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Employment Among People With Spinal Cord Injury in 22 Countries Across the World: Results From the International Spinal Cord Injury Community Survey

Post MW, Reinhardt JD, Avellanet M, Escorpizo R, Engkasan JP, Schwegler U, et al.

Arch Phys Med Rehabil, 2020 12;101(12):2157-2166.
PMID: 32673653 DOI: 10.1016/j.apmr.2020.05.027

OBJECTIVES: To describe the employment situation of individuals with spinal cord injury (SCI) in 22 countries participating in the International Spinal Cord Injury community survey, to compare observed and predicted employment rates, to estimate gaps in employment rates among people with SCI compared with the general population, and to study differences in employment between men and women.
DESIGN: Cross-sectional survey.
SETTING: Community.
PARTICIPANTS: People of employable age (N=9875; 18-64 y) with traumatic or non-traumatic SCI (including cauda equina syndrome) who were at least 18 years of age at the time of the survey, living in the community, and able to respond to one of the available language versions of the questionnaire.
INTERVENTIONS: Not applicable MAIN OUTCOME MEASURES: The observed employment rate was defined as performing paid work for at least 1 hour a week, and predicted employment rate was adjusted for sample composition from mixed logistic regression analysis.
RESULTS: A total of 9875 participants were included (165-1174 per country). Considerable differences in sample composition were found. The observed worldwide employment rate was 38%. A wide variation was found across countries, ranging from 10.3% to 61.4%. Some countries showed substantially higher or lower employment rates than predicted based on the composition of their sample. Gaps between the observed employment rates among participants with SCI and the general population ranged from 14.8% to 54.8%. On average, employment rates were slightly higher among men compared with women, but with large variation across countries. Employment gaps, however, were smaller among women for most countries.
CONCLUSIONS: This first worldwide survey among people with SCI shows an average employment rate of 38%. Differences between observed and predicted employment rates across countries point at country-specific factors that warrant further investigation. Gaps with employment rates in the general population were considerable and call for actions for more inclusive labor market policies in most of the countries investigated.

Matched MeSH terms: Spinal Cord Injuries/epidemiology*
The International Spinal Cord Injury Survey: The Way Forward

Bickenbach J, Batistella L, Gutenbrunner C, Middleton J, Post MW, InSCI, et al.

Arch Phys Med Rehabil, 2020 12;101(12):2227-2232.
PMID: 32663478 DOI: 10.1016/j.apmr.2020.06.011

As a community survey of individuals living with spinal cord injury in 22 countries, representing all 6 of the World Health Organization regions, the International Spinal Cord Injury (InSCI) community survey is one of the few surveys that highlights not only basic medical issues, but also the impact of spinal cord injury (SCI) on the everyday lives of people. The InSCI survey is part of a much larger project known as the Learning Health System for SCI Initiative (LHS-SCI). The objective of this article is to highlight some of the ongoing and planned next steps at the national and international levels. The implementation phase of the LHS-SCI initiative, beginning with the publication of primary results and extending until 2023, will use the results of the InSCI survey as evidence for implementation of recommendations for improving the societal response to the needs of individuals with SCI at the national level. To illustrate the variety of implementation activities currently underway, we provide country examples from Australia, Morocco, Malaysia, and Germany to demonstrate the diversity of approaches to the implementation of InSCI data. The implementation phase of the LHS-SCI initiative promises to usher in a new era of SCI research that will be seamlessly linked to ongoing and effective implementation actions, at both international and national levels and across settings from clinical practice, health systems management, and national policy.

Matched MeSH terms: Spinal Cord Injuries/epidemiology*
Mechanomyography-based muscle fatigue detection during electrically elicited cycling in patients with spinal cord injury

Naeem J, Hamzaid NA, Islam MA, Azman AW, Bijak M

Med Biol Eng Comput, 2019 Jun;57(6):1199-1211.
PMID: 30687901 DOI: 10.1007/s11517-019-01949-4

Patients with spinal cord injury (SCI) benefit from muscle training with functional electrical stimulation (FES). For safety reasons and to optimize training outcome, the fatigue state of the target muscle must be monitored. Detection of muscle fatigue from mel frequency cepstral coefficient (MFCC) feature of mechanomyographic (MMG) signal using support vector machine (SVM) classifier is a promising new approach. Five individuals with SCI performed FES cycling exercises for 30 min. MMG signals were recorded on the quadriceps muscle group (rectus femoris (RF), vastus lateralis (VL), vastus medialis (VM)) and categorized into non-fatigued and fatigued muscle contractions for the first and last 10 min of the cycling session. For each subject, a total of 1800 contraction-related MMG signals were used to train the SVM classifier and another 300 signals were used for testing. The average classification accuracy (4-fold) of non-fatigued and fatigued state was 90.7% using MFCC feature, 74.5% using root mean square (RMS), and 88.8% with combined MFCC and RMS features. Inter-subject prediction accuracy suggested training and testing data to be based on a particular subject or large collection of subjects to improve fatigue prediction capacity. Graphical abstract ᅟ.

Matched MeSH terms: Spinal Cord Injuries/physiopathology*
In vitro evidence consistent with an interaction between wild-type and mutant SOD1 protein associated with canine degenerative myelopathy

Qi Y, Montague P, Loney C, Campbell C, Shafie INF, Anderson TJ, et al.

Eur J Neurosci, 2019 12;50(12):3896-3905.
PMID: 31336405 DOI: 10.1111/ejn.14526

Canine degenerative myelopathy (DM) is a progressive neurological disorder that may be considered to be a large animal model for specific forms of the fatal human disease, familial amyotrophic lateral sclerosis (fALS). DM is associated with a c118G>A mutation of the superoxide dismutase 1 (Sod1) gene, and a significant proportion of cases are inherited in an autosomal recessive manner in contrast to the largely, but not exclusively, dominant mode of inheritance in fALS. The consensus view is that these Sod1/SOD1 mutations result in a toxic gain of function but the mechanisms remain unclear. Here we used an in vitro neuroblastoma cell line transfection system to monitor wild-type and mutant forms of SOD1 fusion proteins containing either a Cherry or an enhanced green fluorescent protein (EGFP) tag. These fusion proteins retained SOD1 enzymatic activity on a native gel assay system. We demonstrate that SOD1 aggregate density is significantly higher in DM transfectants compared to wild-type. In addition, we show by co-immunoprecipitation and confocal microscopy, evidence for a potential interaction between wild-type and mutant forms of SOD1 in co-transfected cells. While in vitro studies have shown SOD1 heterodimer formation in fALS models, this is the first report for DM SOD1. Therefore, despite for the majority of cases there is a difference in the mode of inheritance between fALS and DM, a similar interaction between wild-type and mutant SOD1 forms can occur. Clarifying the role of SOD1 in DM may also be of benefit to understanding the role of SOD1 in fALS.

Matched MeSH terms: Spinal Cord Diseases/genetics
Malaysian adaptation of the physical activity scale for individuals with physical disabilities in individuals with spinal cord injury

Mat Rosly M, Halaki M, Mat Rosly H, Davis GM, Hasnan N, Husain R

Disabil Rehabil, 2020 07;42(14):2067-2075.
PMID: 30686132 DOI: 10.1080/09638288.2018.1544294

Purpose: The Physical Activity Scale for Individuals with Physical Disabilities questionnaire provides an assessment of physical activity after spinal cord injury. This study sought to adapt, with cultural competence, the English questionnaire and translate it into Bahasa Malaysia, including evaluation of content and face validity, internal consistency and test-retest reliability, and completion of a factor analysis in order to validate the Malaysian version.Materials and methods: A total of 250 participants completed the questionnaire that was distributed via email, postal mail, the internet, physically and by word of mouth. Sixty-eight respondents were re-contacted to complete the questionnaire again.Results: The adapted PASIPD demonstrated adequate internal consistency Cronbach's α = 0.68 and acceptable test-retest reliability, intraclass correlation = 0.87. Factor analysis extracted four main dimensions for physical activity; factor 1 (heavy housework, home repair, lawn work and gardening), factor 2 (sports and recreation), factor 3 (light housework and caring for another person) and factor 4 (leisure and occupational activities) that accounted for 64% of the physical activities' total variance.Conclusion: The Malaysian-adapted English and translated Bahasa Malaysia versions of the questionnaires intended to measure physical activity levels in individuals with spinal cord injury, demonstrated good to acceptable validity and reliability. However, some individual items revealed weak reliability measures. Further work is needed to validate the questionnaire's criterion validity against other physical activity measures.Implications for rehabilitationThe Malaysian adaptation of the Physical Activity Scale for Individuals with Physical Disabilities questionnaire provided preliminary support for its use since it has demonstrated adequate construct validity and reliability.The Malaysian adaptation of the Physical Activity Scale for Individuals with Physical Disabilities questionnaire can quantify the physical activity level of community-dwelling individuals with spinal cord injury, whilst deriving descriptive information on their physical activities.Deploying the Physical Activity Scale for Individuals with Physical Disabilities questionnaire to a spinal cord injury population in Malaysia may provide the first data on activities of daily living in an Asian developing country.

Matched MeSH terms: Spinal Cord Injuries/rehabilitation*
Localization of the spinal nucleus of accessory nerve in rat: a horseradish peroxidase study

Ullah M, Mansor O, Ismail ZI, Kapitonova MY, Sirajudeen KN

J Anat, 2007 Apr;210(4):428-38.
PMID: 17428204

The spinal nucleus of the accessory nerve (SNA) comprises the group of somata (perikarya) of motor neurons that supply the sternocleidomastoid and trapezius muscles. There are many conflicting views regarding the longitudinal extent and topography of the SNA, even in the same species, and these disagreements prompted the present investigation. Thirty Sprague-Dawley rats (15 males, 15 females) were used. The SNA was localized by retrograde axonal transport of horseradish peroxidase. Longitudinally, the SNA was found to be located in the caudal part (caudal 0.9-1.2 mm) of the medulla oblongata, the whole lengths of cervical spinal cord segments C1, C2, C3, C4, C5 and rostral fourth of C6. In the caudal part of the medulla oblongata, the SNA was represented by a group of perikarya of motor neurons lying immediately ventrolateral to the pyramidal fibres that were passing dorsolaterally after their decussation. In the spinal cord, the motor neuronal somata of the SNA were located in the dorsomedial and central columns at C1, in the dorsomedial, central and ventrolateral columns at C2 and in the ventrolateral column only at C3, C4, C5 and rostral quarter of C6. The perikarya of motor neurons supplying the sternocleidomastoid were located in the caudal part (caudal 0.9-1.2 mm) of the medulla oblongata ventrolateral to the pyramidal fibres that were passing dorsolaterally after their decussation. They were also located in the dorsomedial and central columns at C1, in the dorsomedial, central and ventrolateral columns at C2 and only in the ventrolateral column at the rostral three-quarters of C3. The perikarya of motor neurons supplying the trapezius muscle were located in the ventrolateral column only in the caudal three-quarters of C2, the whole lengths of C3, C4 and C5, and in the rostral quarter of C6.

Matched MeSH terms: Spinal Cord/cytology*
Pure spinal multiple sclerosis: A possible novel entity within the multiple sclerosis disease spectrum

Schee JP, Viswanathan S

Mult Scler, 2019 07;25(8):1189-1195.
PMID: 29771191 DOI: 10.1177/1352458518775912

We identified five female patients retrospectively with relapsing short-segment partial myelitis whose clinical and paraclinical features were suggestive of cord involvement of multiple sclerosis (MS)-type albeit not rigidly fulfilling the 2017 McDonald criteria. Notably, these patients had not developed any typical MS-like brain lesions despite repeated neuroimaging assessments over years. Comprehensive work-up for differential diagnoses of MS and other causes of transverse myelitis particularly neuromyelitis optica spectrum disorders had been consistently negative on longitudinal follow-up. Thus, we postulate a possible entity of pure spinal MS which may represent a novel forme fruste within the MS disease spectrum.

Matched MeSH terms: Spinal Cord/pathology*
Is neck massage safe? A rare case of tetraplegia and spinal shock after neck manipulation

Ling TH, Zakaria AF, Abdullah AT

J Orthop Surg (Hong Kong), 2017 01;25(1):2309499017690459.
PMID: 28228050 DOI: 10.1177/2309499017690459

Neck manipulation is associated with spinal cord injury. However, occurrence of such cases is infrequent. This article presents a 33-year-old gentleman who sustained acute tetraplegia after neck manipulation. The aim of this case report is to create awareness that vigorous neck manipulation could cause injury to the spinal cord.

Matched MeSH terms: Spinal Cord Injuries/etiology*
Neck stiffness in a post-irradiated nasopharyngeal carcinoma adult: An unusual diagnosis

Lorna Ting KN, Liew YT, Abu Bakar Z, Narayanan P

Auris Nasus Larynx, 2019 Jun;46(3):469-473.
PMID: 30049634 DOI: 10.1016/j.anl.2018.07.002

Nasopharyngeal carcinoma is a neoplasm commonly found in population of South East Asia. The mainstay of treatment is high dose irradiation. Complications from radiotherapy are not uncommon especially to those nearby structures such as vertebrae and spinal cord. A 57 year-old gentleman with nasopharyngeal carcinoma (NPC) who was treated with chemo-radiation (total of 35 fractions,70Gy) presented to us 6 months post therapy with bilateral nasal discharge and progressive neck stiffness. Nasoendoscopy showed inflamed nasophayngeal mucosa and Computed Tomography (CT) brain and cervical spine showed retropharyngeal and anterior epidural collection with extension into atlantoaxial bone and spinal cord compression. Histopathological specimen revealed features of chronic inflammations with multiple actinomycetes colonies. Our patient suffered severe neck stiffness and loss of sensations on both upper limbs. He was treated conservatively with Halo vest and intravenous antibiotics for 8 weeks and recovered fully. Irradiation in NPC is known to cause devastating complications to cervical spine such as osteoradionecrosis, osteomyelitis. It also renders tissues hypoxic and risk of getting rare infection like actinomycosis. This report can represent a great diagnostic and therapeutic challenge with differentials of tumor recurrence, osteoradionecrosis or osteomyelitis. Patients must be regularly followed up to look for possible cervical complications as a result from irradiation, to prevent devastating outcome or prognosis.

Matched MeSH terms: Spinal Cord Compression/etiology
The ability of lipopolysaccharide (LPS) of Pasteurella multocida B:2 to induce clinical and pathological lesions in the nervous system of buffalo calves following experimental inoculation

Marza AD, Jesse Abdullah FF, Ahmed IM, Teik Chung EL, Ibrahim HH, Zamri-Saad M, et al.

Microb Pathog, 2017 Mar;104:340-347.
PMID: 28126667 DOI: 10.1016/j.micpath.2017.01.031

Lipopolysaccharide (LPS) of P. multocida B:2, a causative agent of haemorrhagic septicaemia (HS) in cattle and buffaloes, is considered as the main virulence factor and contribute in the pathogenesis of the disease. Recent studies provided evidences about the involvement of the nervous system in pathogenesis of HS. However, the role of P. multocida B:2 immunogens, especially the LPS is still uncovered. Therefore, this study was designed to investigate the role of P. multocida B:2 LPS to induce pathological changes in the nervous system. Nine eight-month-old, clinically healthy buffalo calves were used and distributed into three groups. Calves of Group 1 and 2 were inoculated orally and intravenously with 10 ml of LPS broth extract represent 1 × 10(12) cfu/ml of P. multocida B:2, respectively, while calves of Group 3 were inoculated orally with 10 ml of phosphate buffer saline as a control. Significant differences were found in the mean scores for clinical signs, post mortem and histopathological changes especially in Group 2, which mainly affect different anatomic regions of the nervous system, mainly the brain. On the other hand, lower scores have been recorded for clinical signs, gross and histopathological changes in Group 1. These results provide for the first time strong evidence about the ability of P. multocida B:2 LPS to cross the blood brain barrier and induce pathological changes in the nervous system of the affected buffalo calves.

Matched MeSH terms: Spinal Cord/pathology
Neuroprotective potential of Spirulina platensis on lesioned spinal cord corticospinal tract under experimental conditions in rat models

Abdullahi D, Ahmad Annuar A, Sanusi J

Ultrastruct Pathol, 2019;43(6):273-289.
PMID: 31779507 DOI: 10.1080/01913123.2019.1695693

Spinal cord injury (SCI) results from penetrating or compressive traumatic injury to the spine in humans or by the surgical compression of the spinal cord in experimental animals. In this study, the neuroprotective potential of Spirulina platensis was investigated on ultrastructural and functional recovery of the spinal cord following surgical-induced injury. Twenty-four Sprague-Dawley rats were divided into three groups; sham group, control (trauma) group, and experimental (S. platensis) group (180 mg/kg) of eight rats each. For each group, the rats were then subdivided into two groups to allow measurement at two different timepoints (day 14 and 28) for the microscopic analysis. Rats in the control and experimental S. platensis groups were subjected to partial crush injury at the level of T12 with Inox number 2 modified forceps by compressing on the spinal cord for 30 s. Pairwise comparisons of ultrastructural grading mean scores difference between the control and experimental S. platensis groups reveals that there were significant differences on the axonal ultrastructure, myelin sheath and BBB Score on Day 28; these correlate with the functional locomotor recovery at this timepoint. The results suggest that supplementation with S. platensis induces functional recovery and effective preservation of the spinal cord ultrastructure after SCI. These findings will open new potential avenue for further research into the mechanism of S. platensis-mediated spinal cord repair.

Matched MeSH terms: Spinal Cord Injuries/pathology*
Torque and mechanomyogram relationships during electrically-evoked isometric quadriceps contractions in persons with spinal cord injury

Ibitoye MO, Hamzaid NA, Hasnan N, Abdul Wahab AK, Islam MA, Kean VS, et al.

Med Eng Phys, 2016 Aug;38(8):767-75.
PMID: 27289541 DOI: 10.1016/j.medengphy.2016.05.012

The interaction between muscle contractions and joint loading produces torques necessary for movements during activities of daily living. However, during neuromuscular electrical stimulation (NMES)-evoked contractions in persons with spinal cord injury (SCI), a simple and reliable proxy of torque at the muscle level has been minimally investigated. Thus, the purpose of this study was to investigate the relationships between muscle mechanomyographic (MMG) characteristics and NMES-evoked isometric quadriceps torques in persons with motor complete SCI. Six SCI participants with lesion levels below C4 [(mean (SD) age, 39.2 (7.9) year; stature, 1.71 (0.05) m; and body mass, 69.3 (12.9) kg)] performed randomly ordered NMES-evoked isometric leg muscle contractions at 30°, 60° and 90° knee flexion angles on an isokinetic dynamometer. MMG signals were detected by an accelerometer-based vibromyographic sensor placed over the belly of rectus femoris muscle. The relationship between MMG root mean square (MMG-RMS) and NMES-evoked torque revealed a very high association (R(2)=0.91 at 30°; R(2)=0.98 at 60°; and R(2)=0.97 at 90° knee angles; P<0.001). MMG peak-to-peak (MMG-PTP) and stimulation intensity were less well related (R(2)=0.63 at 30°; R(2)=0.67 at 60°; and R(2)=0.45 at 90° knee angles), although were still significantly associated (P≤0.006). Test-retest interclass correlation coefficients (ICC) for the dependent variables ranged from 0.82 to 0.97 for NMES-evoked torque, between 0.65 and 0.79 for MMG-RMS, and from 0.67 to 0.73 for MMG-PTP. Their standard error of measurements (SEM) ranged between 10.1% and 31.6% (of mean values) for torque, MMG-RMS and MMG-PTP. The MMG peak frequency (MMG-PF) of 30Hz approximated the stimulation frequency, indicating NMES-evoked motor unit firing rate. The results demonstrated knee angle differences in the MMG-RMS versus NMES-isometric torque relationship, but a similar torque related pattern for MMG-PF. These findings suggested that MMG was well associated with torque production, reliably tracking the motor unit recruitment pattern during NMES-evoked muscle contractions. The strong positive relationship between MMG signal and NMES-evoked torque production suggested that the MMG might be deployed as a direct proxy for muscle torque or fatigue measurement during leg exercise and functional movements in the SCI population.

Matched MeSH terms: Spinal Cord Injuries/physiopathology*
Fulltext Extract from the paralyzed spinal cord of rats enhances neural stem cell proliferation in the neonatal rat brain by upregulating the Notch1/Hes1 pathway

Zhou Q, Tian L, Jia X, Ling KH, Mohd Nor NH, Harun MH, et al.

Minerva Pediatr (Torino), 2023 Oct;75(5):780-783.
PMID: 37284814 DOI: 10.23736/S2724-5276.23.07322-6
Matched MeSH terms: Spinal Cord/metabolism
N-cadherin regulates beta-catenin signal and its misexpression perturbs commissural axon projection in the developing chicken spinal cord

Yang C, Li X, Wang C, Fu S, Li H, Guo Z, et al.

J Mol Histol, 2016 Dec;47(6):541-554.
PMID: 27650519

N-cadherin is a calcium-sensitive cell adhesion molecule that plays an important role in the formation of the neural circuit and the development of the nervous system. In the present study, we investigated the function of N-cadherin in cell-cell connection in vitro with HEK293T cells, and in commissural axon projections in the developing chicken spinal cord using in ovo electroporation. Cell-cell connections increased with N-cadherin overexpression in HEK293T cells, while cell contacts disappeared after co-transfection with an N-cadherin-shRNA plasmid. The knockdown of N-cadherin caused the accumulation of β-catenin in the nucleus, supporting the notion that N-cadherin regulates β-catenin signaling in vitro. Furthermore, N-cadherin misexpression perturbed commissural axon projections in the spinal cord. The overexpression of N-cadherin reduced the number of axons that projected alongside the contralateral margin of the floor plate, and formed intermediate longitudinal commissural axons. In contrast, the knockdown of N-cadherin perturbed commissural axon projections significantly, affecting the projections alongside the contralateral margin of the floor plate, but did not affect intermediate longitudinal commissural axons. Taken together, these findings suggest that N-cadherin regulates commissural axon projections in the developing chicken spinal cord.

Matched MeSH terms: Spinal Cord/metabolism*
A minimally invasive endoscopic transnasal approach to the craniovertebral junction in the paediatric population

Tan SH, Ganesan D, Prepageran N, Waran V

Eur Arch Otorhinolaryngol, 2014 Nov;271(11):3101-5.
PMID: 24986428 DOI: 10.1007/s00405-014-3149-5
Matched MeSH terms: Spinal Cord Compression/diagnosis; Spinal Cord Compression/surgery*
Fulltext The West Nile virus-like flavivirus Koutango is highly virulent in mice due to delayed viral clearance and the induction of a poor neutralizing antibody response

Prow NA, Setoh YX, Biron RM, Sester DP, Kim KS, Hobson-Peters J, et al.

J Virol, 2014 Sep 1;88(17):9947-62.
PMID: 24942584 DOI: 10.1128/JVI.01304-14

The mosquito-borne West Nile virus (WNV) is responsible for outbreaks of viral encephalitis in humans, horses, and birds, with particularly virulent strains causing recent outbreaks of disease in eastern Europe, the Middle East, North America, and Australia. Previous studies have phylogenetically separated WNV strains into two main genetic lineages (I and II) containing virulent strains associated with neurological disease. Several WNV-like strains clustering outside these lineages have been identified and form an additional five proposed lineages. However, little is known about whether these strains have the potential to induce disease. In a comparative analysis with the highly virulent lineage I American strain (WNVNY99), the low-pathogenicity lineage II strain (B956), a benign Australian strain, Kunjin (WNVKUN), the African WNV-like Koutango virus (WNVKOU), and a WNV-like isolate from Sarawak, Malaysia (WNVSarawak), were assessed for neuroinvasive properties in a murine model and for their replication kinetics in vitro. While WNVNY99 replicated to the highest levels in vitro, in vivo mouse challenge revealed that WNVKOU was more virulent, with a shorter time to onset of neurological disease and higher morbidity. Histological analysis of WNVKOU- and WNVNY99-infected brain and spinal cords demonstrated more prominent meningoencephalitis and the presence of viral antigen in WNVKOU-infected mice. Enhanced virulence of WNVKOU also was associated with poor viral clearance in the periphery (sera and spleen), a skewed innate immune response, and poor neutralizing antibody development. These data demonstrate, for the first time, potent neuroinvasive and neurovirulent properties of a WNV-like virus outside lineages I and II.

Matched MeSH terms: Spinal Cord/pathology; Spinal Cord/virology
Factors influencing bladder management in male patients with spinal cord injury: a qualitative study

Engkasan JP, Ng CJ, Low WY

Spinal Cord, 2014 Feb;52(2):157-62.
PMID: 24276416 DOI: 10.1038/sc.2013.145

STUDY DESIGN: Qualitative study using individual in-depth interviews.
OBJECTIVES: The objective of this study was to explore the factors influencing the choice of bladder management for male patients with spinal cord injury (SCI).
SETTING: Public hospitals in Malaysia.
METHODS: Semistructured (one-on-one) interviews of 17 patients with SCI; 7 were in-patients with a recent injury and 10 lived in the community. All had a neurogenic bladder and were on various methods of bladder drainage. Interviews were audio-recorded, transcribed verbatim and analyzed using thematic analyses.
RESULTS: The choice of bladder management was influenced by treatment attributes, patients' physical and psychological attributes, health practitioners' influences and social attributes. Participants were more likely to choose a treatment option that was perceived to be convenient to execute and helped maintain continence. The influence of potential treatment complications on decision making was more variable. Health professionals' and peers' opinions on treatment options had a significant influence on participants' decision. In addition, patients' choices depended on their physical ability to carry out the task, the level of family support received and the anticipated level of social activities. Psychological factors such as embarrassment with using urine bags, confidence in self-catheterization and satisfaction with the current method also influenced the choice of bladder management method.
CONCLUSION: The choice of bladder management in people with SCI is influenced by a variety of factors and must be individualized. Health professionals should consider these factors when supporting patients in making decisions about their treatment options.
Study design: Qualitative study using individual in-depth interviews.

Matched MeSH terms: Spinal Cord Injuries/complications*; Spinal Cord Injuries/psychology
Motorcycle-related spinal injury: crash characteristics

Zulkipli ZH, Abdul Rahmat AM, Mohd Faudzi SA, Paiman NF, Wong SV, Hassan A

Accid Anal Prev, 2012 Nov;49:237-44.
PMID: 23036400 DOI: 10.1016/j.aap.2011.12.011

This study presents an analysis of crash characteristics of motorcyclists who sustained spinal injuries in motorcycle crashes. The aim of the study is to identify the salient crash characteristics that would help explain spinal injury risks for motorcyclists. Data were retrospectively collected from police case reports that were archived at MIROS from year 2005 to 2007. The data were categorized into two subcategories; the first group was motorcycle crashes with spinal injury (case) and the second group was motorcycle crashes without spinal injury (control). A total of 363 motorcyclists with spinal injury and 873 motorcyclists without spinal injury were identified and analyzed. Descriptive analysis and multivariate analysis were performed in order to determine the odds of each characteristic in contributing to spinal injury. Single vehicle crash, collision with fixed objects and crash configuration were found to have significant influence on motorcyclists in sustaining spinal injury (p<0.05). Although relatively few than other impact configurations, the rear-end impacted motorcyclist shows the highest risk of spinal injury. Helmets have helped to reduce head injury but they did not seem to offer corresponding protection for the spine in the study. With a growing number of young motorcyclists, further efforts are needed to find effective measures to help reduce the crash incidents and severity of spinal injury. In sum, the study provides some insights on some vital crash characteristics associated with spinal injury that can be further investigated to determine the appropriate counter-measures and prevention strategies to reduce spinal injury.

Matched MeSH terms: Spinal Cord Injuries/etiology*; Spinal Cord Injuries/mortality
Earnings among people with spinal cord injury

Ramakrishnan K, Loh SY, Omar Z

Spinal Cord, 2011 Sep;49(9):986-9.
PMID: 21556013 DOI: 10.1038/sc.2011.47

Secondary analysis of cross-sectional data.

Matched MeSH terms: Spinal Cord Injuries/economics*; Spinal Cord Injuries/rehabilitation
Endoscopic, endonasal decompression of spinal stenosis with myelopathy secondary to cranio-vertebral tuberculosis: two cases

Puraviappan P, Tang IP, Yong DJ, Prepageran N, Carrau RL, Kassam AB

J Laryngol Otol, 2010 Jul;124(7):816-9.
PMID: 20003599 DOI: 10.1017/S0022215109992271

Tuberculosis can cause extensive osseo-ligamentous destruction at the cranio-vertebral junction, leading to atlanto-axial instability and compression of vital cervico-medullary centres. This may manifest as quadriparesis, bulbar dysfunction and respiratory insufficiency.

Matched MeSH terms: Spinal Cord Compression/etiology; Spinal Cord Compression/surgery*

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