Study design: Retrospective Case Review. Objectives: To describe the clinical presentation and course of patients with magnetic resonance imaging (MRI) features of subacute progressive ascending myelopathy (SPAM). A rare complication of spinal cord injury. Setting: National Spinal Injuries Centre, Stoke Mandeville Hospital, UK. Materials and methods: A retrospective review of the case notes and MRI studies of 11 cases with typical MRI features of ascending myelopathy presenting to a tertiary Spinal Injuries centre over a 15-year period. Results: Eleven patients were identified with MRI features typical of SPAM, a median of 13 days (mean 24, range 4-86 days) following cord injury. The median number of cord segments involved above the initial insult was 6 (mean 6.2, range 4-11). MRI appearances include extension four or more segments cephalad to the initial cord injured segment, cord expansion and increased intramedullary T2 signal with a rim of cord sparing peripherally. Cord changes and neurological deficits improved over time but did not return to the initial injured level on MRI. One patient died (mortality 9%). Conclusion: SPAM is a rare cause of neurological deterioration following spinal cord injury but may remain subclinical. SPAM most commonly presents as neurological deterioration but may present with shoulder pain, respiratory deterioration or remain subclinical. There are characteristic MRI appearances. It can be fatal.

Spinal cord injury is a life transforming condition that is thought to have an impact on the entire family of the affected individual. The needs and psychological outcomes of siblings of children with spinal cord injury (SCI) have not been researched. The current study focuses on the experiences of children living with a brother or sister with SCI. Eight participants (4 male, 4 female) aged between 7 and 18 years were interviewed using a semi-structured interview, concentrating on their unique experiences and understandings of having a brother or sister with SCI. The qualitative method of Interpretative Phenomenological Analysis (IPA) was used to analyze the data and three main themes were identified: "Life interrupted", "What about me?" and "My safety net". Results are discussed in relation to attachment and coping and adjustment theories. The discussion also highlights the clinical implications for siblings and parents of children affected by SCI, and for professionals who work within pediatric SCI settings.

Sexuality remains an important, valued aspect of female identity following SCI; sexual activity continues and though altered remains enjoyable and rewarding. Sexuality rehabilitation should commence early, preparing women for altered sexual sensation, disclosure of altered sexual function to partners, and encouraging early self-exploration. Techniques optimising continence management in preparation for and during sex should be taught. Participants identified a need for women-only education and support groups, increased peer support, self-esteem, communication and social skills training and even fashion advice and pampering sessions during rehabilitation. Support and education for partners are needed. Staff require support to be knowledgeable and confident in addressing women's sexuality needs. Use of the Ex-PLISSIT model for psychosexual support could help staff to better meet these needs.

MR can be used to image acute neurological admissions with a high success rate, particularly using ultrafast methods. In many cases, MR provided extra information of direct clinical relevance not shown on CT.

To validate the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) in paediatric spinal cord injuries (SCIs) patients admitted to the tertiary SCI centre