Spinal cord
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To determine the prevalence of constipation-related symptoms in individuals with chronic spinal cord injury (SCI), to describe the bowel program as reported by patients and including use of bowel medications and evacuation techniques, and to examine the clinical, functional and pharmacological risks of difficulty with evacuation. ⋯ Constipation-related symptoms are highly prevalent in individuals with spinal cord injury, despite considerable laxative use. Our findings suggest that difficulty with evacuation can be predicted on the basis of a patient's clinical profile.
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The case histories of two patients who had had a spinal cord injury (SCI) were selected by the senior author and sent to four experts in the field of SCI. Based on the 1992 American Spinal Injury Association (ASIA) and International Medical Society of Paraplegia (IMSOP) standards, the four participants plus the senior author recorded the motor and sensory scores, the ASIA impairment scale (AIS), the neurological level (NL) and the zone of partial preservation (ZPP). ⋯ This exercise points to the need for all examiners of SCI patients to thoroughly familiarize themselves with the standards and to use the motor and sensory scores to arrive at a NL and ZPP. They also indicate a need to revise the standards to clarify the determination of sensory levels and how to score muscles whose strength is inhibited by pain.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Effectiveness of gabapentin in controlling spasticity: a quantitative study.
The purpose of this investigation was to study the effectiveness of gabapentin in controlling spasticity in persons with spinal cord injury (SCI) using a surface EMG-based quantitative assessment technique called the brain motor control assessment (BMCA). Six men from a Veterans Affairs Medical Center with spasticity due to traumatic SCI were studied as part of a multi-center, placebo-controlled, cross-over, clinical trial of gabapentin. Spasticity was evaluated using multi-channel surface EMG recordings of muscles in the lower extremities, abdomen and low back before and during treatment with oral gabapentin or placebo. ⋯ I. D. may be effective in controlling some features of spasticity in persons with SCI. Higher doses provide greater control of spasticity, and controlled studies using higher doses are needed to evaluate gabapentin's efficacy.
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Review Historical Article
The history of modern spinal traction with particular reference to neural disorders.
The last 200 years of the history of spinal traction is described in the present article. The study starts at the end of the 18th century with the works of JA Venel (1789) who tried to apply the Hippocratic idea to modern surgery. Orthopedic specialists of the last century were mostly preoccupied with corsets and the method gained broader popularity when neurologists paid attention to the similar method of suspension. ⋯ Unfortunately neurologists worked without the cooperation of orthopedic specialists. During the first decades of the 20th century suspension was also replaced by traction in neurology. This method was used by both neurologists and orthopedic specialists but in the last decades neurologists lost their interests in it and it found greater use in traumatology and in spinal surgery where it is still in use today.