Table 1 - uploaded by Filip M Vanhoenacker
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Traumatic myelopathy is a frequent complication after spinal trauma. The prognosis is often very poor, and the condition has important socioeconomic consequences. Knowledge of the epidemiology and imaging features is mandatory to ensure correct diagnosis and timely intervention. Imaging studies play an increasing role in the diagnosis and follow-up...
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Aim:
The aim was to correlate the clinical profile and neurological outcome with findings of imaging modalities in acute spinal cord injury (SCI) patients.
Subjects and methods:
Imaging (radiographs, computed tomography [CT], and magnetic resonance imaging [MRI]) features of 25 patients of acute SCI were analyzed prospectively and correlated wit...
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Citations
... Traumatic spinal cord injury (SCI) or traumatic myelopathy is a devastating neurological condition, imposing a significant burden on the healthcare system [1,2]. SCI leads to varying degrees of motor and sensory deficits, and in some cases, autonomic dysfunction [3,4]. The spectrum of spinal cord injuries ranges from subclinical injuries to complete transection [5][6][7], resulting in varying degrees of motor, sensory, and autonomic dysfunctions, including bowel, bladder, and sexual dysfunctions [6][7][8][9][10]. ...
Traumatic spinal cord injury (SCI) or traumatic myelopathy is a devastating neurological condition and a heavy burden on the health system. There are inflammatory and structural biomarkers with well-defined profiles, and useful for determining the management and prognosis of this pathology. Laboratory studies have shown some utility in confirming the existence of a spinal cord injury. Little knowledge about the molecular processes that occur after a SCI is evident, and it is well known that its understanding is dispensable to establish therapeutic targets that improve the outcomes for this type of patient. Many studies have explored the role of structural and inflammatory markers and some structural and inflammatory biomarkers. In the present article, we review the ongoing research in the field of spinal injury and possible role of biomarkers in the management of these patients.
... Because secondary injury appears to be responsive to pharmacological therapies, several studies have focused on modulating secondary damage pathways, including the use of antioxidant and anti-inflammatory medications [4] . Compression of the spinal cord causes neuroinflammation, which begins with damage to the blood-spinal-cord barrier, is followed by an immune response (expression of various cytokines, such as IL-1, IL-6, IL-12, IFN-γ, TNF-α), which causes reactive astrocyte cells (proliferation and scar formation), then activates Fas and caspase, resulting in apoptosis and necrosis of axons [5][6][7] . ...
Unlabelled:
Posttraumatic myelopathy is defined as a spinal cord injury (SCI) that results in varying degrees of motor and sensory deficits. The degree of 'secondary damage,' which is caused by a variety of cellular, molecular, and biochemical cascades is linked to the outcome of SCI. According to research, the beneficial effects of oleuropein and its derivatives have been linked to radical scavenging/antioxidant actions and anti-inflammatory effects.
Materials and methods:
This study was divided into six groups: control negative (sham-operated) group, control positive 1 and 2 (early chronic and chronic), treatment groups 1, 2, and 3 (prophylactic, concomitant, and late). Olive leaf extract (OLE) given dose was 350 mg/kg body weight. Blood was taken from the left corotic artery before the animals were terminated, seromarker assessment, enzyme-linked immunosorbent assay of IL-6, TNF-α, brain-derived neurotrophic factor (BDNF), and assessment of functional motoric outcome before the animal was terminated.
Results:
Chronic spinal cord compression increased serum levels of IL-6, TNF-α, and decreased serum level of BDNF. OLE 350 mg/kg body weight decreased serum levels of IL-6, TNF-α and increased functional motoric outcome, especially in prophylactic and concomitant therapy.
Discussion:
These findings indicate that OLE may be effective in protecting chronic SCI model.
Conclusion:
Oleuropein has a potential effect to reduce the IL-6 and TNF-α in rabbit model of SCI, and the BDNF value risen after the administration of Oleuropein.
... 35). Verletzungen ▪ Myelonschäden: Diese reichen von Kontusionen überQuetschungen bis hin zu partiellen oder vollständigen Disruptionen mit den assoziierten klinischen Querschnittsymptomen[62,63]. Radikuläre Symptome kommen ebenfalls vor und werden vor allem im Zusammenhang mit zervikalen Plexusschäden beobachtet. ...
Zusammenfassung
Die HWS ist – aufgrund ihrer hohen Mobilität – sowohl hinsichtlich ihrer knöchernen als auch ihrer diskoligamentären Integrität und Stabilität bei Akzelerations-/Dezelerationstraumen stärker gefährdet als andere Wirbelsäulenabschnitte. Dabei treten die meisten derartigen Verletzungen in der unteren HWS auf. Die konventionelle Projektionsradiografie kann weder diesen Abschnitt durchweg suffizient abbilden noch ist das HWS-Röntgen ausreichend sensitiv genug, zervikale Frakturen sicher zu erkennen. Die moderne Multislice-CT-Technik bietet sich hierzu als eine ausreichend sichere und sensitive Methode an, diesen diagnostischen Nachteil – insbesondere zur Beurteilung knöcherner Läsionen – zu überwinden. Der MRT wiederum kommt ein wachsender Stellenwert bei der Einschätzung diskoligamentärer Verletzungsmuster zu, und sie ist unverzichtbar zur Beurteilung intraspinaler Pathologien, insbesondere von traumatischen Myelonläsionen. Im Weiteren werden die für die HWS exklusiven Verletzungsmuster des kraniozervikalen Überganges einschließlich HWK II gesondert und ausführlich besprochen.
Multiple diverse pathologies result in the clinical presentation of myelopathy. The preferred way to image the spinal cord depends on clinical history, anatomic site of interest, and patient issues limiting certain imaging modalities. This radiology-focused article discusses pertinent physiological considerations, reviews basic and newer imaging techniques, and examines several distinct disease entities in order to highlight the key role of imaging in the work-up of myelopathy.
Background
The lumbar spine forms the lowermost part of the mobile spinal column. Due to anatomical properties, the lumbar spine is highly flexible in the sagittal directions, thus, rendering it susceptible to both flexion and extension forces with the thoracolumbar junction being the most vulnerable part of it. To date, the modern thoracolumbar spine fracture classification is given by the AOSpine classification system based on the well-known Magerl classification of vertebral fracture morphology but now includes both neurological criteria and clinical modifiers, such as ankylosing spondylitis.DiagnosticsWhereas plain radiography remains a mainstay in the diagnostic evaluation of low-energy trauma patients, computed tomography (CT) exhibits its unsurpassed power in polytrauma and plays a decisive role in all equivocal cases where the osseous situation is unclear. However, magnetic resonance imaging (MRI) is increasingly gaining importance for assessing both discoligamentous integrity and intraspinal condition. Both CT and MRI have direct input in classifying fractures according to the AOSpine classification.ResultsRegarding fracture morphology, three main types (A–C) based on the stability are distinguished. C‑type spinal injuries are all considered unstable, irrespective of type and severity of vertebral malalignment. Injuries to the anterior and posterior ligamentous complex are also considered to interfere with stability (B-type injuries).Conclusions
Special fracture patterns of the injured ankylosed and osteoporotic spine as well as of the pediatric lumbar spine are discussed. A survey is also given about several differential diagnoses (malignant fractures, anomalies, normal variants).
