• Title/Summary/Keyword: Spinal Cord

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서울지역 외상성 척수손상환자의 발생률 추정 및 발생관련요인 (Estimation of Incidence Rate and Factors Related to Occurrence of Traumatic Spinal Cord Injury in Seoul)

  • 정낙수;정치경;이원철
    • 한국전문물리치료학회지
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    • 제6권2호
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    • pp.1-15
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    • 1999
  • For the purpose of disclosing estimated annual incidence rate and causative factors of traumatic spinal cord injury and obtaining basic data for the establishment of effective measures to prevent this injury, the medical record of 204 cases of Seoul residents with spinal cord injury which admitted in 46 general hospitals and National rehabilitation center located in Seoul, including Sam Yook Rehabilitation Center and Jung Ang Hospital in Kyungi do and occurred in 1995 were analyzed. The results were as follows: 1) The estimated annual incidence rate of traumatic spinal cord injury in 1995 of Seoul residents was 20.5 per million population. This incidence rate was the highest in the 40th years (34.1), followed by in the 50th years (26.5) and in the 20th years (25.6) in descending order. 2) The incidence rate ratio between male and female was 3.5:1. 3) The leading cause of injury was the highest in traffic accidents (42.2%), followed by falls from elevation (29.4%) and falls on the same level (9.8%). 4) Traffic accident mainly occured from 20th years to 40th years and falls from elevation in 50th years. 5) The level of spinal cord injury was the highest in cervical cord (63.2%), followed by the thoracic cord (21.1%) and lumbosacral cord (15.7%). Traffic accidents mainly caused in cervical cord injury whereas thoracic cord injury and lumbosacral cord injury were caused from falls from elevation. Above theconsiderations in mind, it suggested that in order to prevent traumatic spinal cord injuries, safety education of falls from elevation should be focused on the 20th years and 50th years male, moreover safety education of traffic accidents will be needed in the 30th years and 40th years male.

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전기자극이 체중 부하를 제거한 신생 흰쥐 척수조직의 NT-3 및 MAP2 발현에 미치는 영향 (Influence of Electrical Stimulation on NT-3 and MAP2 Expression of Neonatal Rat Spinal Cord During Suspension Unloading)

  • 구현모;이선민
    • 한국전문물리치료학회지
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    • 제14권2호
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    • pp.11-20
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    • 2007
  • The development of neonatal neuromuscular system is accomplished by the functional interaction between the spinal neurons and its target cells, skeletal muscle cells, and the intrinsic and extrinsic factors affecting this process. The aim of this study was to identify the effect of suspension unloading (SU) and neuromuscular electrical stimulation (NMES) upon the development of the neonatal spinal cord. For this study, the neonatal rats were randomly divided into three groups: a control group, an experimental group I, and an experimental group II. The SU for experimental group I and II was applied from postnatal day (PD) 5 to PD 30, and the NMES for experimental group II was applied from PD 16 to PD 30 using NMES that gave isometric contraction with 10 Hz for 30 minutes twice a day. In order to observe the effect of SU and NMES, this study observed neutrophin-3 (NT-3) and microtubule associated protein 2 (MAP2) immunoreactivity in the lumbar spinal cord (L4-5) at the PD 15 and PD 30. The results are as follows. At PD 15, lumbar spinal cord of experimental group I and II had significantly lower NT-3 and MAP2 immunoreactivity than control group. It proved that a microgravity condition restricted the spinal development. At PD 30, lumbar spinal cord of control group and experimental group II had significantly higher NT-3 and MAP2 immunoreactivity than experimental group I. It proved that the NMES facilitated the spinal development by spinal cord-skeletal muscle interaction. These results suggest that weight bearing during the neonatal developmental period is essential for the development of neuromuscular development. Also, the NMES on its target skeletal muscle can encourage the development of the spinal cord system with a full supplementation of the effect of weight bearing, which is an essential factor in neonatal developmental process.

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Morphological Patterns of the Anterior Median Fissure in the Cervical Spinal Cord Evaluated by Computed Tomography After Myelography

  • Oichi, Yuki;Hanakita, Junya;Takahashi, Toshiyuki;Minami, Manabu;Kawaoka, Taigo;Funakoshi, Yusuke;Kawauchi, Takeshi;Ohtake, Yasufumi
    • Neurospine
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    • 제15권4호
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    • pp.388-393
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    • 2018
  • Objective: Computed tomography following myelography (CTM) revealed an unusual flow of contrast dye into the anterior median fissure (AMF) in a patient with cervical spondylotic myelopathy. Since then, several AMF configurations have been observed on CTM. Therefore, we evaluated morphological patterns of the AMF on CTM and investigated the significance and mechanisms of contrast dye flow into the AMF. Methods: Morphological patterns of the AMF on CTM were examined in 79 patients. Group A (24 patients) underwent surgery because of symptomatic cervical myelopathy. Group B (43 patients) had no clinical symptoms but showed spinal cord compression on CTM. Group C (12 patients), who showed neither clinical symptoms nor cord changes, underwent CTM for lumbar lesion evaluation. AMF patterns were classified into 4 types according to their configurations on CTM (reversed T, Y, V, and O types). Results: In group B, the reversed T type and Y type appeared significantly more often near the compressed portion (p<0.001). A similar tendency was seen in group A. The V and O types were most frequently observed in group C (p<0.001). Conclusion: On CTM, contrast dye tends to flow into the AMF of the cervical cord when the spinal cord is compressed. We speculate that there may be 3 possible mechanisms for this phenomenon: deformation of the epipial layer of the AMF due to cervical cord compression, AMF dilatation due to atrophy of the anterior funiculus or anterior horn, and temporary AMF dilatation when it becomes an alternative route for cerebrospinal fluid circulation.

Activation of Matrix Metalloproteinases-9 after Photothrombotic Spinal Cord Injury Model in Rats

  • Jang, Jae-Won;Lee, Jung-Kil;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • 제50권4호
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    • pp.288-292
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    • 2011
  • Objective : Matrix metalloproteinases (MMPs), especially MMP-2 and MMP-9 have been known to play an important role in secondary inflammatory reaction after spinal cord injury (SCI). The aim of this study was to investigate the expression and activity of MMP-2 and MMP-9 and to determine their relationship with disruption of endothelial blood-barrier after photochemically induced SCI in rats. Methods : Female Sprague-Dawley rats, weighing between 250 and 300 g (aged 8 weeks) received focal spinal cord ischemia by photothrombosis using Rose Bengal. Expressions and activities of MMP-2 and MMP-9 were assessed by Western blot and gelatin zymography at various times from 6 h to 7 days. Endothelial blood-barrier integrity was assessed indirectly using spinal cord water content. Results : Zymography and Western blot analysis demonstrated rapid up-regulation of MMP-9 protein levels in spinal cord after ischemic onset. Expressions and activities of MMP-9 showed a significant increased at 6 h after the photothrombotic ischemic event, and reached a maximum level at 24 h after the insult. By contrast, activated MMP-2 was not detected at any time point in either the experimental or the control groups. When compared with the control group, a significant increase in spinal cord water content was detected in rats at 24 h after photothrombotic SCI. Conclusion : Early up-regulation of MMP-9 might be correlated with increased water content in the spinal cord at 24 h after SCI in rats. Results of this study suggest that MMP-9 is the key factor involved in disruption of the endothelial blood-barrier of the spinal cord and subsequent secondary damage after photothrombotic SCI in rats.

척수 장애인의 성적 적응 경험 (Sexual Adjustment Process of Individuals with Spinal cord Injury)

  • 강현숙;고정은;서연옥;이은희
    • 재활간호학회지
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    • 제3권1호
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    • pp.80-97
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    • 2000
  • The purpose of this study is to identify and describe a process of sexual adjustment of individuals with spinal cord injury: and to describe and explore positive and negative influences on the adjustment process. This qualitative study was conducted with 10 Korean individuals with spinal cord injury who had been physically disabled for more than one year. Data were collected and analysed at a same time using grounded theory method. Major categories of this study showed a process how the individuals with spinal cord injury adjust to their individual life as sexual beings. The process included and individual responses to the behavioral efforts including and . Initially physical aspects of sexuality seemed to be affected by spinal cord injuries. The changed physical aspects then influenced other aspects of their sexual life. Life satisfaction of each individual as a sexual being revealed as very subjective. It could be defined according to how the individual approved their sexual life no matter what and how much behavioral effort the person had done. In this study 3 types of sexual adjustment aspects were explored: 'Active adjustment' 'Passive adjustment' 'Maladjustment'. There were negative and positive factors influencing the adjustment process of individuals with spinal cord injury. Those factors might come from themselves, from families, or from social situations. Findings of this study suggested that sexual life of individuals with spinal cord injury should not be understood as a physical or behavioral matter. It was a combination of physical, psychological and social aspects of life. Therefore, appropriate rehabilitation programs for the sexual adjustment of individuals with spinal cord injury need to concern heterogeneous life values of them and obtain individualized services for each individual at a different stage of the sexual adjustment process.

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척수경색 환자에 관한 한방 복합치료 효과 : 증례 보고 (The Effect of Complex Korean Medical Treatment on Spinal Cord Infarction : A Case Report)

  • 박기남;김소연;김은석;김정호;김영일
    • Journal of Acupuncture Research
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    • 제33권2호
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    • pp.189-200
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    • 2016
  • Objectives : The purpose of this study is to report the clinical effect of Korean medical treatment on spinal cord infarction. Methods : We treated a patient who was diagnosed with spinal cord infarction. We used acupuncture, bee venom pharmacopuncture, herbal medicine, moxibustion and physical therapy. We evaluated the patient through Manual Muscle Testing (MMT) and International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) score. Results : MMT grade improved grade from 1 to 5 and ISNCSCI score increased from 2 to 14. Conclusion : According to these results, this report suggests that Korean medical treatment could be effective for spinal cord infarction.

Muscular Adaptations and Novel Magnetic Resonance Characterizations of Spinal Cord Injury

  • Lim, Woo-Taek
    • 한국전문물리치료학회지
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    • 제22권2호
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    • pp.70-80
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    • 2015
  • The spinal cord is highly complex, consisting of a specialized neural network that comprised both neuronal and non-neuronal cells. Any kind of injury and/or insult to the spinal cord leads to a series of damaging events resulting in motor and/or sensory deficits below the level of injury. As a result, muscle paralysis (or paresis) leading to muscle atrophy or shrinking of the muscle along with changes in muscle fiber type, and contractile properties have been observed. Traditionally, histology had been used as a gold standard to characterize spinal cord injury (SCI)-induced adaptation in spinal cord and skeletal muscle. However, histology measurements is invasive and cannot be used for longitudinal analysis. Therefore, the use of conventional magnetic resonance imaging (MRI) is promoted to be used as an alternative non-invasive method, which allows the repeated measurements over time and secures the safety against radiation by using radiofrequency pulse. Currently, many of pathological changes and adaptations occurring after SCI can be measured by MRI methods, specifically 3-dimensional MRI with the advanced diffusion tensor imaging technique. Both techniques have shown to be sensitive in measuring morphological and structural changes in skeletal muscle and the spinal cord.

Effects of Oriental Medicinal Drugs on Axonal Regeneration in the Spinal Cord Neurons

  • An Joung-Jo;NamGung Uk;Seo In-Chan;Kim Yoon-Sik
    • 동의생리병리학회지
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    • 제19권6호
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    • pp.1640-1646
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    • 2005
  • An oriental medicinal drugs Jahageo (JHG, Hominis placenta) were examined to determine its effects on the responsiveness of central nervous system neurons after injury. We found that JHG was involved in neurite outgrowth of DRG sensory axons. JHG treatment also increased expression of axonal growth-associated protein GAP-43 in DRG sensory neurons after sciatic nerve injury and in the injured spinal cord. JHG treatment during the spinal cord injury increased induction levels of cell division cycle 2 (Cdc2) protein in DRG as well as in the spinal cord. Histochemical investigation showed that induced Cdc2 in the injured spinal cord was found in non-neuronal cells. These results suggest that JHG regulates activities of non-neuronal cells such as oligodendrocyte and astrocyte in responses to spinal cord injury and protects neuronal responsiveness after axonal damage.

High-Level Cervical Spinal Cord Stimulation Used to Treat Intractable Pain Arising from Transverse Myelitis Caused by Schistosomiasis

  • Kim, Jin-Kyung;Hong, Seok-Ho;Lee, Jung-Kyo
    • Journal of Korean Neurosurgical Society
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    • 제47권2호
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    • pp.151-154
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    • 2010
  • The efficacy of spinal cord stimulation (SCS) for treatment of various chronic painful conditions is well established. Very few reports have documented the use of SCS for treatment of chronic pain after spinal cord injury. We present a case showing a good outcome after such treatment, and suggest that high cervical stimulation may be efficacious. A 53-year-old male underwent SCS on the C1-3 level for treatment of intractable neuropathic pain below the T3 level, and in the upper extremities, arising from spinal cord injury resulting from transverse myelitis caused by schistosomiasis. High cervical SCS significantly improved the pain in the upper extremities and at the T3-T10 dermatome level. The patient continues to report excellent pain relief 9 months later. The present case suggests that high cervical stimulation may improve chronic pain in the upper extremities and the T3-T10 dermatome level arising from spinal cord injury.

척수경색증으로 인한 하반신불수(下半身不隨) 환자에 대한 치험례 (A Case study about Paraplegia diagnosed as Spinal cord infarction)

  • 배효상;한경석;최재영;박성식;최정락
    • 사상체질의학회지
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    • 제14권2호
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    • pp.160-168
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    • 2002
  • Spinal cord infarction in vascular impairment of spinal cord is rare in the world. and besides, because spinal cord has small cross-sectional area and almost all tract of sensory system and motor system pass away, spinal cord disease is one of the terrible diseases, that leaves usually permanent and severe neurological sequela. The case is about a patient who is 57 years old woman. Both of her legs were suddenly paralyzed and her case was diagnosed as spinal cord infarction in medical center. In our hospital, we focussed on her basic physiological condition-defecation, urination, dormitio, diet, etc. In the case of this patient, power and sense of both legs with physiolocal condition improved remarkably through Sasang Constitutional Medicine with rehabilitative therapy.

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