Epidemiology, Demographics, and Pathophysiology of Acute Spinal Cord Injury

Sekhon, Lali H.S.; Fehlings, Michael G.

doi:10.1097/00007632-200112151-00002

Cited by 1,235 publications

(839 citation statements)

References 115 publications

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“…These figures are in keeping with previous reports in the literature [18]. The reported incidence of significant injuries such as traumatic brain injury or major chest injuries ranges from 20 to 57% [21]. Typically these multi-system traumas occur in RTAs.…”

Section: Discussionsupporting

confidence: 89%

Demographics of acute admissions to a National Spinal Injuries Unit

Lenehan¹,

Boran²,

Street³

et al. 2009

Eur Spine J

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Records of all patients admitted to our unit from 1999 to 2003 were compiled from a prospective computerized spinal database. In this 5-year period, 942 patients were acutely hospitalized at the National Spinal Injuries Unit. There were 686 (73%) males and 256 (27%) females, with an average age of 32 years (range 16-84 years). The leading cause of admission with a spinal injury was road traffic accidents (42%), followed by falls (35%), sport (11%), neoplasia (7.5%) and miscellaneous (4.5%). The cervical spine was most commonly affected (51%), followed by lumbar (28%) and thoracic (21%). On admission 38% of patients were ASIA D or worse, of which one-third were AISA A. Understanding of the demographics of spinal column injuries in unique populations can help us to develop preventative and treatment strategies at both national and international levels.

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Section: Discussionsupporting

confidence: 89%

Demographics of acute admissions to a National Spinal Injuries Unit

Lenehan¹,

Boran²,

Street³

et al. 2009

Eur Spine J

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“…1 A total of 55% of patients sustain an injury at the cervical level with the rest divided equally between thoracic, thoracic-lumbar and lumbar-sacral levels. 1 Previously, about two-thirds of SCI patients had a complete transection of the spinal cord, however this trend is changing and now less than half sustain a complete SCI. 2,3 About 70% of SCI patients are under 40 years of age and 80-85% are men.…”

Section: Introductionmentioning

confidence: 99%

Effects of repeated ejaculations on semen characteristics following spinal cord injury

et al. 2005

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Study design: Prospective randomised controlled study. Objective: To evaluate the effects of repeated ejaculation on semen characteristics following spinal cord injury (SCI) in a prospective randomised controlled study. Setting: Spinal Research Centre, Stanmore, UK and Institute of Urology and Nephrology, London, UK. Methods: A total of 74 patients with SCI above T10 were tested by vibro-ejaculation using a Ferticare penile vibrator (Multicept A/S Horsholm, Denmark) using a standardised technique. The ejaculate was examined according to WHO protocol. The successfully vibro-ejaculated subjects (n ¼ 32) were randomised into a study group (n ¼ 18) and a control group (n ¼ 14). The patients in the study group vibro-ejaculated weekly for 3 months with semen analysis performed at baseline and then monthly. The control group vibro-ejaculated at baseline and at the end of the 3-month period. Two experienced observers performed the semen analysis independently. All measures were compared for statistical significance across the two groups at the beginning and at the end of the 3-month period using a two-tailed student t-test. Significance was determined at the 95% confidence interval (Po0.05). Results: In total, 10 patients in the study group and nine in the control group have completed the study so far. Six patients have dropped out of the study group and three from the control group for varied reasons. Two patients are currently enrolled in the study and control groups. The morphology and forward progression of sperm shows a statistically significant increase in the study group. The motility improves but is not statistically significant in the study group. No significant adverse effects were reported. Conclusions: We have shown in this unique randomised controlled study that repeated ejaculation does improve the sperm characteristics in SCI patients. It is suggested that SCI men should undergo repeated ejaculation for at least 3 months before trying intravaginal or intrauterine insemination techniques. If this fails then in vitro fertilisation can be used. This method promotes natural conception, is intimate and cost effective.

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“…Vertebral fracture-dislocation has been cited as the most common mechanism of cervical SCI in humans (Sekhon and Fehlings, 2001), is associated with ''complete'' SCI in humans (Pickett et al, 2006), and in rats causes more severe histological indices of damage compared to contusion and flexion-distraction injury mechanisms (Choo et al, 2007;. Despite this, fracture-dislocation is relatively understudied injury mechanism in experimental SCI research.…”

Section: Discussionmentioning

confidence: 99%

Effects of Advanced Age on the Morphometry and Degenerative State of the Cervical Spine in a Rat Model

Laing

Cox

Tetzlaff

et al. 2011

The Anatomical Record

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Aging causes changes in the geometry of the human cervical spine that may influence the tissue response to applied loads. Rat models are often used to study spinal cord injuries (SCI) and have the potential to enhance our understanding of the effect of age on SCI. The goal of this study was to characterize the morphometry and degenerative state of the cervical spine in Fisher 344 rats, and to determine the influence of age on these variables. Fifteen rats were split into three age groups: young adult (3 months of age), aged (12-18 months) and geriatric (30 months). Following tissue harvest we used a lCT scanner to image the cervical and upper thoracic spine from each specimen. Analysis software was used to measure variables including canal pinch diameter (the most rostral point on the dorsal aspect of a vertebral body to the most caudal aspect of the lamina on the immediately rostral vertebra), vertebral canal depth, width, and area, vertebral body height, depth, width, and area, and intervertebral disc thickness. Orthopaedic surgeons used midsagittal images to rate the degenerative state of the intervertebral discs. For all measures except disc thickness there was a significant increase (mean (SD) ¼ 15.0 (9.7)%) for the aged compared to young specimens (P < 0.05). There were significant differences between the aged and geriatric specimens for only vertebral body depth (P ¼ 0.016) and area (P ¼ 0.020). Intervertebral disc degeneration was significantly greater on the ventral aspect of the spinal column (P < 0.001), with a trend toward increased degeneration in the geriatric specimens (P ¼ 0.069). The results suggest that agerelated morphometric differences may need to be accounted for in experimental aging models of SCI in rats. Anat Rec, 294:1326Rec, 294: -1336Rec, 294: , 2011. V V C 2011 Wiley-Liss, Inc.

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Epidemiology, Demographics, and Pathophysiology of Acute Spinal Cord Injury

Cited by 1,235 publications

References 115 publications

Demographics of acute admissions to a National Spinal Injuries Unit

Demographics of acute admissions to a National Spinal Injuries Unit

Effects of repeated ejaculations on semen characteristics following spinal cord injury

Effects of Advanced Age on the Morphometry and Degenerative State of the Cervical Spine in a Rat Model

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