Paraplegic patients: how to measure balance and what is normal or functional?

Barkoh, Kaku; Lucas, Joshua; Lee, Larry; Hsieh, Patrick C.; Wang, Jeffrey C.; Rolfe, Kevin

doi:10.1007/s00586-018-5471-x

Cited by 3 publications

(2 citation statements)

References 30 publications

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“…There is some controversy in the literature concerning spinopelvic alterations in SCI patients with upper thoracic injury level [21,22], while there is a paucity of literature that directly addresses sagittal imbalance in paraplegic patients. Some studies have shown significant alterations of the sagittal thoracolumbopelvic but not of the cervical alignment parameters in the nonambulatory paraplegic patients compared to ambulatory patients, depending on the level of the SCI [21][22][23].…”

Section: Discussionmentioning

confidence: 99%

Quality of Life in Adult Patients Receiving Cervical Fusion for Fresh Subaxial Cervical Injury: The Role of Associated Spinal Cord Injury

Korovessis

Mpountogianni

Syrimpeis

et al. 2021

BioMed Research International

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Purpose. To study postoperative Health-Related Quality of Life (HRQOL) after instrumented fusion for fresh subaxial cervical trauma and the effect of spinal cord injury (SCI). Methods. From a total of 65 patients, 17 (26%) patients suffered on admission from SCI. Twenty-five patients underwent anterior, 25 posterior, and 15 circumferential cervical surgery for a single cervical injury. Sagittal roentgenographic parameters were measured in 65 age-matched asymptomatic controls and in patients on admission, eight months postoperatively and at final follow-up (lower C2-C7 curvature, cervical sagittal vertical axis (cSVA), spinocranial angle (SCA), T1-slope, neck tilt (NT), thorax inlet angle (TIA), cervical tilt (CT), cranial tilt (CrT), and occiput–C2 angle (C0-C2)). In the last evaluation, SCI patients were compared with their counterparts without SCI using national validated HRQOL instruments (SF-36 and neck disability index (NDI)). Results. Fusion included an average of 3 vertebrae (range 2-4 vertebrae). All 65 patients were followed for an average of 5.5 years, (range 3-7 years) postoperatively. In the last evaluation, 10 (15.4%) patients with incomplete SCI improved postoperatively at 1-2 grades. At the last observation, patients with SCI showed poorer HRQOL scores than their counterparts without SCI. In particular, each SF-36 domain score was correlated with SCA, T1-slope, cSVA, and CT. At baseline, patients showed higher NT, CrT, and C0-C2 angle than controls. Eight months postoperatively, cSVA, NT, TIA, and cranial tilt (CrT) were increased in patients. In the last observation, there was difference in the sagittal roentgenographic parameters between patients with SCI compared to those without SCI. Patients aged ≥55 years had postoperatively increased cSVA, NT, and CrT compared to their younger counterparts. Conclusion. At the final observation, HRQOL scores were lower in patients with SCI than in their non-SCI counterparts, obviously because of the associated neurologic impairment. SF-36 scores correlated with several sagittal roentgenographic parameters. These correlations should be taken in consideration by spine surgeons when performing cervical spine surgery for fresh cervical spine injuries.

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Section: Discussionmentioning

confidence: 99%

Quality of Life in Adult Patients Receiving Cervical Fusion for Fresh Subaxial Cervical Injury: The Role of Associated Spinal Cord Injury

Korovessis

Mpountogianni

Syrimpeis

et al. 2021

BioMed Research International

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“…Data were processed using Kubios HRV(TM) version 2.1. The parameters analyzed were the sympathetic nervous system index (SNS) and parasympathetic nervous system index (PNS) were analyzed [16,17].…”

Section: Data Collection and Descriptionmentioning

confidence: 99%

The Use of Orthostatic Device for 90 Minutes Does Not Change Cardiovascular and Biomechanical Parameters of Patients with Spinal Cord Injury

Oliveira¹,

Silva

Leopoldino³

et al. 2022

Applied Bionics and Biomechanics

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Background. Changes in autonomic function are often caused by spinal cord injuries, which lead to limited orthostatic positioning in these patients. Objective. To investigate the cardiovascular and biomechanical parameters during 90 min of postural elevation equipment usage comparing spinal cord injury and healthy subjects. Methods. A device was used that allowed patients with spinal cord injuries to remain in an orthostatic posture for 90 min. During this period, the physiological parameters were measured every 15 min. Cardiovascular parameters (heart rate, oxygen saturation, blood pressure, and autonomic nervous system) and biomechanical parameters of the plantar pressure distribution were evaluated. For blood pressure, heart rate, oxygen saturation, and autonomic nervous system, a two-way analysis of variance was applied. The mixed-effect model was applied to plantar pressure. The significance level was set at p < 0:05 for all statistical analyses. Results. No differences were observed between the groups in systolic blood pressure (F = 0:07), diastolic blood pressure (F = 0:14), heart rate (F = 0:56), and oxygen saturation (F = 0:23) at any of the time intervals throughout the experiment (p > 0:05). No statistical difference was observed in the mean plantar pressure values between the groups (p = 0:35) during the period in which they remained in the orthostatic position. Conclusion. The present study showed the absence of differences between spinal cord injury patients and control participants using the orthostatic device in terms of cardiovascular and biomechanical parameters over 90 min.

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Function Preservation or Oncological Appropriateness in Spinal Bone Tumors?

Girolami¹,

Boriani

Ghermandi³

et al. 2019

Spine

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Study Design. Retrospective review of prospectively collected data. Objective. To evaluate (1) if the segmental resection of the content of the spinal canal could provide an Enneking appropriate tumor-free margin for local control of primary bone tumors surrounding and invading the canal and (2) the safety profile of the segmental resection of the neurostructures. Summary of Background Data. Treatment outcomes of primary malignant and benign aggressive bone tumors of the spine have been dramatically changed by the application of the musculoskeletal oncologic principles described by Enneking. However, the efficacy of spinal oncology surgery might be limited by unique features of spinal anatomy. Methods. Database search was conducted with the following inclusion criteria: en bloc resection, segmental inclusion of the spinal canal content in the surgical specimen, histologically proven diagnosis, minimum follow-up of 2 years. Exclusion criteria were piecemeal excision of the tumor (debulking) and diagnosis other than primary bone tumors (metastasis, or local extension of extraosseous tumors). Results. A consecutive cohort of eight patients (three men, five women) was available for review. Two patients died within 3 months from the surgery for systemic disease progression or sequelae of the surgery. En bloc resection with segmental spinal canal content inclusion was able to achieve local control of the disease in four out of remaining six cases (66.7%) at an average follow-up of 68.7 months (range 12–174 mo). Three patients in whom local control was achieved are free from disease at an average follow-up of 98.7 months (range 38–174), and one died for systemic disease progression (after 38 mo). Seven out of 8 patients (87.5%) experienced overall 16 complications. Conclusion. En bloc resection including the spinal canal content (spinal amputation) to achieve a tumor-free margin might be considered to perform an Enneking appropriate treatment for motivated patients. Level of Evidence: 4

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Paraplegic patients: how to measure balance and what is normal or functional?

Cited by 3 publications

References 30 publications

Quality of Life in Adult Patients Receiving Cervical Fusion for Fresh Subaxial Cervical Injury: The Role of Associated Spinal Cord Injury

Quality of Life in Adult Patients Receiving Cervical Fusion for Fresh Subaxial Cervical Injury: The Role of Associated Spinal Cord Injury

The Use of Orthostatic Device for 90 Minutes Does Not Change Cardiovascular and Biomechanical Parameters of Patients with Spinal Cord Injury

Function Preservation or Oncological Appropriateness in Spinal Bone Tumors?

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