve injury classification and guide surgical decision making yet clinical validation remains necessary. ⋯ This is the first prospective application of the SLIC system. With regard to our primary outcome, neurological status, the SLIC system was found to be a safe and effective guide in the surgical treatment of SCST.
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Long-term follow-up of spinal cord stimulation to restore cough in subjects with spinal cord injury.
To determine the long-term effects of the cough stimulation system. ⋯ Subjects continued to use the system on a long-term basis beyond the period of close follow-up and to continued derive significant clinical benefits.
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Randomized Controlled Trial
The effect of repetitive transcranial magnetic stimulation on refractory neuropathic pain in spinal cord injury.
To investigate the analgesic effect of repetitive transcranial magnetic stimulation (rTMS) on intractable neuropathic pain in patients with spinal cord injury (SCI). ⋯ Our results demonstrated analgesic effect of rTMS on intractable neuropathic pain in SCI was not superior to placebo. However, middle-term (over 6 weeks) pain relief by rTMS is encouraging and suggests the need for future studies with a larger sample size.
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Differential diagnosis of acute/subacute intrinsic spinal cord lesions can be challenging. In addition, intramedullary neoplasms typically show gadolinium enhancement, mass effect, and cord expansion. ⋯ Astrocytoma must remain as a possible diagnosis of spinal cord lesions, even without typical characteristics of neoplasms. Furthermore, biopsy should always be considered when diagnosis is uncertain.
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Pain remains a problem for many with spinal cord injury (SCI), and there is a need for sound, randomized clinical trials examining the efficacy of existing and novel therapeutics. SCI-related pain is complex, as more than one type of pain is often experienced. The purpose of this report is to (i) demonstrate how to design and power calculation of a clinical trial of SCI pain using multiple pain sites per individual; (ii) discuss consequences of failing to adjust for this; and (iii) provide intraclass correlation (ICC) estimates for common pain outcome measures that may be used to power future clinical trials in SCI pain. ⋯ Powering for future SCI pain trials and statistical analysis of trial outcomes may be substantially compromised if methods do not account for the intra-individual associations between pain sites, ultimately affecting study interpretations and evidence-based practice. We present ICC estimates based on SCI pain data for purposes of estimating power for future trials.