Updates in the Early Management of Acute Spinal Cord Injury

Lambrechts, Mark J.; Issa, Tariq Z.; Hilibrand, Alan S.

doi:10.5435/jaaos-d-23-00281

Cited by 2 publications

(1 citation statement)

References 55 publications

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“…Due to the incomplete understanding of its pathogenesis, the treatment options for SCI are limited. Currently, early methylprednisolone combined with surgical intervention is the main approach ( 4 ). As the primary injury caused by direct trauma is unavoidable, there is an urgent clinical need for an effective treatment specifically targeting secondary injury.…”

Section: Introductionmentioning

confidence: 99%

Research progress on the inhibition of oxidative stress by teriparatide in spinal cord injury

Ai,

Xiong,

Deng

et al. 2024

Front. Neurol.

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Spinal cord injury (SCI) is currently a highly disabling disease, which poses serious harm to patients and their families. Due to the fact that primary SCI is caused by direct external force, current research on SCI mainly focuses on the treatment and prevention of secondary SCI. Oxidative stress is one of the important pathogenic mechanisms of SCI, and intervention of oxidative stress may be a potential treatment option for SCI. Teriparatide is a drug that regulates bone metabolism, and recent studies have found that it has the ability to counteract oxidative stress and is closely related to SCI. This article summarizes the main pathological mechanisms of oxidative stress in SCI, as well as the relationship between them with teriparatide, and explores the therapeutic potential of teriparatide in SCI.

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Section: Introductionmentioning

confidence: 99%

Research progress on the inhibition of oxidative stress by teriparatide in spinal cord injury

Ai,

Xiong,

Deng

et al. 2024

Front. Neurol.

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The Impact of Socioeconomic Status on the Presence of Advance Care Planning Documents in Patients With Acute Cervical Spinal Cord Injury

Issa,

McCurdy,

Lee

et al. 2024

J Am Acad Orthop Surg

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Introduction: Patients presenting with spinal cord injury (SCI) often times have notable deficits or polytrauma and may require urgent decision making for early management. However, their presentation may affect decision-making ability. Although advance care planning (ACP) may help guide spine surgeons as to patient preferences, the rate at which they are available and disparities in ACP completion are still not understood. The objective of this study was to evaluate disparities in the completion of ACP among patients with acute SCI. Methods: All patients presenting with cervical SCI to the emergency department at an urban, tertiary level I trauma center from 2010 to 2021 were identified from a prospective database of all consults evaluated by the spine service. Each patient's medical record was reviewed to assess for the presence of ACP documents such as living will, power of attorney, or advance directive. Community-level socioeconomic status was assessed using the Distressed Communities Index. Bivariable and multivariable analyses were performed. Results: We identified 424 patients: 104 (24.5%) of whom had ACP. Patients with ACP were older (64.8 versus 56.5 years, P = 0.001), more likely White (78.8% versus 71.9%, P = 0.057), and present with ASIA Impairment Scale grade A SCI (21.2% versus 12.8%, P = 0.054), although the latter two did not reach statistical significance. On multivariable logistic regression, patients residing in at-risk communities were significantly less likely to have ACP documents compared with those in prosperous communities (odds ratio [OR]: 0.29, P = 0.03). Although patients living in distressed communities were less likely to complete ACP compared with those in prosperous communities (OR 0.50, P = 0.066), this did not meet statistical significance. Female patients were also less likely to have ACP (OR: 0.43, P = 0.005). Conclusion: Female patients and those from at-risk communities are markedly less likely to complete ACP. Attention to possible disparities during admission and ACP discussions may help ensure that patients of all backgrounds have treatment goals documented.

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Updates in the Early Management of Acute Spinal Cord Injury

Cited by 2 publications

References 55 publications

Research progress on the inhibition of oxidative stress by teriparatide in spinal cord injury

Research progress on the inhibition of oxidative stress by teriparatide in spinal cord injury

The Impact of Socioeconomic Status on the Presence of Advance Care Planning Documents in Patients With Acute Cervical Spinal Cord Injury

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