Background: Vertebral column injuries are severe and common injuries in sugical emergencies. In vertebral column injuries, thoracolumbar location damages commonly because of its anatomic features. Objective: To describe clinical, subclinical features, and results of treatment in patients with vertebral column injuries who operated by combined two incisions; To discuss operative indications for thoracolumbar Burst fracture injuries. Subjects and method: The prospective study was performed in patients with thoracolumbar vertebral column injuries who operated at Viet Duc, from January to December 2005. All patients were evaluated about clinical, subclinical features, operative indications and techniques, and results. Results: The time from the accident to the operation was 24-72 hours (54.8%), over 6 days (25.8%), 3-6 days (12.9%), and 6-24 hours (6.5%). 13 of 31 cases damaged in L2, and 12 cases damaged in L1. The average time of operation was 5 hours 43 minutes (ranged 4 hours to 8 hours 30 minutes). The average transfused blood amount was one unit (ranged from 0 to 4 units). For complete paralysis, most patients recovered fully. For thoracolumbar Burst fracture injuries with incomplete paralysis, it should operate by front incision. In Burst fracture injuries with clear-off vertebra, no paralysis; it also should operate by front incision. Conclusions: The operation with combined two incisions (front and behind) was safe and effective technique for thoracolumbar vertebral column fixation.
Spinal Injuries/ surgery ; pathology ; therapy ;

Since loss of oligodendrocytes and consequent demyelination of spared axons severely impair the functional recovery of injured spinal cord, it is reasonably expected that the reduction of oligodendroglial death and enhanced remyelination of demyelinated axons will have a therapeutic potential to treat spinal cord injury. Amelioration of axonal myelination in the injured spinal cord is valuable for recovery of the neural function of incompletely injured patients. Here, this article presents an overview about the pathophysiology and mechanism of axonal demyelination in spinal cord injury and discusses its therapeutic significance in the treatment of spinal cord injury. Moreover, it further introduces the recent strategies to improve the axonal myeliantion to facilitate functional recovery of spinal cord injury.
Animals ; Demyelinating Diseases ; therapy ; Humans ; Spinal Cord Injuries ; therapy

Subacute posttraumatic ascending myelopathy is a rare disorder, unrelated to syrinx formation or mechanical instability, which may gradually emerge within the first 1-2 weeks after a spinal cord injury and may lead to diagnostic and prognostic dilemmas. We present a case of 24-year-old female with unstable wedge compression fracture of L1 vertebrae with signal changes in the upper lumbar cord causing complete paraplegia below D9 with bladder and bowel involvement. In the subsequent week, she developed a delayed progressively increasing neurological deficit with cord signal abnormality on MRI extending cephalad from the injury site to the upper dorsal cord. The patient had no initial clinical improvement initially but showed a delayed recovery over months.
Adult ; Female ; Humans ; Spinal Cord Diseases ; etiology ; therapy ; Spinal Cord Injuries ; complications ; Spinal Fractures ; complications

Cervical Vertebrae ; injuries ; Humans ; Spinal Injuries ; diagnosis ; therapy ; Thoracic Vertebrae ; injuries

Humans ; Spinal Fractures ; classification ; diagnosis ; therapy ; Thoracic Vertebrae ; injuries ; surgery

OBJECTIVE: To compare the clinical effect on intestinal dysfunction of spinal cord injury (SCI) between the comprehensive therapy of moxibustion (moxibustion for opening the governor vessel and regulating the spirit) and rehabilitation training and the simple treatment with rehabilitation training. METHODS: A total of 60 patients with intestinal dysfunction of SCI were randomized into a comprehensive therapy group and a rehabilitation group, 30 cases in each one (3 cases were dropped out in each group). On the base of the routine western medicine treatment and rehabilitation training, the bowel training and rectal function training were provided, once a day in the rehabilitation group. In the comprehensive therapy group, on the base of the treatment as the rehabilitation group, the moxibustion was exerted at Yaoyangguan (GV 3), Mingmen (GV 4), Zhiyang (GV 9), Dazhui (GV 14) and Baihui (GV 20), etc, once a day, 30 min each time. In both groups, the treatment for 4 weeks was as one course and 3 courses of treatment were required. Separately, before treatment, after 4, 8 and 12 weeks of treatment, the scores of neurogenic bowel dysfunction (NBD) and World Health Organization quality of life scale (WHOQOL-BREF) were observed and the clinical effect was evaluated after 12 weeks of treatment. RESULTS: After treatment, the total effective rate was 88.9% (24/27) in the comprehensive therapy group, which was higher than 74.1% (20/27) in the rehabilitation group (<0.05). After 4, 8 and 12 weeks of treatment, NBD scores were all reduced obviously as compared with those before treatment in the two groups (all <0.01). After 8 and 12 weeks of treatment, NBD scores in the comprehensive therapy group were lower than the rehabilitation group (both <0.05). After 4, 8 and 12 weeks of treatment, the scores of all of the domains (psychology, physiology, social relations and environment) in WHOQOL-BREF were higher than those before treatment in the two groups (all <0.01). After 4 weeks of treatment, the scores in the psychology and physiology domains in the comprehensive therapy group were higher than the rehabilitation group (all <0.05). After 8 and 12 weeks of treatment, the scores of all of the domains in the comprehensive therapy group were higher than the rehabilitation group (all <0.05). CONCLUSION The comprehensive treatment of moxibustion and rehabilitation training achieves the better effect on intestinal dysfunction of SCI than the simple rehabilitation training and greatly improves the quality of life in SCI patients.
Acupuncture Points ; Humans ; Moxibustion ; Quality of Life ; Spinal Cord Injuries ; therapy

Spinal cord injury is a highly disabled neurological disease, and there is still a lack of effective treatments. Studies have proved that olfactory ensheathing cells are one of the ideal seed cells for promoting nerve regeneration after spinal cord injury. Olfactory ensheathing cells can promote axonal germination and elongation through secretion, interaction with astrocytes, regulation of inflammatory reaction, migration characteristics, myelination, anti-oxidation, lipid regulation and other channels. Thus olfactory ensheathing cells play the role of neuroprotection and nerve repair. In recent years, some studies have used bioengineering, tissue engineering, reprogramming and other technologies to enhance the efficacy of olfactoryensheathing cells from different aspects, thereby providing new therapeutic strategies for optimizing the cell therapy of spinal cord injury. This article will summarize the mechanism of olfactory ensheathing cells in repairing spinal cord injury, and review the progress of optimizing strategy of olfactory ensheathing cells in treating spinal cord injury recently, so as to provide new research ideas for the further developing the repair potential of olfactory ensheathing cells and optimize the cell therapy effect of spinal cord injury.
Cell Transplantation ; Humans ; Nerve Regeneration ; Spinal Cord Injuries/therapy*

China ; Disaster Medicine ; methods ; Earthquakes ; Humans ; Rescue Work ; Spinal Cord Injuries ; complications ; therapy ; Spinal Injuries ; complications ; therapy

Spinal cord injury (SCI) has been considered an incurable condition and it often causes devastating sequelae. In terms of the pathophysiology of SCI, reducing secondary damage is the key to its treatment. Various researches and clinical trials have been performed, and some of them showed promising results; however, there is still no gold standard treatment with sufficient evidence. Two therapeutic concepts for SCI are neuroprotective and neuroregenerative strategies. The neuroprotective strategy modulates the pathomechanism of SCI. The purpose of neuroprotective treatment is to minimize secondary damage following direct injury. The aim of neuroregenerative treatment is to enhance the endogenous regeneration process and to alter the intrinsic barrier. With advancement in biotechnology, cell therapy using cell transplantation is currently under investigation. This review discusses the pathophysiology of SCI and introduces the therapeutic candidates that have been developed so far.
Biotechnology ; Cell Transplantation ; Cell- and Tissue-Based Therapy ; Regeneration ; Spinal Cord Injuries* ; Spinal Cord* ; Transplants

"Subluxation" is the core of pathological conception of spinal injuries treated by spinal manipulation. The conception of "Subluxation" not only includes changes of joint anatomy,but also emphasizes on joint dysfunction which is caused by changes of the anatomical position. The name of "Subluxation" in manual medicine is the same as modern medicine,but the content is obviously different. Nonetheless, it would be confused and not reflect the characteristics of manual practices. So we can consider changing the name of "Subluxation" in manual medicine into "Yatuowei".
Animals ; Humans ; Manipulation, Spinal ; Models, Animal ; Spinal Injuries ; therapy ; Terminology as Topic