Management of degenerative changes and stenosis of the lumbar spinal canal secondary to cervical spinal cord injury

Abel, Rainer; Bazo, Humberto Antonio Cerrel; Kluger, P.; Selmi, Fahed; Meiners, Thomas; Vaccaro, Alex; Ditunno, John F.; Gerner, Hans Jürgen

doi:10.1038/sj.sc.3101435

Cited by 5 publications

(2 citation statements)

References 24 publications

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“…Another pathophysiologic process that could affect all levels of SCI is the observed changes in adipose metabolism due to increased bouts of sympathetic activity that results in increased glycerol release and possible contribution to insulin resistance (Karlsson, 1999b). Finally, the literature frequently reports increased muscle spasms as a symptom of AD (Head and Riddoch, 1917;Kewalramani, 1980;Mathias and Bannister, 1999;Abel et al, 2003). While the mechanisms of this motor-sympathetic association are not known, the potential confounding effect of sympathetic reflexes on spasms has implications for all levels of injury where spasticity often contributes to disability (Skold et al, 1999).…”

Section: Introductionmentioning

confidence: 99%

Leg sympathetic response to noxious skin stimuli is similar in high and low level human spinal cord injury

Garrison

Schmit

2008

Clinical Neurophysiology

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Objective-To determine if sympathetically mediated vasoconstriction in the lower extremities is injury-level dependent. Although sympathetic responses have been measured in the limbs of people with high and low level SCI using blood flow measurements, including Doppler ultrasound and venous plethysmography, a direct comparison between injury levels has not been made.Methods-Volunteers with chronic SCI were grouped according to injury level. Above T6: high level (HL, n=7), and T6 and below: low level (LL, n=6). All subjects had complete motor and sensory loss. Leg arterial flows were recorded by venous occlusion plethysmography, and continuous heart rate and mean arterial pressure (MAP) were measured. The conditioning stimulus consisted of transcutaneous stimulation to the arch of the contralateral foot.Results-HL and LL subjects demonstrated a significant decrease in arterial conductance during stimulation with no significant difference found between groups. As expected, only group HL demonstrated a significant increase in MAP.Conclusions-These results support our hypothesis that local (leg) sympathetic responses are similar for both high and low level SCI.Significance-While low level SCI does not typically present with autonomic dysreflexia, bouts of increased reflex sympathetic activity could have ramifications for metabolism as well as renal and motor system function.

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Section: Introductionmentioning

confidence: 99%

Leg sympathetic response to noxious skin stimuli is similar in high and low level human spinal cord injury

Garrison

Schmit

2008

Clinical Neurophysiology

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“…It is characterized by the degeneration and painless swelling of the joints. The joints most frequently affected are the weight-bearing joints, predominantly the mid-foot and then ankle [ 4 ], knee, hip and rarely the spine [ 5 ] and upper extremity, especially seldom in hands [ 6 ]. The involved joints are partly dependent on the underlying neurological condition such as foot and ankle in diabetes [ 7 ], knees in tabes dorsalis [ 8 ], upper extremity joints in syringomyelia [ 9 ] and hand in syringomyelia [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Case series on the Charcot neuroarthropathy in hands after cervical central cord syndrome

Wang

Tong

Liu

et al. 2022

BMC Musculoskelet Disord

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Background Charcot neuroarthropathy (CNA) of the upper extremity occurs most frequently in shoulders. However, CNA in the hands is uncommon and seldom be reported. The onset of CNA is usually insidious. If this process continues undetected, it can result in joint deformity, ulceration and/or superinfection, loss of function, and amputation or even death. In this article, we are going to present three cases of CNA in the hands of individuals with cervical spinal cord injury (SCI) with central cord syndrome. Case presentation Three male individuals with cervical spinal stenosis contracted tetraplegia (American Spinal Injury Association Impairment Scale Grade D, D, and B) due to spinal cord contusion after a trauma and developed hand swelling without pain 2 to 3 months after their SCI. X-ray showed degenerative joint changes in the hands. CNA was considered due to the patient’s history of cervical SCI, loss of motor function and sensation, symptoms of painless swelling, physical examination, and X-ray findings. The self-care sub scores of Spinal Cord Independence Measure III improved slightly only during rehabilitation and follow-up due to poor hand function. Conclusions CNA may develop after a central or peripheral neurological disorder. Nearly every joint of the body can be affected and the lower limbs are the most frequently involved. However, CNA of the hand is rare. We present three patients with CNA in the hands after cervical SCI and review the features and early differential diagnosis of CNA. Currently there is no specific treatment available. Therefore, early identification of CNA and adequate protection to the affected joints seem important.

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Aging with spinal cord injury

Capoor

Stein

2005

Physical Medicine and Rehabilitation Clinics of North America

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Management of degenerative changes and stenosis of the lumbar spinal canal secondary to cervical spinal cord injury

Cited by 5 publications

References 24 publications

Leg sympathetic response to noxious skin stimuli is similar in high and low level human spinal cord injury

Leg sympathetic response to noxious skin stimuli is similar in high and low level human spinal cord injury

Case series on the Charcot neuroarthropathy in hands after cervical central cord syndrome

Aging with spinal cord injury

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