Objectives: The aim of this study was to compare the effects of a locomotor training (LT) combined rehabilitation program with a rehabilitation-only program on pulmonary function in spinal cord injury (SCI) patients by investigating spirometric analyses of the patients. Setting: Rehabilitation center in Ankara, Turkey. Methods: Fifty-two patients (40 male, 12 female) with SCI enrolled in the study. The subjects were divided into two groups: the first group (group A) received both LT and a rehabilitation program and the second group (group B) received only the rehabilitation program for 4 weeks. The LT program was prescribed as three 30-min sessions per week. Pulmonary function was evaluated spirometrically in both groups before and after the rehabilitation program. Results:The spirometric values of the SCI patients, including forced vital capacity, forced expiratory volume in 1 second, forced expiratory flow rate and vital capacity (VC) and VC%, increased significantly with LT in the first group (all Po0.05). Maximum voluntary ventilation values increased significantly in both groups (both Po0.05). Conclusion: These findings suggest that LT is effective for improving pulmonary function in SCI patients. We also highlight the useful effects of LT, which are likely the result of erect posture, gait and neuroplastic changes that prevent potential complications in SCI patients.

Study design: Retrospective study.Objectives: To analyze the neurogenic bladder characteristics and treatment approaches in patients with upper and lower cervical spinal cord injury (SCI) in order to make proper and reasonable decisions to the relevant patients. Setting: Rehabilitation center in Ankara, Turkey. Method: Ninety patients with cervical SCI were included. The urodynamic analyses of the patients were conducted retrospectively by using the urodynamic laboratory records. The patients were divided into two groups as the upper cervical SCI (UCSCI) group (C1-C5) and lower cervical SCI (LCSCI) group (C6-C8). Results: In this study, 82 male (91.1%) and 8 (8.9%) female patients were included. There were 51 UCSCI patients with the mean age of 34.2 ± 16.1 years and 39 LCSCI patients with the mean age of 30.4 ± 12.5 years. Detrusor overactivity and preservation of the bladder-filling sensation were significantly more frequent in the UCSCI group than in the LCSCI group (P ¼ 0.048, P ¼ 0.000 respectively). Moreover, there were statistically significant differences between the groups regarding the bladder-emptying methods, residual volume and the frequency of anticholinergic and alpha blocker use (all Po0.05). No significant difference was found between the groups regarding the frequency of autonomic dysreflexia, detrusor hypocompliancy and the bladder-storage and -emptying disorders (all P40.05). INTRODUCTIONSpinal cord injury (SCI) is a disease that is resulted by traumatic or nontraumatic reasons, and it causes restriction of self-care, mobilization and daily activities of the patients to a considerable degree. The SCI incidence was reported to be 15-40 per million. 1,2 The damage as a result of this injury not only limits the movement of the patient but also causes vital changes in the functions of many organs and lead to life-threatening complications. The aforementioned problems are more severe in cases of cervical SCI. Neurogenic bladder is commonplace in SCI patients. It decreases life span and adversely affects the quality of life. [3][4][5][6] Although the neurogenic bladder was one of the most important cause of morbidity/mortality in SCI patients in the past when the examination and treatment were not sufficiently developed, it has reached to a curable level today as a result of new developments.The purpose of this study was to analyze the neurogenic bladder characteristics and treatment approaches retrospectively in the cervical SCI cases by using the urodynamic records of our hospital. As there were some differences in the functional abilities like hand function, sitting balance, and so on in upper (C1-C5) and lower (C6-C8) cervical SCI patients, we hypothesized that neurogenic bladder characteristics and treatment approaches would also differ in these groups. The aim of this study was to make proper and reasonable decisions for the neurogenic bladder treatment approaches in relevant patients with cervical SCI.

There have been previous reports of both demographic and clinical features with urodynamic evaluation results of patients with traumatic spinal cord injury (SCI). These studies were conducted on patients with cervical and thoracal SCI, but there has been no comparative study evaluating the urodynamic outcomes of patients with lumbosacral SCI. Therefore, it was aimed to investigate the bladder features and treatment options in patients with lumbosacral SCI to be able to take appropriate therapeutic decisions. The urodynamic data of 121 patients with lumbar and sacral SCI were obtained retrospectively using the urodynamics unit records. The patients were grouped as upper lumbar (L1 and L2) SCI (ULSCI) and lower lumbar-sacral (L3 to S5) SCI (LLSSCI). The patients were 92 males (76 %) and 29 (24 %) females, comprising 74 (61.2 %) ULSCI patients and 47 (38.8 %) LLSSCI patients. Detrusor hypocompliancy and anticholinergic prescription were more frequent in the ULSCI group than in the LLSSCI group, while alpha-blocker prescription was more frequent in the LLSSCI group than in the ULSCI group. There was a statistically significant difference between the groups in respect of the rates of bladder-emptying method on admission. A higher mean micturated urine volume was observed in the LLSSCI group than in the ULSCI group. The rates of bladder-filling sensation, detrusor overactivity, bladder-storage and emptying disorders, prescribed emptying method, and residual urine volume were similar in both groups. These results showed that there are differences in neurogenic bladder features and treatment options for patients with upper lumbar and lower lumbar-sacral SCI.

A 60-yr-old woman reported severe pain in the proximal part of her left forearm. The pain was also radiating toward the median nerve-innervated areas of the arm, especially during elbow flexion. Ultrasonographic imaging showed a well defined ganglion cyst around the distal biceps tendon close to the median nerve. Under ultrasound guidance, the cyst was aspirated and corticosteroid injection was performed. The patient's complaint improved 1 wk after the injection, and she started to flex her elbow without any pain. This case highlights the role of ultrasonography as a useful adjunctive tool not only to morphologically confirm a peripheral nerve entrapment but also to uncover the possible underlying etiology and to guide precisely during an intervention.