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Quantitative MRI analysis correlates with surgical outcome of cervical spinal cord injury without radiological evidence of trauma

Dear Spinal Cord reader,

In this summer issue of Spinal Cord we have 2 interesting reviews: Barros Filho et al. studied gunshot spinal cord injuries which causes in most a complete neurological deficit. Surgical treatment is associated with a higher complication rate than conservative treatment. Therefore, the surgeon must know the treatment limitations and recognize patients who would truly benefit from surgery.

Aberg Hakansson (Wellspect company) has written a review on re-use versus single-use catheters for intermittent catheterization. Both off-label re-use and re-use of catheters intended for multiple-use occur and is not legally supported. The actual literature would support the use of single-use hydrophilic catheters to reduce the risk of urethral trauma and UTI, but further research is needed.

Basic research studies: Wang et al. used sodium hyaluronate-ciliary neurotrophic factor (CNTF) gelatinous particles in rats to study an influence on the recovery. Their findings suggest a powerful functional recovery attributable partly to an increase in axonal regrowth as well as in replenishment of β-tubulin-III-positive neuron-like cells. Van Gorp et al. present two studies on translation of a rat thoracic contusion model. Decreased below-level withdrawal thresholds do not reflect pain-like hypersensitivity in rodent models of (thoracic contusion) SCI. A large body of previous preclinical SCI pain research needs reinterpretation. They actually found below-level thermal and mechanical hypoesthesia and also excluded a relation between withdrawal hyperreflexia and spasticity. Withdrawal hyperreflexia might still prove useful to model spasms or clonus. In a second study backward locomotion is a highly sensitive and quick test to discriminate between sham, mild, and moderate SCI, even after six weeks. Backward locomotion testing may improve the translational value of experimental results for the clinic.

Clinical investigations: Ahmed et al. evaluated the efficacy of body computed tomography (CT) in spinal cord injury (SCI) patients with sepsis, and found a specific radiological diagnosis in 14% and non-specific findings in 68%. Sun et al. present that Quantitative MRI analysis may provide reliable information for the prediction of the initial neurological status and surgical outcome of patients with SCI without radiological evidence of trauma.

Pharmacology: Halim et al. describe a significant incidence of deep venous trombosis (DVT) in Indian subjects with SCI but definitely less than what has been reported in western literature. Pharmacological prophylaxis (LMWH in this study) significantly decreased the incidence of DVT in subjects with ASCI.

Urology: Virseda et al. compare video urodynamics (VUD) with one voiding cycle ambulatory urodynamics monitoring (AUM). The differences between both methods discourages the use of AUM with just one voiding cycle in the evaluation of patients with SCI.

Physical activity: Kiuchi et al. examined the relationship between sensors attached on the upper limbs and energy expenditure (EE) at the time of wheelchair propulsion.Their findings suggest that combining the synthesized values of angular velocity and acceleration of the motion sensors on the upper limbs might reflect EE during a wheelchair driving activity on a treadmill.

Surgery: Yang et al. found rib suspension surgery partially restoring the thoracic breathing of the patients with high cervical SCI, thereby improving vital capacity, cough, and expectoration.

Quality of life: Kivisild et al. confirmed that functioning and physical role limitation are the most pronounced deficits in health related QoL. Compared with data from other countries, all scores for the RAND-36 scales are lower in Estonia. The HRQoL following TSCI is affected by severity of injury, depression, age and employment status.

Enjoy reading.

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Correspondence to J J Wyndaele.

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Wyndaele, J. Quantitative MRI analysis correlates with surgical outcome of cervical spinal cord injury without radiological evidence of trauma. Spinal Cord 52, 503 (2014). https://doi.org/10.1038/sc.2014.104

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