We present a case of lumbosacral fracture-dislocation, which was spontaneously reduced during radiological examination. Such rapid reduction is, however, not reliable for long-term stability. We would like to report this case briefly because spontaneous reduction of lumbosacral fracture-dislocation has not been reported previously.
Adult ; Dislocations/*physiopathology/surgery ; Humans ; Lumbar Vertebrae/*injuries ; Male ; Sacrum/*injuries ; Spinal Fractures/*physiopathology/surgery

OBJECTIVETo study the relationship between muscle motor evoked potentials (MEP) and hindlimbs motor function in rabbits with spinal cord injury.

METHODSForty-five rabbits were randomly divided into 9 groups, including one control group and 8 injured groups (receiving Allen's injury of 0, 50, 75, 100, 125, 150, 175, 200, or 250 gcf). Hindlimb strength and muscle MEP were recorded at the 1st day and 4th week postoperatively. At 4 weeks after spinal section, the spinal cord tissue was sampled for histological examination with HE staining and immunohistochemistry with anti-NF antibody of the corticospinal tract fibers.

RESULTSDuring the operation, MEP showed an all-or-none pattern with significant correlations to postoperative optical density of NF and postoperative hindlimb motor function. The latency prolongation of the muscle MEP at the 4th week showed a linear correlation to the hindlimb Tarlov's score, whereas the MEP amplitude was not correlated to postoperative hindlimb motor function.

CONCLUSIONSThe all-or-none pattern of muscle MEP can be used to evaluate the severity of spinal cord injury.

Animals ; Evoked Potentials, Motor ; Hindlimb ; physiopathology ; Pyramidal Tracts ; physiopathology ; Rabbits ; Spinal Cord Injuries ; physiopathology

OBJECTIVETo investigate the anorectal status in patients with lumbosacral spinal cord injury (SCI).

METHODSTwenty six patients (23 males, 3 females) with lumbosacral SCI and 13 normal volunteers were enrolled into this study as controls. The median age was 43.7 years (ranging 17-68 years) and the median time of patients since injury was 59.1 months (ranging 8 months-15 years). They were diagnosed as complete lumbosacral SCI (n =2, American Spinal Injury Association (ASIA) score A), or incomplete lumbosacral SCI (n=24, ASIA score B-D) with mixed symptoms of constipation and/or fecal incontinence, and were studied by anorectal manometry. None of the patients had any medical treatments for neurogenic bowel prior to this study.

RESULTSThe maximum anal resting pressure in lumbosacral SCI patients group was slightly lower than that in control group (One-way ANOVA: P=0.939). During defecatory maneuvers, 23 of 26 (88.5%) patients with lumbosacral SCI and 1 of 13 (7.7%) in the control group showed pelvic floor dysfunction (PFD) (Fisher's exact test: P<0.0001). Rectoanal inhibitory reflex (RAIR) was identified in both patients with lumbosacral SCI and the controls. The rectal volume for sustained relaxation of the anal sphincter tone in lumbosacral SCI patients group was significantly higher than that in the control group (Independent-Samples t test: P<0.0001). The mean rectal volume to generate the first sensation was 92.7 ml+/-57.1 ml in SCI patients, 41.5 ml+/-13.4 ml in the control group (Independent-Samples t test: P<0.0001).

CONCLUSIONSMost of the patients with lumbosacral SCI show PFD during defecatory maneuvers and their rectal sensation functions are severely damaged. Some patients exhibit abnormal cough reflex. Anorectal manometry may be helpful to find the unidentified supraconal lesions. RAIR may be modulated by central nervous system (CNS).

Adolescent ; Anal Canal ; physiopathology ; Constipation ; etiology ; physiopathology ; Fecal Incontinence ; etiology ; physiopathology ; Female ; Humans ; Lumbar Vertebrae ; injuries ; Male ; Rectum ; physiopathology ; Sacrum ; injuries ; Sensation ; Spinal Cord Injuries ; complications ; physiopathology

Spinal cord injury (SCI) commonly affects males in their reproductive years. After spinal cord injury, most men experience fertility related problems including erectile and ejaculatory dysfunction, impaired spermatogenesis, abnormal sperm viability, motility, and morphology, genitourinary infection and endocrine abnormalities. In this article we will review the pathophysiology, evaluation and management of infertility in spinal cord injury. The impact of spinal cord injury on seminal plasma and the contribution of seminal oxidative stress to the poor sperm quality of men with spinal cord injury will be presented. Success with sperm retrieval techniques and assisted reproductive technology in SCI men with spinal cord injury will be discussed.
Ejaculation ; Humans ; Infertility, Male ; etiology ; Male ; Reproductive Techniques ; Semen ; Spinal Cord Injuries ; complications ; physiopathology ; Testis ; physiopathology

AIMTo explore an accurate neurophysiological technique that demonstrates small functional differences after spinal cord injury and assesses therapeutic interventions.

METHODSA modified weight drop (WD) technique was used at T8 in rats to build graded spinal cord injury model. Rubrospinal MEPs were recorded at T13 epidurally to monitor spinal cord function in end week 4 after graded spinal cord injury. The efficacy of this techniques to monitor spinal cord function was compared to BBB locomotor rating scale and histologic evaluation.

RESULTSA characteristic peak complex of rubrospinal MEPs in sham-operated group consisted of 5-7 positive waves and 4-5 negative waves emerging after red nucleus stimulation. The summed peak to peak amplitude (for practical reasons, called peak amplitude) was (195.25 +/- 34.35) microV and decreased following spinal cord injury. The latency of the first peak (positive wave) was (1.57 +/- 0.15) ms and prolonged following spinal cord injury. Significant Linear relationship existed between the peak amplitude and the BBB scores (r = 0.79) and between the peak amplitude and the residual matter obtained from the section with maximum tissue damage( r = 0.87). The close relationship between the latency of the first peak and the BBB scores (r = -0.88) and between the latency of the first peak and residual matter (r = -0.86) were observed.

CONCLUSIONAmplitudes and latencies of rubrospinal MEPs are very valuable parameters to demonstrate small function differences. Rubrospinal MEPs can be used as a reliable measure for motor function prognosis after spinal cord injury.

Animals ; Evoked Potentials, Motor ; Male ; Rats ; Rats, Wistar ; Red Nucleus ; physiopathology ; Spinal Cord Injuries ; pathology ; physiopathology

OBJECTIVETo investigate the damage characteristics and biomechanical mechanisms of the thoracolumbar vertebral bursh fracture during the impact loading.

METHODSFrom September 2008 to October 2009, 10 fresh human thoracolumbar spine specimens were collected for experimental model and divided into two groups. Biomechanical static and dynamic impact strength test were performed respectively in two groups. The static and dynamic data from thoracolumbar vertebrae shock response in different loads were observated.

RESULTSThoracolumbar yield load was (5 280.00 +/- 354.2) N, yield displacement was (13.32 +/- 2.07) mm, the limit load was(6 590.00 +/- 249.20) N, ultimate displacement was (20.60 +/- 2.57) mm, load speed was 0.02 g, and the average limit load of dynamic mechanical properties of thoracic and lumbar vertebrae was (14 425.60 +/- 1101.52) N, the average reaction time load was (17.29 +/- 2.04) ms, the average of acceleration was (36.80 +/- 2.81) g, the dynamic displacement was (45.11 +/- 1.13) mm.

CONCLUSIONThoracolumbar vertebral burst fracture is a serious injury caused by the release of high-energy moment, the role of biomechanical forces are in a pattern of pulse change, thoracic and lumbar vertebrae present with the viscoelastic properties of biological materials.

Biomechanical Phenomena ; Cadaver ; Humans ; Lumbar Vertebrae ; injuries ; Spinal Fractures ; metabolism ; physiopathology ; Stress, Mechanical ; Thoracic Vertebrae ; injuries

Traumatic injury or inflammatory irritation of the peripheral nervous system often leads to persistent pathophysiological pain states. It has been well-documented that, after peripheral nerve injury or inflammation, functional and anatomical alterations sweep over the entire peripheral nervous system including the peripheral nerve endings, the injured or inflamed afferent fibers, the dorsal root ganglion (DRG), and the central afferent terminals in the spinal cord. Among all the changes, ectopic discharge or spontaneous activity of primary sensory neurons is of great clinical interest, as such discharges doubtless contribute to the development of pathological pain states such as neuropathic pain. Two key sources of abnormal spontaneous activity have been identified following peripheral nerve injury: the injured afferent fibers (neuroma) leading to the DRG, and the DRG somata. The purpose of this review is to provide a global account of the abnormal spontaneous activity in various animal models of pain. Particular attention is focused on the consequence of peripheral nerve injury and localized inflammation. Further, mechanisms involved in the generation of spontaneous activity are also reviewed; evidence of spontaneous activity in contributing to abnormal sympathetic sprouting in the axotomized DRG and to the initiation of neuropathic pain based on new findings from our research group are discussed. An improved understanding of the causes of spontaneous activity and the origins of neuropathic pain should facilitate the development of novel strategies for effective treatment of pathological pain.
Animals ; Axotomy ; Ganglia, Spinal ; cytology ; Humans ; Neuralgia ; physiopathology ; Neurons, Afferent ; cytology ; Peripheral Nerve Injuries ; physiopathology ; Spinal Cord ; cytology

OBJECTIVETo observe the morphological characteristics of sacral fracture under different impact loads.

METHODTen fresh pelvic specimens were loaded in dynamic or static state. A series of mechanical parameters including the pressure strain and velocity were recorded. Morphological characteristics were observed under scanning electron microscope.

RESULTSThe form of sacral fracture was related to the impact energy. Under low energy impact loads, ilium fracture, acetabulum fracture and crista iliaca fracture were found. Under high energy impact loads, three types of sacral fracture occurred according to the classification of Denis: sacral ala fracture, Type I fracture; sacral foramen cataclasm fracture, Type II fracture; central vertebral canal fracture, Type III fracture. Nerve injury of one or two sides was involved in all three types of sacral fracture. The fracture mechanism of sacrum between the dynamic impact and static compression was significantly different. When the impact energy was above 25 J, sacral foramen cataclasm fracture occurred, involving nerve root injury. When it was below 20 J, ilium and sacral fracture was most likely to occur. When it was 20 approximately 25 J, Type I fracture would occur. While in the static test, most of the fracture belonged to ilium or acetabulum fracture. The cross section of sacrum was crackly and the bone board of Haversian system was brittle, which could lead to separation of bone boards and malposition of a few of cross bone boards.

CONCLUSIONSIn dynamic state, sacrum fracture mostly belongs to Type I and Type II, and usually involves the nerve roots. Sacrum fracture is relevant to the microstructures, the distribution of the bone trabecula, the osseous lacuna and the Haversian system of sacrum. The fracture of ilium and acetabulum more frequently appears in static state, with slight wound of peripheral tissues.

Biomechanical Phenomena ; Humans ; Male ; Microscopy, Electron, Scanning ; Sacrum ; injuries ; pathology ; Spinal Fractures ; pathology ; physiopathology ; surgery ; Spinal Nerve Roots ; injuries

OBJECTIVETo establish an animal model of tractive spinal cord injury in rats in order to investigate its pathophysiological changes and clinical significance.

METHODST(12)-L(3) spines were tracted longitudinally with a special spinal retractor that was put on the proccessus transverses of T(12)-L(3) vertebrae of the rat after exposing T(13)-L(2) spinal cord via dual laminectomy. At the same tine, the spinal cord function was monitored by cortical somatosensory evoked potential (CSEP). Rats were randomly divided into four groups according to the amplitude of CSEP P(1)-N(1) wave, the amount of the decreasing P(1)-N(1) wave was 30% (the 30% group), 50% (the 50% group) and 70% (the 70% group), respectively. After traction, the changes of the neural behavioral function in rats were observed and the morphological structure of the spinal cord was analyzed quantitatively with image analysis system of computer.

RESULTSWith traction of spine, compared with the control group, the 30% group had no marked difference in combined behavioral score (CBS), neuron count, section area of neuron and Nissl body density, but the 50% and 70% groups had marked difference (P<0.01). Light microscope showed that the neuron volume was slightly small and the Nissl body was reduced lightly in the 30% group; the neuron space was enlarged and the neuron was degenerative, reductive, and dissolved, and the spinal cord structure was destroyed in the 50% and 70% groups.

CONCLUSIONSThe animal model of tractive spinal cord injury in rats is a reproducible, graded and clinic mimic. The model in this article provides a valuable assistance in further understanding etiopathology and screening effective measures of therapy and prophylaxis of the injury.

Animals ; Female ; Male ; Models, Animal ; Rats ; Rats, Sprague-Dawley ; Spinal Cord Injuries ; physiopathology ; Traction

OBJECTIVETo observe dynamic changes of intracellular calcium ([Ca(2+)]i) after spinal cord injury, and to study the relationship between the changes of [Ca(2+)]i and the functional damage of the spinal cord.

METHODSThe rats were subjected to a spinal cord contusion by using a modified Allen's method. The [Ca(2+)]i in the injured segment of the spinal cord was measured by the technique of La(3+) blockage and atomic absorption spectroscopy at 1, 4, 8, 24, 72, and 168 hours after injury. The motor function on the inclined plane was measured at the same time.

RESULTSThe spinal cord [Ca(2+)]i increased significantly (P<0.05 or P<0.01) aft er spinal cord injury. There was a significant correlation (P<0.05) between the changes of [Ca(2+)]i and the motor function.

CONCLUSIONS[Ca(2+)]i overload may play an important role in the pathogenesis of spinal cord injury.

Animals ; Calcium ; metabolism ; Linear Models ; Male ; Rats ; Rats, Wistar ; Spectrophotometry, Atomic ; Spinal Cord Injuries ; metabolism ; physiopathology