• Journal of Trauma and Injury
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• v.32 no.2
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• pp.80-85
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• 2019

Purpose: To compare the time intervals to magnetic resonance imaging (MRI) and surgical treatment in patients having traumatic cervical spinal cord injury (SCI) with and without bony lesions. Methods: Retrospectively analyzed adult patients visited Kyungpook National University Hospital and underwent surgical treatment for cervical SCI within 24 hours. The patients who were suspected of having cervical SCI underwent plain radiography and computed tomography (CT) upon arrival. After the initial evaluation, we evaluated the MRI findings to determine surgical treatment. Waiting times for MRI and surgery were evaluated. Results: Thirty-four patients were included. Patients' mean age was 57 (range, 23-80) years. Patients with definite bony lesions were classified into group A, and 10 cases were identified (fracture-dislocation, seven; fracture alone, three). Patients without bony lesions were classified into group B, and 24 cases were identified (ossification of the posterior longitudinal ligament, 16; cervical spondylotic myelopathy, eight). Mean intervals between emergency room arrival and start of MRI were 93.60 (${\pm}60.08$) minutes in group A and 313.75 (${\pm}264.89$) minutes in group B, and the interval was significantly shorter in group A than in group B (p=0.01). The mean times to surgery were 248.4 (${\pm}76.03$) minutes in group A and 560.5 (${\pm}372.56$) minutes in group B, and the difference was statistically significant (p=0.001). The American Spinal Injury Association scale at the time of arrival showed that group A had a relatively severe neurologic deficit compared with group B (p=0.046). There was no statistical significance, but it seems to be good neurological recovery, if we start treatment sooner among patients treated within 24 hours (p=0.198). Conclusions: If fracture or dislocation is detected by CT, cervical SCI can be easily predicted resulting in MRI and surgical treatment being performed more rapidly. Additionally, fracture or dislocation tends to cause more severe neurological damage, so it is assumed that rapid diagnosis and treatment are possible.

• Journal of the Korea Convergence Society
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• v.11 no.6
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• pp.69-74
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• 2020

Prior to the development of guidelines for occupational therapy for spinal cord injury, this study explored the actual condition of occupational therapy applied to patients with spinal cord injury and the range of guidelines required by the clinic, thereby raising the necessity and establishing an evidence-based rehabilitation intervention service system. It is thought that it will be used for research in the same field. As a survey method, a total of 15 days of surveys were conducted from October 3 to 17, 2019, among 112 occupational therapists, focusing on the organizations currently employed by occupational therapists. As a result, there are 106 physical activity training (94.6%), daily life movement training (85.7%), education-counseling-information 44 (39.3%), and guardian education 39 (34.8). %). The research results confirmed the recognition and clinical needs of occupational therapy guidelines.

• The Journal of Internal Korean Medicine
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• v.41 no.2
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• pp.122-131
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• 2020

Background: This study aimed to determine the effects of complex Korean medicine treatments on a patient suffering from tetraplegia caused by spinal cord injury. Case Summary: A 64-year-old female patient diagnosed with tetraplegia was treated using acupuncture, electroacupuncture, pharmacopuncture, knee joint motion style treatment (MST), and herbal medicine. Clinical symptoms were measured using the numeric rating scale (NRS) and manual muscle test (MMT). After 67 days of treatment, the NRS score for lower back pain and knee pain decreased from 7 to 3. For the shoulder joint the MMT grade improved from 3+/4+(Rt./Lt.) to 4/5-; in the hip joint, it improved from 3-/3+ to 4/4+. No side effects were observed from the treatments used in this case report. Conclusion: The complex Korean Medicine treatments appeared to be effective in recovering muscle strength and reducing pain in patients with tetraplegia caused by spinal cord injury.

• Journal of Ginseng Research
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• v.46 no.1
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• pp.11-22
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• 2022

Spinal cord injury (SCI) is defined as damage to the spinal cord that temporarily or permanently changes its function. There is no definite treatment established for neurological complete injury patients. This study investigated the effect of ginseng extract and ginsenosides on neurological recovery and antioxidant efficacies in rat models following SCI and explore the appropriate dosage. Searches were done on PubMed, Embase, and Chinese databases, and animal studies matches the inclusion criteria were selected. Pair-wise meta-analysis and subgroup analysis were performed. Ten studies were included, and the overall methodological qualities were low quality. The result showed ginseng extract and ginsenosides significantly improve neurological function, through the Basso, Beattie, and Bresnahan (BBB) locomotor rating scale (pooled MD = 4.40; 95% CI = 3.92 to 4.88; p < 0.00001), significantly decrease malondialdehyde (MDA) (n = 290; pooled MD = -2.19; 95% CI = -3.16 to 1.22; p < 0.0001) and increase superoxide dismutase (SOD) levels (n = 290; pooled MD = 2.14; 95% CI = 1.45 to 2.83; p < 0.00001). Both low (<25 mg/kg) and high dosage (25 mg/kg) showed significant improvement in the motor function recovery in SCI rats. Collectively, this review suggests ginseng extract and ginsenosides has a protective effect on SCI, with good safety and a clear mechanism of action and may be suitable for future clinical trials and applications.

• Journal of Korean Physical Therapy Science
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• v.10 no.1
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• pp.47-57
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• 2003

The purpose of this study was to evaluate the problem on activities of daily living ; the problem which spinal cord injured patients have when they adapt in daily living ; Subjects were 113 members who used the hospital which is located in Kwangju-city from November 20, 2001 to May 20, 2002. The evaluation of the ADL was performed according to MBI and collected data were statistically analysed by SPSS PC for paired Chi-square test T-test, One way ANOVA and Duncan's post-hoc test. The result's were as follows; 1. Modified Barthel Index average mark was $63.77{\pm}33.60$ points and MBI score distribution according to characteristics of injury is as following. 1) A patient who had long duration of injury, small injury region, incomplete paralysis in paralysis degree, paraplegia in paralysis type got high MBI score as statistical and significantly(p<0.05). 2. Society adaptation state by characteristics of spinal cord injured is an following. 1) After lapse of time of disease, a patient who is injured for a long term present surrounding environmental problem, a patient who is injured for a short term shows psychological problem. In society activity, as lapse of time of disease is long, patient did many hobby activity and same private club, on the other hand as lapse of time of diseases is short, the others appeared high and significantly as statistical(p<0.01). 2) In society activity by injury region, cervical injury and thoracic injury did more hobby activity than lumbar injury and in lumbar injury same private club or religion life appeared higher than thoracic injury of cervical injury significantly as statistical(p<0.01). 3) In walk method by paralysis degree Complete paralysis had more wheelchair life than incomplete paralysis(p<0.01). 4) In serious problem by paralysis type psychological problem in quadriplegia and surrounding environmental problem in paraplegia appeared high and significantly as statistical(p<0.01). 3. In society adaptation state by MBI score difference between variables appeared but it wasn't significantly.

• Journal of Trauma and Injury
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• v.26 no.3
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• pp.151-156
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• 2013

Purpose: Traumatic cervical SCI is frequently accompanied by dural tear and the resulting cerebrospinal fluid (CSF) leak after surgery can be troublesome and delay rehabilitation with increasing morbidity. This study evaluated the incidence of intraoperative CSF leaks in patients with traumatic cervical spinal cord injury (SCI) who underwent anterior cervical surgery and described the reliable management of CSF leaks during the perioperative period. Methods: A retrospective study of medical records and radiological images was done on patients with CSF leaks after cervical spine trauma. Results: Seven patients(13.2%) were identified with CSF leaks during the intraoperative period. All patients were severely injured and showed structural abnormalities on the initial magnetic resonance image (MRI) of the cervical spine. Intraoperatively, no primary repair of dural tear was attempted because of a wide, rough defect size. Therefore, fibrin glue was applied to the operated site in all cases. Although a wound drainage was inserted, it was stopped within the first 24 hours after the operation. No lumbar drainage was performed. Postoperatively, the patients should kept their heads in an elevated position and early ambulation and rehabilitation were encouraged. None of the patients developed complications related to CSF leaks during admission. Conclusion: The incidence of CSF leaks after surgery for cervical spinal trauma is relatively higher than that of cervical spinal stenosis. Therefore, one should expect the possibility of a dural tear and have a simple and effective management protocol for CSF leaks in trauma cases established.

• International Neurourology Journal
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• v.22 no.4
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• pp.275-286
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• 2018

Purpose: OnabotulinumtoxinA (BoNT-A) is a promising therapy for treating neurogenic detrusor overactivity (NDO) in individuals with spinal cord injury (SCI). This systematic review and meta-analysis aimed to carry out an in-depth review and to make an objective estimation of the efficacy and safety of BoNT-A on NDO after SCI. Methods: The PubMed, Embase, and Cochrane databases were searched for all relevant articles published from 2001 to 2016 that referred to NDO, SCI, and BoNT-A or botulinum toxin A. All data were recorded in an Excel spreadsheet by 2 individual reviewers. Review Manager version 5.3 was used to carry out the meta-analysis. Results: This analysis included 17 studies involving 1,455 patients. Compared with placebo and baseline, BoNT-A was effective in increasing maximum cystometric capacity, volume at first involuntary detrusor contraction, cystometric bladder capacity (all P<0.00001), compliance (P=0.001), and the number of patients with complete dryness (P=0.0003), and decreasing detrusor pressure, the number of patients with no involuntary detrusor contractions, the maximum flow rate, the incidence of detrusor overactivity (all P<0.00001), and the number of urinary incontinence episodes (P=0.001). There were no statistically significant differences between doses of 200 U and 300 U or between injections into the detrusor and submucosa. There were no life-threatening adverse events. Conclusions: BoNT-A is effective and safe in treating NDO after SCI. There were no statistically significant differences between doses of 200 U and 300 U or between injecting into the detrusor and submucosa. However, more high-quality randomized controlled trials are still needed.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.6
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• pp.108-115
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• 2021

The purpose of this study was to investigate the therapeutic effect of fludrocortisone in patients suffering from cervical spinal cord injury (SCI) with orthostatic hypotension (OH). Twenty-six patients with cervical SCI diagnosed with OH through a head-up tilt test were randomly assigned, and they were given either conservative treatment or additional fludrocortisone treatment. Fludrocortisone was administered for 2 weeks, increasing from 0.1 mg to 0.2 mg week . Blood pressure (BP), heart rate (HR), and blood parameters were measured at the beginning and after 2 weeks. After 2 weeks of treatment, there was a significant increase in the baseline BP of the treatment groups (p<.05). When analyzing the drop ratio, there was a tendency for a lower orthostatic BP drop in the treatment groups. Mild adverse events were reported in 7.69% of the treatment groups. Fludrocortisone exhibited therapeutic effects such as preventing cardiovascular complications and continuing rehabilitation through increased baseline BP and reduced OH, and can therefore be considered as a treatment option for OH in patients with SCI.

• Journal of the Korean Physical Therapy Association
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• s.3
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• pp.27-37
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• 1981

The Sexual Function Study and Its Rehabilitation Of the Patients With Spinal Cord Injuries Park Ji Whan, R.P.T. Dept. of Rehabilitation Medicine, nanyang University Hospital The patient with complete spinal cord injuries cannot expect normal intercourse. In spite of these ultimate limitations. coitus is practied with gratification by about a third of paraplegic men. and probably a higher percentage of paraplegic women. Th-is is possible since a significant percentage of paraplegic men can have erections .In patients with upper motor neurone lesions at any spinal level, reflex erections can be produced by local stimulation , in. patients with lesions at higher levels, the probability of success is greater. The ability to have erections, psychic or reflex or both, usually appears within six months after injury .

• Physical Therapy Korea
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• v.17 no.1
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• pp.9-16
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• 2010

This study aimed to compare 2 protocols recommended to patients with chronic cervical cord injury: each protocol included breathing exercises (inhalation-oriented or exhalation-oriented) and facilitation maneuver for the accessory respiratory muscles. Seventeen patients with chronic cervical cord injury volunteered to participate in this study, and we randomized these patients into 2 groups: the inhalation-oriented breathing exercise group (IOBEG) and exhalation-oriented breathing exercise group (EOBEG), consisting of 8 and 9 patients, respectively. Patients in the IOBEG performed inspiratory exercises using intermittent positive pressure breathing devices, while those in the EOBEG performed expiratory exercises using incentive spirometry. All exercises were performed by the subjects twice a day for 4 weeks, with each session lasting an average of 20 min. The outcomes were assessed on the basis of the pre- and post-treatment values of vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and FEV1/FVC. In the IOBEG, no significant differences were observed between the pre- and post-treatment values of any of the measured variables (p>.05); however, in the EOBEG, significant improvement was noted in the VC, FVC, FEV1 measured (p<.05) after the treatment. In addition, the rates of change in the values of VC, FVC, and FEV1 differed significantly between the 2 groups (p<.05). These findings suggest that the EOBEs can enhance respiratory function and are clinically feasible in patients with chronic cervical cord injury. Further studies will be undertaken to evaluate the clinical application of these findings.