Pediatric acute hyperextension spinal cord injury (SCI) named as PAHSCI by us, is a special type of thoracolumbar SCI without radiographic abnormality and highly related to back-bend in dance training, which has been increasingly reported. At present, it has become the leading cause of SCI in children, and brings a heavy social and economic burden. Both domestic and foreign academic institutions and dance education organizations lack a correct understanding of PAHSCI and relevant standards, specifications or guidelines. In order to provide standardized guidance, the expert team formulated this guideline based on the principles of science and practicability, starting from the diagnosis, differential diagnosis, etiology, admission evaluation, treatment, complications and prevention. This guideline puts forward 23 recommendations for 14 related issues.
Child ; Humans ; Spinal Cord Injuries/complications* ; Spinal Cord

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

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

Adult ; Hematoma, Epidural, Spinal ; etiology ; Humans ; Male ; Spinal Fractures ; complications ; surgery ; Thoracic Vertebrae ; injuries ; surgery

Autophagy ; Cervical Cord ; injuries ; Humans ; Magnetic Resonance Imaging ; Spinal Cord Injuries ; complications ; diagnosis ; pathology

Spondyloptosis in the clinic is rarely reported. We herein present a 47-year-old female, who suffered from a crush injury directly by a heavy cylindrical object from the lateral side. She was diagnosed to have traumatic L₃ spondyloptosis with multiple traumas. Staged surgical procedures were conducted and a three-year follow-up was obtained. Eventually, normal spinal alignment was restored, and neurological deficits were gradually improved. At three years follow-up, the motor strength scores and function of the sphincters were incompletely improved. Previously published reports on traumatic lumbar spondyloptosis were reviewed and several critical points for management of this severe type of spinal injury were proposed. First, thoracolumbar and lumbosacral junction were mostly predilection sites. Second, numerous patients involving traumatic lumbar spondyloptosis were achieved to American Spinal Injury Association grade A. Third, lumbar spondyloptosis was commonly coupling with cauda equina injury. Finally, the outcomes were still with poorly prognosis and recovery of patients was correlation to spondyloptosis severity. Based on this case report and literatures review, we highlighted that the spinal alignment restoration relying on staged operations and following rehabilitation hereof are both important once facing with multiple traumas. Furthermore, we suggested to perform routine CT angiography during lumbar spondyloptosis to justify whether there are large vessel compression or injury.
Female ; Humans ; Middle Aged ; Lumbar Vertebrae/injuries* ; Spondylolisthesis/surgery* ; Spinal Injuries ; Multiple Trauma/complications*

OBJECTIVETo evaluate the effects of cervical vertebrae degeneration on traumatic cervical cord injury.

METHODSFrom January 2009 to December 2010, 24 patients with cervical cord injury without obvious fractures and dislocations were treated with operation, and their data were retrospectively analyzed. Among them, 16 males and 8 females, aged from 46 to 70 years old with an average of 59.1 years. Patients were divided into light degeneration group (6 cases), moderate degeneration group (10 cases) and severe degeneration group (8 cases), according to the preoperative degenerative degree of cervical vertebrae. Preoperative neurological dysfunction and postoperative neurological recovery were compared according to the JOA scores of Japanese Orthopaedic Society; quality of life were evaluated according to SF-36 scale (36-item Short Form Health Survey, SF-36).

RESULTSAll patients were followed up from 4 to 16 months with an average of 12 months. The JOA score of light, moderate, severe degeneration group were 12.1 +/- 1.5, 10.3 +/- 1.8, 7.3 +/- 1.0, respectively; and were respectively increased to 16.3 +/- 1.0, 15.3 +/- 1.4, 13.0 +/- 2.3 at the 3 months after operation. Postoperative JOA score showed the improvement rate of mid-long-term neurological level was light degeneration group (89.8%) > moderate degeneration group (76.6%) > severe degeneration group (58.8%). The results of preoperative SF-36 scale showed light degeneration group > moderate degeneration group > severe degeneration group; there was significant difference in comparison of two groups (P < 0.05 ).

CONCLUSIONCervical degeneration is an important pathologic basis and risk factor in traumatic cervical cord injury, and the degenerative degree will directly influence the injury degree and prognosis of neurological function, the clinical relationship between them should be sufficiently paid attention to.

Aged ; Cervical Vertebrae ; injuries ; surgery ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Spinal Cord Injuries ; surgery ; Spinal Diseases ; complications

Adult ; Autonomic Dysreflexia ; therapy ; Cesarean Section ; Female ; Humans ; Pregnancy ; Pregnancy Complications ; therapy ; Spinal Cord Injuries ; complications

OBJECTIVETo analyze the reliability of magnetic resonance imaging (MRI) in detecting posterior ligament complex injury in thoracolumbar fractures.

METHODSNinety-five patients with thoracolumbar fracture were evaluated by palpation of the inter-spinal gap, plain radiography, and MRI before operation. In addition to conventional MRI sequences, a fat-suppressed T2-weighted sagittal sequence was performed. Surgery was performed by a posterior approach. During the operation, posterior ligament complex was examined.

RESULTSA wide inter-spinal gap was palpated in 41 patients and was found in 55 patients on plain radiography. According to MRI, injury to the supraspinal ligament was suspected in 85 patients, the inter-spinal ligament in 83 patients, and the ligamentum flavum in 26 patients. There were 82 supraspinal ligament injuries, 80 inter-spinal ligament injuries, and 20 ligamentum flavum injuries in operative findings. The relations between plain radiography and operative findings, between MRI interpretation and operative findings were statistically significant.

CONCLUSIONA fat-suppressed T2-weighted sagittal sequence of MRI is a highly sensitive, specific, and accurate method to detect posterior ligament complex injury and which is recommended for the accurate evaluation of posterior ligament complex injury in thoracolumbar fractures.

Adult ; Female ; Humans ; Joint Capsule ; injuries ; Ligaments, Articular ; injuries ; Lumbar Vertebrae ; injuries ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Soft Tissue Injuries ; diagnosis ; Spinal Fractures ; complications ; Thoracic Vertebrae ; injuries

The authors report a rare case of air gunshot wound to the thoracic spinal cord in Korea. A case of 17 year-old girl with a air-gunshot wound to the thoracic spine was presented with paraplegia. Radiologic studies revealed a bullet in the fifth thoracic spinal canal. The cerebrospinal fluid leaked through the entry point of the bullet was noted. After laminectomy and dural opening, a intramedullary hematoma with lodged bullet in the contused cord was found. They are removed successfully with any postoperative complications. The bullet was composed of lead. We report this case focusing on the pathophysiology and surgical treatment with review of literatures.
Adolescent ; Cerebrospinal Fluid ; Female ; Hematoma ; Humans ; Korea ; Laminectomy ; Paraplegia ; Postoperative Complications ; Spinal Canal ; Spinal Cord ; Spinal Cord Injuries ; Spine* ; Wounds and Injuries* ; Wounds, Gunshot