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Query: UMLS:C0599766 (functional recovery)
 13,441 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors describe a case of malformative kyphosis with paraplegia, treated by transthoracic antero-lateral decompression and anterior spinal fusion by posterior spinal fusion six weeks later. The result of the surgical treatment has been excellent with complete functional recovery. The spinal fusion seems to be the main element of the treatment, by contrast it is impossible to assess the role played by the antero-lateral decompression.
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PMID:[Kyphotic paraplegia treated by antero-lateral transthoracic decompression and double autograft]. 76 90

The efficacy of antifibrinolytic therapy with epsilon aminocaproic acid (EACA) in experimental spinal cord injury is assessed by use of a standardized trauma model at both nonparaplegic and paraplegic trauma doses. Evaluation of neurologic parameters, cortical evoked response and histopathology of the injured spinal cord demonstrated that within the contusion range studied, EACA has no significant therapeutic effect. The ability of the animal to walk was the most reliable criterion indicative of functional recovery, and was closely paralleled by return of the cortical evoked response. Spinal cord cavitation in excess of 60% uniformly resulted in paraplegia. The data from this experiment show no evidence of a significant secondary injury occurring after spinal cord trauma that is amenable to posttraumatic antifibrinolytic therapy.
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PMID:The effect of antifibrinolytic therapy in experimental spinal cord trauma. 83 5

Somatosensory cortical-evoked responses and clinical function were followed in cats for up to 4 weeks after spinal cord compression injury. Despite abolition of cortical responses for from 3 to 19 days after injury, good functional recovery occurred.
Paraplegia 1977 Aug
PMID:Somatosensory cortical-evoked responses after feline experimental spinal cord injury. 90 19

Four patients with a typical clinical picture of spinal extradural heamatoma of the conus area are presented. Initial symptoms were acute low back pains. The development of symmetrical paraparesis took place in a matter of hours, and spread to total paraplegia. The sensory level was as high as the groins and bladder and rectum paralysis developed early. All patients were over 63, mean age 67 years. Two patients had coagulation defects, one was on anticoagulants, and the other had a severe thrombocytosis. Two patients had used salicylates for rheumatic pains; in one of those patients there was a hemangioma on PAD . In 2 patients, the neuroradiological diagnosis was confirmed with rhizography (Figs. 1 and 2); in the third patient the rhizography was misleading but in her and in a fourth patient the oxygen-myelography was diagnostic, showing an extradural compression in the conus area. Haematomas were removed in all patients through an extensive decompressive laminectomy within 24 hours from the onset of the symptoms. Recovery was good in 2 cases, and fair in one patient who had a poor recovery of the bladder function. In on patient, both paraplegia and bladder paralysis were permanent after 3 years. The differential diagnosis by myelography between the cauda equina syndrome caused by typical disc compression from the one side and from vascular medullary syndromes and myelitis from the other side should be clear. For good functional recovery, early myelography and operative decompression are imperative.
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PMID:Acute paraplegia caused by a spontaneous extradural heamatoma of the conus medullaris area. 118 53

The effect of spinal cord compression identified with magnetic resonance imaging (MRI), on neurological prognosis, was retrospectively evaluated in 36 patients with acute spinal cord injury. Of the 21 patients without cord compression, 16 had potentially reversible injury (normal spinal cord or cord oedema), all having functional recovery. Of the 15 patients with cord compression, 3 had operative decompression. In the 12 patients who did not undergo surgery, the degree of recovery was directly related to the magnitude of spinal cord compression, only one of the patients with moderate or marked cord compression having useful motor function at follow up. In contrast, the 3 patients with surgical decompression had at least 2 grades of improvement, all having functional recovery. These findings raise the possibility that MRI may be used to identify a patient group who will benefit from surgical decompression. A numerical index is proposed to prospectively identify patients for surgical decompression, and further studies are underway to evaluate this.
Paraplegia 1992 Oct
PMID:Suggested MRI criteria for surgical decompression in acute spinal cord injury. Preliminary observations. 144 98

Reflex sympathetic dystrophy (RSD) has been reported in incomplete spinal cord injury patients, most often occurring unilaterally; however to our knowledge, bilateral RSD has not been reported in patients with a central cord syndrome. We report a case of bilateral RSD in a patient with incomplete cervical myelopathy and the clinical picture of central cord syndrome. Diagnosis of RSD was based upon clinical, roentgenographic and scintigraphic findings. Management of RSD included elevation of forearm and hands, gentle active and passive range of movements of all upper extremity joints and systemic corticosteroids. With treatment, pain subsided, the range of motion of the joints improved and the patient achieved good functional recovery.
Paraplegia 1990 Jan
PMID:Reflex sympathetic dystrophy in central cord syndrome: case report and review of the literature. 215 93

Vertebral haemangiomas are slowly growing benign tumours and are usually asymptomatic. They rarely cause symptoms and signs related to cord compression. Larger lesions create significant problems during surgery because of haemorrhage and vascular supply crucial to spinal cord function. In such severely symptomatic vertebral haemangiomas, radiation therapy has been tried and good results obtained, especially in terms of good functional recovery. We have treated 17 patients (including nine paraplegic patients) with radiotherapy (Co-60). Treatment was given by single posterior field, encompassing the involved area with a dose of 35-40 Gy in 3 to 4 weeks (five fractions per week). All patients with pain and tenderness were relieved completely (87.5%) or partially (12.5%). Similarly patients with numbness and paresis showed either complete (66.7%) or partial response (33.3%) from symptoms on follow-up. Out of nine paraplegic patients six (66.6%) had recovered completely, one (11.2%) partially and two (22.2%) had no response. The two patients who did not show any marked relief, had paraplegia of longer duration (more than 6 months). Our study indicates that severely symptomatic vertebral haemangioma can be successfully treated by radiation therapy and it can be chosen as first line of treatment with an optimum dose of 35-40 Gy in 3 to 4 weeks.
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PMID:Radiation therapy for symptomatic vertebral haemangioma. 226 5

The residual, reversible potentials of neurological-functional recovery in patients paralysed due to a cervical cord injury were periodically checked according to the various assessment methods from the initial period of 72 hours after injury to the final follow-up of 7 years. In our series, the data on the neurological changes were a little different from those reported in the literature. In the complete paralysis group, only 2 of the 30 patients showed slight functional recovery of less than 1 grade in the Frankel classification with descent of the cord lesion level. Twenty three patients showed descent of a half to one segment from the initial cord lesion level. The remaining 5 patients deteriorated because of ascent of a half to two segments from the initial cord lesion level. All patients with complete paralysis remained essentially unchanged. In the incomplete group, 58 of the 70 patients had significant recovery of more than 1 grade in the Frankel classification. The grade of neurological recovery was different in each patient. Patients with a central cord lesion showed remarkably better recovery of the cord function than those with other types of cord lesions. Nineteen of the 49 patients with a central cord lesion regained independent walking ability with or without aid. Neurological recovery in the incomplete paralysis group might be expected until approximately 6 months after injury. The early appearance of signs of recovery was an indication of better results. There was no difference in the neurological recovery between patients who had been realigned surgically and those who have been realigned non-surgically. Our neurological-functional assessment method reflecting the sectional and logitudinal cord level function and expressing more detailed information was demonstrated. Magnetic resonance imaging (MRI) was used to assess residual cord function. The area of abnormal signal intensity almost corresponded to the cord level diagnosed neurologically.
Paraplegia 1989 Jun
PMID:Periodical, neurological-functional assessment for cervical cord injury. 276 11

Transplants of central nervous system to adult spinal cords are considered as potential aids in regeneration of the spinal cord and/or recovery of function after injury. The organization and development of the implant are important issues in seeking the potential for a transplant and host to become functionally integrated. This study uses embryonic cerebral cortex transplanted into the spinal cord of adult rats (T6) and examined the development and organization of the transplant with an antibody to vasoactive intestinal polypeptide (VIP). The cell bodies of VIP neurons are in the implants at 30 days postimplantation, but few of the somata have processes. By 45 days postimplantation, VIP neurons in the implant have dendrites and axons and are clearly recognizable as cortical bipolar cells which are not normally present in the thoracic spinal cord. These data show that neurons in embryonic cerebral cortical implants into the spinal cord elaborate the appropriate biochemical and morphological constituents in spite of the ectopic location. However, the cell processes develop at a slower than normal pace. Morphological interaction between the host spinal cord and the implant can be demonstrated possibly as early as 45 days postimplantation and clearly at 6 months following the implant. Thus, further examination of cerebral cortical implants as a potential aid in alleviation of paraplegia subsequent to spinal cord injury is warranted.
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PMID:Vasoactive intestinal polypeptide neurons in fetal cortical homografts to adult rat spinal cord. 351 3

Fetal central nervous system homografts to adult spinal cord are considered a potential aid for recovery of function after paraplegia. This study utilizes somatostatin (SOM) immunohistochemistry to study the organization of an embryonic day 14 (E14) neocortical homograft into the spinal cord of an adult host over 6 postoperative months. Although the E14 homograft does not contain SOM-positive cells, SOM-reactive neurons are expressed by 30 days postimplantation and are still present in 6-month-old homografts. SOM-immunoreactive neurons are bitufted or multipolar and have dendrites that are confined to the graft. The homograft contains SOM-immunoreactive axons entering and/or exiting from lamina II in the host dorsal horn and SOM-positive homografted neurons send axons into the host ventral columns. These data show that the SOM peptide neocortical phenotype is preserved in homografts to spinal cord but there is anatomical host-homograft integration.
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PMID:Somatostatin-like neurons are expressed in fetal neocortical homografts in adult rat spinal cord. 352 88


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