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- Gedde, M. H., et al.
(författare)
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Traumatic vs non-traumatic spinal cord injury: A comparison of primary rehabilitation outcomes and complications during hospitalization
- 2019
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Ingår i: Journal of Spinal Cord Medicine. - : Informa UK Limited. - 1079-0268 .- 2045-7723. ; 42:6, s. 695-701
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare outcome for patients with traumatic (TSCI) and non-traumatic spinal cord injuries (NTSCI) after primary rehabilitation regarding neurological improvement measured by the American Spinal Injury Association Impairment Scale (AIS), length of stay and complications. Design: Retrospective comparative cohort study on patients with TSCI and NTSCI, hospitalized during a ten-year period at Haukeland University Hospital, Norway. Impairment, length of stay and complications during first in-patient rehabilitation period were analyzed. Uni- and multivariate analysis was performed. Setting: Spinal Cord Rehabilitation Unit, Haukeland University Hospital, Norway Participants: A total of 174 persons with a spinal cord injury (SCI) were included; 102 with TSCI and 72 with NTSCI. Outcome measures: Neurological improvement measured by AIS from admission to discharge, number of weeks in the hospital, frequency and significance of complications were compared. Results: Improvement in AIS after primary rehabilitation did not differ between TSCI and NTSCI. Length of stay was in average 3.4 weeks longer for TSCI. Urinary tract infections and pressure ulcers significantly influenced length of stay in both groups. Urinary tract infections were more frequent in TSCI (67%) vs NTSCI (42%). Pressure ulcers were more frequent among NTSCI (24%) vs TSCI (14%). Pneumonia and neuropathic pain did not depend on etiology and did not influence length of stay. Conclusions: Patients with SCI have a rehabilitation potential regardless of etiology. Complications are frequent in both groups and often prolong hospitalization. Complication patterns differ in the two groups, and specific prevention and optimal treatment will shorten and optimize the length of primary rehabilitation. © 2019, © The Academy of Spinal Cord Injury Professionals, Inc. 2019.
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| 2. |
- Heary, Robert F., et al.
(författare)
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Cervical spondylotic myelopathy : A two decade experience
- 2019
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Ingår i: Journal of Spinal Cord Medicine (JSCM). - : Taylor & Francis. - 1079-0268 .- 2045-7723. ; 42:4, s. 407-415
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Forskningsöversikt (refereegranskat)abstract
- Context: Cervical myelopathy occurs as a result of compression of the cervical spinal cord. Symptomatology includes, but is not limited to, pain, weakness, paresthesias, or gait/balance difficulties. Objective: To present a two-decade experience with the management of cervical myelopathy. Methods: Literature was reviewed to provide current guidelines for management as well as accompanying clinical presentations. Results: Surgical decompression, if necessary, may be achieved from either an anterior, a posterior, or a combined anterior-posterior (AP) approach. The indications for each approach, as well as the surgical techniques, are described. Conclusion: Several etiologies may lead to cord compression and cervical myelopathy. The best vector of approach with regard to anterior versus posterior surgical intervention is still under investigation. Regardless, management via surgical decompression has been demonstrated repeatedly to improve the CSM patients' quality of life.
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| 3. |
- Norin, Lizette, et al.
(författare)
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Housing accessibility and its associations with participation among older adults living with long-standing spinal cord injury
- 2017
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Ingår i: Journal of Spinal Cord Medicine. - : Informa UK Limited. - 1079-0268 .- 2045-7723. ; 40:2, s. 230-240
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To describe the housing situation and aspects of participation among older adults living with long-standing spinal cord injury (SCI) with attention to SCI severity, and to examine whether and how objective housing accessibility (based on objectively measurable criteria) is associated with aspects of participation. Design: Cross-sectional study utilizing the assessment tools Impact on Participation and Autonomy (IPA) and Housing Enabler (HE). Adjusting for demographic, social and injury related data, associations between objective housing accessibility and aspects of participation were analyzed by means of ordinal regression models. Setting: Home and community settings. Participants: Older adults (≥ 50 years) (N = 123), with a traumatic or non-traumatic SCI for at least 10 years. To make comparisons within the sample, three groups of SCI severity were formed using the American Spinal Injury Association (ASIA) Impairment Scale. Results: Housing adaptations and environmental barriers were common and differed between SCI severity groups; those with AIS D injuries had fewer adaptations and more environmental barriers indoors. A majority of the participants in the total sample perceived their participation as good or very good in most of the IPA activities studied. Accessibility indoors was significantly associated with autonomy indoors (P = 0.009), family role (P = 0.002) and participation problems (P = 0.004); more accessibility problems were associated with less participation and more participation problems. Conclusion: This study indicates that optimizing the housing environment for older adults with SCI can potentially increase their participation and make them more autonomous. Further studies based on longitudinal data are needed to determine the causality of the associations identified.
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