Preliminary Findings After Nonoperative Management of Traumatic Cervical Spinal Cord Injury on a Background of Degenerative Disc Disease: Providing Optimum Patient Care and Costs Saving in a Nigerian Setting

Adedigba, Joseph A.; Oremakinde, Adetunji; Huang, Brendan; Maulucci, Christopher M.; Malomo, Adefolahan O.; Shokunbi, Temitayo; Adeolu, Augustine Abiodun

doi:10.1016/j.wneu.2020.07.035

Cited by 4 publications

(7 citation statements)

References 34 publications

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“…30 Frankel grades were used to measure spinal stability status, finding that over 85% of patients with both grade B and grade C Frankel grades had an improved grade upon discharge. 30 Furthermore, all patients demonstrated satisfactory spinal stability after conservative treatment with the hard cervical collar. 30 Given the improvements shown in patients with underlying degenerative disease with traumatic cervical SCI, nonoperative management should be considered as a viable option.…”

Section: Potential Benefits As a Cost-effective Alternativementioning

confidence: 99%

“…Cervical collars have the potential to provide adequate care in resource-limited settings, especially given their relative cost-effectiveness and accessibility. 30…”

Section: Potential Benefits As a Cost-effective Alternativementioning

confidence: 99%

“…immobilization. 30 Frankel grades were used to measure spinal stability status, finding that over 85% of patients with both grade B and grade C Frankel grades had an improved grade upon discharge. 30 Furthermore, all patients demonstrated satisfactory spinal stability after conservative treatment with the hard cervical collar.…”

Section: Potential Benefits As a Cost-effective Alternativementioning

confidence: 99%

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Cervical collar use in spinal cord injury management

Kolli,

Medina,

DeYoung

et al. 2024

Clinical and Translational Dis

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BackgroundThe use of cervical collars in the management of acute cervical spine injuries has been part of standard practice in the trauma setting for decades, aimed at preventing secondary injuries.ObjectivesTo review the recent evidence challenging the routine use of cervical collars, addressing the limited scientific support, associated risks, and guidelines for their use.MethodsA comprehensive literature review was conducted, analyzing recent studies and guidelines from authoritative bodies such as the American Association for Neurological Surgeons and the Congress of Neurological Surgeons. The review focused on the efficacy, risks, and recommendations regarding cervical collar use in acute cervical spine injuries.ResultsRecent evidence questions the routine use of cervical collars, highlighting limited scientific support and several associated risks, including pressure ulcers and decreased venous return. Cervical collars may also be contraindicated in individuals with abnormal spinal structures, such as those with Ankylosing Spondylitis. The efficacy of cervical collars is debated, particularly concerning undiagnosed spinal fractures, where delayed diagnosis can result in permanent injuries. Despite these risks, cervical collars may be beneficial in low‐resource areas and when used effectively with early clearance post‐injury. Current guidelines recommend immobilizing patients suspected of cervical spine injury but stress the importance of proper evaluation of the need for immobilization. Recent guidelines advocate for spinal motion restriction over traditional immobilization, emphasizing the need for better risk assessment and implementation strategies.Conclusions/Clinical ImportanceRe‐evaluating the routine use of cervical collars is crucial due to potential risks and limited supporting evidence, with a focus on individualized assessment and adherence to updated guidelines favoring spinal motion restriction.

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Section: Potential Benefits As a Cost-effective Alternativementioning

confidence: 99%

“…Cervical collars have the potential to provide adequate care in resource-limited settings, especially given their relative cost-effectiveness and accessibility. 30…”

Section: Potential Benefits As a Cost-effective Alternativementioning

confidence: 99%

Section: Potential Benefits As a Cost-effective Alternativementioning

confidence: 99%

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Cervical collar use in spinal cord injury management

Kolli,

Medina,

DeYoung

et al. 2024

Clinical and Translational Dis

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“…As stated above, dorsal displacement of the vertebral body fragments and herniated injured intervertebral disc, compress the anterior surface of the cord causing anterior spinal cord syndrome (Figure 1A,B), which represents around 1-3% of all traumatic SCI [34,35]. However, 50% has also been described [36]. Of the different spinal cord syndromes, anterior cord syndrome has the worst prognosis.…”

Section: Introductionmentioning

confidence: 95%

New Model of Ventral Spinal Cord Lesion Induced by Balloon Compression in Rats

et al. 2020

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Despite the variety of experimental models of spinal cord injury (SCI) currently used, the model of the ventral compression cord injury, which is commonly seen in humans, is very limited. Ventral balloon compression injury reflects the common anatomical mechanism of a human lesion and has the advantage of grading the injury severity by controlling the inflated volume of the balloon. In this study, ventral compression of the SCI was performed by the anterior epidural placement of the balloon of a 2F Fogarty’s catheter, via laminectomy, at the level of T10. The balloon was rapidly inflated with 10 or 15 μL of saline and rested in situ for 5 min. The severity of the lesion was assessed by behavioral and immunohistochemical tests. Compression with the volume of 15 μL resulted in severe motor and sensory deficits represented by the complete inability to move across a horizontal ladder, a final Basso, Beattie and Bresnahan (BBB) score of 7.4 and a decreased withdrawal time in the plantar test (11.6 s). Histology and immunohistochemistry revealed a significant loss of white and gray matter with a loss of motoneuron, and an increased size of astrogliosis. An inflation volume of 10 μL resulted in a mild transient deficit. There are no other balloon compression models of ventral spinal cord injury. This study provided and validated a novel, easily replicable model of the ventral compression SCI, introduced by an inflated balloon of Fogarty´s catheter. For a severe incomplete deficit, an inflated volume should be maintained at 15 μL.

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“…Studies have reported that if DVT is not treated in time, it can lead to patients with large-scale pulmonary embolism and the incidence rate is 20 %-30 % [7] . DVT treatment includes a lot of joint contents such as thrombolytic therapy, anticoagulation, Inferior Vena Cava (IVC) filter indwelling, mechanical thrombectomy, Traditional Chinese Medicine (TCM), acupoint compression and psychological intervention [8,9] . We should create individualized treatment plans in line with the patient's age, etiology, course of disease, thrombus classification etc., in clinic.…”

mentioning

confidence: 99%

The Clinical Efficacy of Maizhiling Combined with Low Molecular Weight Heparin in the Treatment of Deep Vein Thrombosis after Spinal Cord Injury

Ma¹,

Liu²,

Wang³

et al. 2021

IJPS

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This research aims to discuss the clinical efficacy of Maizhiling combined with low molecular weight heparin calcium in the treatment of deep vein thrombosis after spinal cord injury, in the meantime to discuss the effects of the drug combination on coagulation function, hemodynamics and clinical safety. We chose 40 patients with deep vein thrombosis after spinal cord injury in our hospital as the study cohort divided them into control group (n=20) and observation group (n=20) randomly. The control group received low molecular weight heparin calcium subcutaneous injections while the observation group received low molecular weight heparin calcium intravenous infusion of low molecular weight heparin calcium and oral Maizhiling. Then make a contrast of the affected limbs detumescence time, lower limb circumference, coagulation parameters, overall response rate, incidence of complications and adverse drug reactions after treatment between both groups. After treatment, the observation group's swelling time and the average difference of lower limb circumference were significantly reduced (p<0.01), prothrombin time, activated partial thromboplastin time and D-dimer both were significantly lower (p<0.01) and the clinical effective rate was higher (p<0.05). Both groups incidence of complications and adverse drug reactions have no significant difference (p>0.05). Low molecular weight heparin calcium combined with Maizhiling is effective on spinal cord injury deep vein thrombosis patients. The lower extremity swelling time is significantly shortened, the blood coagulation function and blood viscosity are improved, and the adverse drug incidence and complications are not increased. The combined use is used to treat patients with deep vein thrombosis. It is worth widely using in clinical practice.

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Preliminary Findings After Nonoperative Management of Traumatic Cervical Spinal Cord Injury on a Background of Degenerative Disc Disease: Providing Optimum Patient Care and Costs Saving in a Nigerian Setting

Cited by 4 publications

References 34 publications

Cervical collar use in spinal cord injury management

Cervical collar use in spinal cord injury management

New Model of Ventral Spinal Cord Lesion Induced by Balloon Compression in Rats

The Clinical Efficacy of Maizhiling Combined with Low Molecular Weight Heparin in the Treatment of Deep Vein Thrombosis after Spinal Cord Injury

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