Generally, patients with severe burst fractures, instability, or neurological deficits require surgical treatment. In most cases, circumferential reconstruction is performed. Surgical methods for three-column reconstruction include anterior, lateral, and posterior approaches. In cases involving an anterior or lateral approach, collaboration with general or thoracic surgeons may be necessary because the adjacent anatomical structures are unfamiliar to spinal surgeons. Risks include vascular or lumbar plexus injuries and cage displacement, and in most cases, additional posterior fusion surgery is required. However, the posterior approach is the most common and anatomically familiar approach for surgeons performing spinal surgery. We present a case in which three-column reconstruction was performed using only the posterior approach to treat a patient with a severe lumbar burst fracture.
Purpose: The purpose of the study was to understand and explain the essences and structures of the experience of Korean women who have had a spinal cord injury. Methods: The data were collected in 2010 through individual in-depth interviews using open-ended questions. A total of 9 women with spinal cord injuries participated in the study. Each interview lasted about 2 hours. Verbatim transcripts were analyzed using phenomenological analysis. Results: Five theme clusters emerged from the analysis using Colaizzi's method: frozen mind with rigid body; shame due to restrictions of physical function and dependency; struggle to go back to the previous normal body; disabilities that are noticeable in everyday family life; rebirth by discarding the obsessions of the past. These theme clusters illustrate that although most participants faced very strange and unbearable situations in most aspects of life after the injury, they were empowered finally by finding their hope and by giving new meanings to the current existence. Conclusion: This study provides deep understanding of women with spinal cord injuries who are relatively alienated from society. Based on the results of the study, health professionals could develop effective nursing interventions to improve quality of life of these women.
Purpose: This study is a qualitative research on the adaptation of the spinal cord injury after fortuitous the accident. Methods: The subjects are fifteen spinal cord injuries. As a study method, this author employed Grounded theory, one of the qualitative research methods. For data analysis, the procedures of Grounded theory methodology was adopted, and then the data collection were collected for six months from March to September 2009. Concerning the frequence of interviewing, each participants went through individual interviewing twice at least and up to four times if necessary. Results: As a result of open coding, total thirty six concepts and twenty categories were drawn. To synthesize these categories, they came to choose 'Going into the new self-made spinal cord injury' as a nuclear category. Typological analysis based on the result of the paradigm model divided them into a reality-avoiding, passive coping, reality-maintaining, reality-overcoming, and self-fulfillment type. Conclusion: As a result of this study, family support to those with spinal cord disability is an important factor for their motive for rehabilitation and adjustment, spinal disabilities were accepted to mostly the disabilities in relations with colleagues. Thus it is necessary to give them a nursing intervention through disability group for successful adjustment to life with disability.
Kim, Hyuk Gun;Kim, Min Seo;Lim, Han Mil;Joeng, So;Shin, Uk Ju
Journal of Music and Human Behavior
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v.15
no.2
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pp.23-39
/
2018
The purpose of this research was to investigate the effects of respiratory rehabilitation using a wind instrument for patients suffering from spinal cord injuries. From January 15, 2018 to April 15, 2018, we conducted ten 1-hour sessions of a harmonica program with eight patients with spinal cord injuries with average age of 37 years who could not perform abdominal breathing by themselves. We measured and compared patients' breathing capacity before and after the 10 sessions. Designed particularly for patients with spinal cord injuries resulting in a limited range of neck movement, the study used a 10-hole diatonic harmonica whose length was relatively short. For those patients who had difficulty using their hands, a harmonica holder was provided. Participants were trained to play simple tunes. They were guided to use abdominal breathing to make sounds, with emphasis on those parts requiring long and strong breathing. The results showed that for all eight patients both their breathing volume and their inspiratory volume increased following participation in the harmonica program. Also, the program had psychological benefits (e.g., more life satisfaction and less sadness) and additional physical benefits (e.g., less dizziness due to low blood pressure and better phlegm spitting). This study offers a unique way to help patients with spinal cord injuries to improve their breathing capacity, which may also be associated with a greater quality of life.
Study Design: Retrospective case series. Purpose: Cauda equina syndrome (CES) is associated with etiologies such as lumbar disc herniation (LDH) and lumbar canal stenosis (LCS). CES has a prevalence of 2% among patients with LDH and exhibits variable outcomes, even with early surgery. Few studies have explored the factors influencing the prognosis in terms of bladder function. Therefore, we aimed to assess the factors contributing to bladder recovery and propose a simplified bladder recovery classification. Overview of Literature: Few reports have described the prognostic clinical factors for bladder recovery following CES. Moreover, limited data are available regarding a meaningful bladder recovery status classification useful in clinical settings. Methods: A single-center retrospective study was conducted (April 2012 to April 2015). Patients with CES secondary to LDH or LCS were included. The retrieved data were evaluated for variables such as demographics, symptom duration, neurological symptoms, bladder symptoms, and surgery duration. The variable bladder function outcome during discharge and at follow-up was recorded. All subjects were followed up for at least 2 years. A simplified bladder recovery classification was proposed. Statistical analyses were performed to study the correlation between patient variables and bladder function outcome. Results: Overall, 39 patients were included in the study. Majority of the subjects were males (79.8%) with an average age of 44.4 years. CES secondary to LDH was most commonly seen (89.7%). Perianal sensation (PAS) showed a significant correlation with neurological recovery. In the absence of PAS, bladder function did not recover. Voluntary anal contraction (VAC) was affected in all study subjects. Conclusions: Intactness of PAS was the only significant prognostic variable. Decreased or absent VAC was the most sensitive diagnostic marker of CES. We also proposed a simplified bladder recovery classification for recovery prognosis.
Today the number of the disabled people with a spinal cord injury is increasing by the acquired factor. The purpose of the study is to furnish basic data for the study of satisfactory clothing construction data by considering the physical variation by the time passed the since the injury. Also the study includes the actual measuring of the disabled men with spinal cord injuries which is compared with the data of the 5th national anthropometric survey of Korea and makes it possible to grasp the distinguished physical feature of the disabled men with the spinal cord injury. As a result, first, the measured data are smaller than those of the 5th national anthropometric survey of Korea in the items of height and length of the upper half of the body related to stature. Second, the measured data are bigger than those of the 5th national anthropometric survey of Korea in the items of breadth, depth and circumference of the upper half of the body related to the exercise. Third, there are differences in the items of depth of the lower half of the body, breadth and circumference in the analysis of the time passed since the injury.
The purpose of this study is to compare sexual concerns and adjustment between men and women with spinal cord injuries. A total of 108 persons (67 men and 41 women), registered to the Spinal Cord Injury Organization or admitted at rehabilitation unit from February 1999 to February 2000, were selected as subjects of the study. Participants answered the questionnaires concerning importance of life events, sexual concern, sexual adjustment, relationship with a sex partner, and depression. The results are as follows : 1) There were no significant differences between men and women in the general characteristics except sexual dysfunction. 2) With respect to eleven different life areas, sex life ranked the fifth among men, whereas it occupied the lowest position for women among the 11 areas. However economic status was the most highly-ranked for both sex. 3) Men took much interest in the "methods and techniques for achieving sexual satisfaction", "Helping a partner cope emotionally with limitations on sexual activity", whereas women were interested in "Helping a partner cope emotionally with limitations on sexual activity" and "Ability to have children". 4) The means of sexual adjustment, relationship with a sex partner, and depression among men were higher than women. But there was no significant difference between two groups. As a result, the study suggests that there are no significant differences in the general characteristics between men and women with spinal cord injuries except sexual dysfunction. Men evaluated the sexual events highly compared to women, and differences were also shown in terms of sexual concerns between men and women. Therefore differential approaches to sexual rehabilitation are required; in both socio-psychological and physical aspects for men and particularly in socio-psychological respect for women.
Journal of the Korean Physical Therapy Association
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s.3
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pp.27-37
/
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 .
The purpose of this study was to identify the degree of sexual adjustment and quality of life in married men with spinal cord injuries and to furnish primary data to sexuality rehabilitation nursing practice which can lead to ideal sexual life and quality of life those men with SCI. Seventy married men with SCI were conveniently sampled in Kwangju, Suncheon, Mokpo and Seoul for responding the questionnaire, which was based on this research. With the research scale, SIS (Sexual interest and satisfaction) by Siosteen et al.(1990) and SB(Sexual behaviour) by Kreuter et al.(1996) were used for the measurement of sexual adjustment. And, for measuring quality of life was used SCI QL-23(Spinal cord injury of life-23) scale by Lundqvist et al.(1997). Data were collected from January 20 to March 20, 1999, using a structured questionnaire. A hundred volumes of questionnaire were used. and 85 volumes were collected, 70 volumes were used as research data after excluding 15 volumes unsuitable to data analysis. The obtain data were analysed using percentage, t-test, ANOVA, Duncan test, and Pearson's correlation by SAS PC+ program. The results were as follows: 1. The mean score of sexual interest and satisfaction of the subjects was 8.42. out of 18. The ways of their sexual behavior after spinal cord injuries were embracing and caressing (62.9%), kissing(58.6%), caressing breast with hands (55.7%), caressing breast with hands (52.9%), caressing genitals with hands (37.2%), caressing genitals with mouth(30.0%) and sexual intercourse (18.6%). The mean score of quality of life was 52.53 out of 100. 2. Age(F=3.24, p=.045) and caregiver (F=4.02, p=.022)were major variables which reveals significant differences in terms for sexual interest and satisfaction. The later results on Duncan's test showed that subjects who were in their 30s or 40s were significant higher than subjects whose age were in their 50s in their sexual interest and satisfaction. Also subjects with their spouse's care or mother's care were higher than those with other's care. 3. Subjects with incomplete paraplegia were higher than those with the complete paraplegia in sexual interest and satisfaction (F=3.01, p=.036). 4. Variables that showed the significant differences in the quality of life were education(t=2.860, p=.007) and period of marriage(t=2.125, p=.037). and occupational status(t=-2.161, p=.034). High school graduates, those who married before spinal cord injuries and those who didn't have occupation were higher than the other subjects. 5. Variables that revealed significant differences in the quality of life were time passage after spinal cord injuries(F=8.72, p=.001) and injured level of spinal cord(F=3.32, p=.042). Duncan's test showed that subjects who had lived for less than 4 years were higher those with time passage of 5-9 years and 10 years. Also subjects with lumbar injuries were higher than those with thoracic injuries in terms of quality of life. 6. There was negatively correlated between sexual interest and satisfaction and quality of life(r=-.256, p<.05). As a result of these findings sexuality rehabilitation for individuals with SCI was very important issue for their quality of life. Thus, registered nurses who care clients with SCI should activily participate in the client's sexual needs. Also, various sexual behaviors as well as sexual intercourse should be encouraged for the sexual adjustment of client's with SCI.
Jain, Vaibhav;Madan, Ankit;Thakur, Manoj;Thakur, Amit
Neurospine
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v.15
no.4
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pp.368-375
/
2018
Objective: To evaluate the results of operative management of subaxial spine injuries managed with 2-level anterior cervical corpectomy and fusion with a cervical locking plate and autologous bone-filled titanium mesh cage. Methods: This study included 23 patients with a subaxial spine injury who matched the inclusion criteria, underwent 2-level anterior cervical corpectomy and fusion at our institution between 2013 and 2016, and were followed up for neurological recovery, axial pain, fusion, pseudarthrosis, and implant failure. Results: According to Allen and Ferguson classification, there were 9 cases of distractive extension; 4 of compressive extension; 3 each of compressive flexion, vertical compression, and distractive flexion; and 1 of lateral flexion. Sixteen patients had a score of 6 on the Subaxial Injury Classification system, and the rest had a score of more than 6. The mean follow-up period was 19 months (range, 12-48 months). Neurological recovery was observed in most of the patients (78.21%). All patients experienced relief of axial pain. None of the patients received a blood transfusion. Twenty-one patients (91.3%) showed solid fusion and 2 (8.69%) showed possible pseudarthrosis, with no complications related to the cage or plate. Conclusion: Two-level anterior cervical corpectomy and fusion, along with stabilization with a cervical locking plate and autologous bone graft-filled titanium mesh cage, can be considered a feasible and safe method for treating specific subaxial spine injuries, with the benefits of high primary stability, anatomical reduction, and direct decompression of the spinal cord.
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