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Jazayeri SB, Kankam SB, Golestani A, Shobeiri P, Gholami M, Dabbagh Ohadi MA, Maroufi SF, Fattahi MR, Malekzadeh H, Jazayeri SB, Ghodsi Z, Ghodsi SM, Rahimi-Movaghar V. A systematic review and meta-analysis of the global epidemiology of pediatric traumatic spinal cord injuries. Eur J Pediatr 2023; 182:5245-5257. [PMID: 37814152 DOI: 10.1007/s00431-023-05185-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 08/23/2023] [Accepted: 08/28/2023] [Indexed: 10/11/2023]
Abstract
Despite being relatively rare, pediatric traumatic spinal cord injury (TSCI) is a debilitating event with high morbidity and long-term damage and dependency. This study aims to provide insight on the epidemiological characteristics of pediatric TSCI worldwide. The studies were included if they provided data for the pediatric population with the diagnosis of TSCI. Information sources included PubMed, Embase, Web of Science, and Scopus. All databases were searched from 1990 to April 2023. The quality of included studies was evaluated by Joanna Briggs Institute Critical Appraisal Tools. The results of the meta-analysis were presented as forest plots. PROSPERO Registration code: CRD42020189757. We identified 87 studies from 18 developed and 11 developing countries. Of the 87 studies evaluated, 52 studies were considered medium quality, 27 studies were considered high quality, and 8 studies were considered low quality. In developed countries, the proportion of TSCIs occurring in patients aged 0-15 years was 3% (95% CI: 2.2%; 3.9%), while in developing countries, it was 4.5% (95% CI: 2.8%; 6.4%). In developed countries, the pooled incidence of pediatric TSCI was 4.3/millions of children aged 0-15/year (95% CI: 3.1; 6.0/millions children aged 0-15/year) and boys comprised 67% (95% CI: 63%; 70%) of cases. The most prevalent level of injury was cervical (50% [95% CI: 41%; 58%]). The frequency of SCI Without Obvious Radiological Abnormality (SCIWORA) was 35% (95% CI: 18%; 54%) among children 0-17 years. The most common etiology in developed countries was transport injuries (50% [95% CI: 42%; 57%]), while in developing countries falls were the leading cause (31% [95% CI: 20%; 42%]). The most important limitation of our study was the heterogeneity of studies in reporting age subgroups that hindered us from age-specific analyses. Conclusion: Our study provided accurate estimates for the epidemiology of pediatric TSCI. We observed a higher proportion of pediatric TSCI cases in developing countries compared to developed countries. Furthermore, we identified distinct epidemiological characteristics of pediatric TSCI when compared to adult cases and variations between developing and developed countries. Recognizing these unique features allows for the implementation of cost-effective preventive strategies aimed at reducing the incidence and burden of TSCI in children. What is Known: • Pediatric Traumatic Spinal Cord Injury (TSCI) can have profound physical and social consequences for affected children, their families, and society as a whole. • Epidemiological insights are vital for they provide the data and understanding needed to the identification of vulnerable populations, aiding in the development of targeted prevention strategies and effective resource allocation. What is New: • The estimated incidence of pediatric TSCI in developed countries is 4.3 cases per million children aged 0-15. The proportion of pediatric TSCI cases in relation to all-age TSCI cases is 3% in developed countries and 4.5% in developing countries. • The etiology of TSCI in pediatric cases differs between developing and developed countries. In developed countries, transport injuries are the most prevalent cause of pediatric TSCI, while falls are the least common cause. Conversely, in developing countries, falls are the leading cause of pediatric TSCI.
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Affiliation(s)
- Seyed Behnam Jazayeri
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Samuel Berchi Kankam
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
- International Neurosurgery Group (ING), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Ali Golestani
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Parnian Shobeiri
- School of Medicine, Tehran University of Medical Science, Tehran, Iran
| | - Morteza Gholami
- Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular, Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical, Tehran, Iran
| | | | - Seyed Farzad Maroufi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Fattahi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
- Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Hamid Malekzadeh
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Zahra Ghodsi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Ghodsi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Universal Scientific Education and Research Network (USERN), Tehran, Iran.
- Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
- Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran.
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Deng L, Chen Y, Wang Z, Zeng N, Zhang Q, Zhou T, Chen Y, Wu S. Analysis of the influencing factors related to neuropathic pain in patients with spinal cord injuries: a retrospective study. Br J Neurosurg 2023; 37:1588-1593. [PMID: 35200073 DOI: 10.1080/02688697.2022.2043242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 02/12/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND The aim of this study was to investigate the related influencing factors of neuropathic pain (NP) in patients with spinal cord injury (SCI). METHODS Patients diagnosed with SCI between January 2016 and December 2019 in the Department of Rehabilitation Medicine, Affiliated Hospital of Guizhou Medical University, were screened for NP by using the Douleur Neuropathique 4 (DN4) questionnaire. A total of 133 patients diagnosed with SCI with NP were finally included in the study. We collected the patients' basic information, including gender, age, body mass index (BMI), disease course, injury segment, American Spinal Injury Association (ASIA) grade, occupation, educational level, whether painkillers were used, stability of economic support, and pain level. Univariate and multiple ordered logistic regression analyses were used to examine the influencing factors of NP in the patients with SCI. RESULTS The chi-square test revealed that disease course, injury level, severity of SCI (ASIA classification), stable economic support during hospitalization, and the use of painkillers had statistical significance (p < .01). A multivariate logistic regression analysis was performed to analyze the influencing factors of NP. ASIA grade, stable economic support, and use of painkillers were independent influencing factors of NP in patients with SCI, among which injury severity was the independent risk factor (odds ratio [OR] > 1). Stable economic support and painkiller use were protective factors (OR < 1). CONCLUSIONS In this study, we found no significant correlation between NP after SCI and sex, age, BMI, disease course, injury level, and occupation. However, the injury severity was an independent risk factor, and stable economic support and painkiller use were protective factors.
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Affiliation(s)
- Luoyi Deng
- Department of Rehabilitation Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, PR China
| | - Yuan Chen
- Department of Rehabilitation Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, PR China
| | - Zhitao Wang
- Department of Rehabilitation Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, PR China
| | - Ni Zeng
- Department of Rehabilitation Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, PR China
| | - Qian Zhang
- Department of Rehabilitation Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, PR China
| | - Tengfei Zhou
- Department of Rehabilitation Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, PR China
| | - Yan Chen
- Department of Rehabilitation Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, PR China
- School of Clinical Medicine, Guizhou Medical University Guiyang, Guiyang, PR China
| | - Shuang Wu
- Department of Rehabilitation Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, PR China
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Wang X, Du J, Jiang C, Zhang YY, Tian F, Chen Z, Zhang Y, Zhang Y, Yan L, Hao D. Epidemiological characteristics of traumatic spinal cord injuries in a multicenter retrospective study in northwest China, 2017-2020. Front Surg 2022; 9:994536. [PMID: 36299569 PMCID: PMC9589158 DOI: 10.3389/fsurg.2022.994536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 09/12/2022] [Indexed: 11/05/2022] Open
Abstract
Background Traumatic spinal cord injuries (TSCIs) are worldwide public health problems that are difficult to cure and impose a substantial economic burden on society. There has been a lack of extensive multicenter review of TSCI epidemiology in northwest China during the Corona Virus Disease 2019 (COVID-19) pandemic. Method A multicenter retrospective study of 14 selected hospitals in two provinces in northwest China was conducted on patients admitted for TSCI between 2017 and 2020. Variables assessed included patient demographics, etiology, segmental distribution, treatment, waiting time for treatment, and outcomes. Results The number of patients with TSCI showed an increasing trend from 2017 to 2019, while there were 12.8% fewer patients in 2020 than in 2019. The male-to-female ratio was 3.67:1, and the mean age was 48 ± 14.9 years. The primary cause of TSCI was high falls (38.8%), slip falls/low falls (27.7%), traffic accidents (23.9%), sports (2.6%), and other factors (7.0%). The segmental distribution showed a bimodal pattern, peak segments were C6 and L1 vertebra, L1 (14.7%), T12 (8.2%), and C6 (8.2%) were the most frequently injured segments. In terms of severity, incomplete injury (72.8%) occurred more often than complete injury (27.2%). The American Spinal Injury Association impairment scale of most patients did not convert before and after treatment in the operational group (71.6%) or the conservative group (80.6%). A total of 975 patients (37.2%) from urban and 1,646 patients (62.8%) from rural areas were included; almost all urban residents could rush to get treatment after being injured immediately (<1 h), whereas most rural patients get the treatment needed 4-7 h after injury. The rough annual incidence from 2017 to 2020 is 112.4, 143.4, 152.2, and 132.6 per million people, calculated by the coverage rate of the population of the sampling hospital. Conclusion The incidence of TSCI in northwest China is high and on the rise. However, due to pandemic policy reasons, the incidence of urban residents decreased in 2020. The promotion of online work may be an effective primary prevention measure for traumatic diseases. Also, because of the further distance from the good conditional hospital, rural patients need to spend more time there, and the timely treatment of patients from remote areas should be paid attention to.
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Affiliation(s)
- Xiaohui Wang
- Department of Spinal Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi'an, China,Department of Orthopaedic, The First Affiliated Hospital of Xi’an Jiaotong University, Xi'an, China
| | - Jinpeng Du
- Department of Spinal Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi'an, China
| | - Chao Jiang
- Department of Spinal Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi'an, China
| | - Yong-yuan Zhang
- Department of Spinal Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi'an, China
| | - Fang Tian
- Department of Spinal Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi'an, China,Department of Orthopaedic, The First Affiliated Hospital of Xi’an Jiaotong University, Xi'an, China
| | - Zhe Chen
- Department of Spinal Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi'an, China,Department of Orthopaedic, The First Affiliated Hospital of Xi’an Jiaotong University, Xi'an, China
| | - Yuyang Zhang
- Department of Spinal Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi'an, China,Department of Orthopaedic, The First Affiliated Hospital of Xi’an Jiaotong University, Xi'an, China
| | - Ying Zhang
- Orthopaedic Third Ward, Yulin No. 2 Hospital, Yulin, China
| | - Liang Yan
- Department of Spinal Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi'an, China
| | - Dingjun Hao
- Department of Spinal Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi'an, China,Department of Orthopaedic, The First Affiliated Hospital of Xi’an Jiaotong University, Xi'an, China,Correspondence: Ding-jun Hao
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Xia Q, Yuan H, Wang T, Xiong L, Xin Z. Application and progress of three-dimensional bioprinting in spinal cord injury. IBRAIN 2021; 7:325-336. [PMID: 37786558 PMCID: PMC10528796 DOI: 10.1002/ibra.12005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/10/2021] [Accepted: 11/10/2021] [Indexed: 02/05/2023]
Abstract
Spinal cord injury (SCI) is a central nervous system disorder that can lead to sensory and motor dysfunction, which can seriously increase pressure and economic burden on families and societies. The current SCI treatment is mainly to stabilize the spine, prevent secondary damage, and control inflammation. Drug treatment is limited to early, large-scale use of steroids to reduce the effects of edema after SCI. In short, there is no direct treatment for SCI. Recent 3D bioprinting development provides a new solution for SCI treatment: a series of spinal cord bionic scaffolds are being developed to improve spinal cord function after injury. This paper reviews the pathophysiological characteristics of SCI, current treatment methods, and the progress of 3D bioprinting in SCI. Finally, its challenges and prospects in SCI treatment are summarized.
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Affiliation(s)
| | - Hao Yuan
- Department of Orthopaedic SurgeryAffiliated Hospital of Zunyi Medical UniversityZunyiGuizhouChina
- Institute of Neuroscience and Animal Zoology DepartmentKunming Medical UniversityKunmingYunnanChina
| | - Ting‐Hua Wang
- Institute of Neuroscience and Animal Zoology DepartmentKunming Medical UniversityKunmingYunnanChina
- Jinzhou Medical UniversityJinzhouLiaoningChina
- Department of Anesthesiology, Translational Neuroscience Center, Institute of Neurological Disease, West China HospitalSichuan UniversityChengduSichuanChina
| | - Liu‐Lin Xiong
- Department of AnesthesiologyAffiliated Hospital of Zunyi Medical UniversityZunyiGuizhouChina
| | - Zhi‐Jun Xin
- Department of Orthopaedic SurgeryAffiliated Hospital of Zunyi Medical UniversityZunyiGuizhouChina
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Shao M, Zheng C, Ma X, Lyu F. Ecto-5'-nucleotidase (CD73) inhibits dorsal root ganglion neuronal apoptosis by promoting the Ado/cAMP/PKA/CREB pathway. Exp Ther Med 2021; 22:1374. [PMID: 34650622 PMCID: PMC8506929 DOI: 10.3892/etm.2021.10809] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 04/21/2021] [Indexed: 12/17/2022] Open
Abstract
Spinal cord injury (SCI) is a serious affliction that can lead to insufficient blood supply to the spinal cord, resulting in nutrient and energy deficiency in nerve cells such as neurons. In the present study, a spinal cord injury mouse model was constructed using wild-type (WT) and ecto-5'-nucleotidase (CD73)-/- mice. The results of TUNEL and immunofluorescence assays indicated that the apoptosis of neurons in CD73-/- mice was increased after spinal cord injury. Dorsal root ganglion (DRG) neurons from WT and CD73-/- mice were cultured in low glucose and hypoxic conditions to simulate the effects of spinal cord injury on neurons. Subsequently, a western blot assay was used to detect the expression of CD73, caspase-3 and Bcl-2. Flow cytometry was used to detect cell apoptosis and the corresponding kits were used to detect changes in lactate dehydrogenase (LDH), superoxide dismutase (SOD), malondialdehyde (MDA), reactive oxygen species (ROS), adenosine triphosphate (ATP) and cell activity. The results revealed that the apoptosis level of CD73-overexpressing DRG neurons was decreased under anoxia and glucose deficiency. The release of LDH, MDA and the production of ROS in CD73 DRG neurons was decreased, while the synthesis of ATP, the activity of SOD and cell activity increased after hypoxia-hypoglycemia treatment. Additional cellular studies demonstrated that blocking the expression and hydrolase activity of CD73 with α,β-methylene ADP (APCP) could counteract the protective effect of CD73 on neuronal apoptosis, while adenosine (Ado) could rescue the increased apoptosis caused by CD73 deletion. In addition, the cAMP/ protein kinase A (PKA)/cAMP response element-binding protein (CREB) signaling pathway was also positively regulated by CD73 and Ado. In conclusion, CD73 could inhibit DRG neuronal apoptosis by promoting the Ado/cAMP/PKA/CREB pathway.
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Affiliation(s)
- Minghao Shao
- Department of Spine Surgery, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China
| | - Chaojun Zheng
- Department of Spine Surgery, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China
| | - Xiaosheng Ma
- Department of Spine Surgery, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China
| | - Feizhou Lyu
- Department of Spine Surgery, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China.,Department of Orthopedics, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200040, P.R. China
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6
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Hao D, Du J, Yan L, He B, Qi X, Yu S, Zhang J, Zheng W, Zhang R, Huang DG, Yang J, Zhu M, Ouyang J, Zhao H, Ding K, Shi H, Cao Y, Zhang Y, Tang Q, Liu Y, Zhang Z, Wang Y, Tian Y, Chen H, Bai L, Li H, Mu C, Wang Y, Wang X, Jiang C, Lin J, Lin B, Fan S, Nie L, Song J, Ma X, Shao Z, Gao Y, Guan Z, Song Y, Ma W, Chen Q. Trends of epidemiological characteristics of traumatic spinal cord injury in China, 2009-2018. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2021; 30:3115-3127. [PMID: 34392419 DOI: 10.1007/s00586-021-06957-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 06/12/2021] [Accepted: 08/06/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVE We focus on providing the first comprehensive national dataset on the incidence, injury aetiology and mortality of TSCI in China. METHODS A multi-stage stratified cluster sampling method was used. We included TSCI cases from all hospitals in three regions, nine provinces and 27 cities in China via search of electronic medical records and retrospectively analysed the characteristics of TSCI in China from 2009 to 2018. We estimated the incidence of TSCI in the total population and subgroups. RESULTS There were 5954 actual cases in 2009, corresponding to a total estimated TSCI incidence of 45.1 cases per million population (95% CI, 44.0-46.3). There were 10,074 actual cases in 2018, corresponding to a total estimated TSCI incidence of 66.5 cases per million population (95% CI, 65.2-67.8) (P < 0.001; annual average percentage change (AAPC), 4.4%). From 2009 to 2018, the incidence of almost all sex/age groups showed an increasing trend over time (P < 0.001; AAPC, 0.7-8.8%). The elderly population (aged 65-74) displayed the highest incidence of TSCI (with an average annual incidence of 127.1 cases per million [95% CI, 119.8-134.3]). CONCLUSIONS The TSCI incidence increased significantly from 2009 to 2018. The incidence in the elderly populations was consistently high and continues to increase over time. The mortality of TSCI patients in hospitals is relatively low and continues to decrease each year, but elderly individuals remain at a high risk of hospital death.
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Affiliation(s)
- Dingjun Hao
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiao Tong University, Youyidong Road, Xi'an, 710000, Shaanxi Province, China.
| | - Jinpeng Du
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiao Tong University, Youyidong Road, Xi'an, 710000, Shaanxi Province, China
| | - Liang Yan
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiao Tong University, Youyidong Road, Xi'an, 710000, Shaanxi Province, China
| | - Baorong He
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiao Tong University, Youyidong Road, Xi'an, 710000, Shaanxi Province, China
| | - Xiao Qi
- Office of Epidemiology, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shicheng Yu
- Office of Epidemiology, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiaojiao Zhang
- Office of Epidemiology, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wenjing Zheng
- Office of Epidemiology, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Rongqiang Zhang
- Office of Epidemiology, School of Public Health, Shaanxi University of Traditional Chinese Medicine, Xianyang, China
| | - Da-Geng Huang
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiao Tong University, Youyidong Road, Xi'an, 710000, Shaanxi Province, China
| | - Junsong Yang
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiao Tong University, Youyidong Road, Xi'an, 710000, Shaanxi Province, China
| | - Ming Zhu
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiao Tong University, Youyidong Road, Xi'an, 710000, Shaanxi Province, China
| | - Jiawei Ouyang
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiao Tong University, Youyidong Road, Xi'an, 710000, Shaanxi Province, China
| | - He Zhao
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiao Tong University, Youyidong Road, Xi'an, 710000, Shaanxi Province, China
| | - Keyuan Ding
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiao Tong University, Youyidong Road, Xi'an, 710000, Shaanxi Province, China
| | - Haodong Shi
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiao Tong University, Youyidong Road, Xi'an, 710000, Shaanxi Province, China
| | - Yang Cao
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiao Tong University, Youyidong Road, Xi'an, 710000, Shaanxi Province, China
| | - Ying Zhang
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiao Tong University, Youyidong Road, Xi'an, 710000, Shaanxi Province, China
| | - Qinghua Tang
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiao Tong University, Youyidong Road, Xi'an, 710000, Shaanxi Province, China
| | - Yuan Liu
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiao Tong University, Youyidong Road, Xi'an, 710000, Shaanxi Province, China
| | - Zilong Zhang
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiao Tong University, Youyidong Road, Xi'an, 710000, Shaanxi Province, China
| | - Yuhang Wang
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiao Tong University, Youyidong Road, Xi'an, 710000, Shaanxi Province, China
| | - Ye Tian
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiao Tong University, Youyidong Road, Xi'an, 710000, Shaanxi Province, China
| | - Hao Chen
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiao Tong University, Youyidong Road, Xi'an, 710000, Shaanxi Province, China
| | - Lulu Bai
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiao Tong University, Youyidong Road, Xi'an, 710000, Shaanxi Province, China
| | - Heng Li
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiao Tong University, Youyidong Road, Xi'an, 710000, Shaanxi Province, China
| | - Chenchen Mu
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiao Tong University, Youyidong Road, Xi'an, 710000, Shaanxi Province, China
| | - Youhan Wang
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiao Tong University, Youyidong Road, Xi'an, 710000, Shaanxi Province, China
| | - Xiaohui Wang
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiao Tong University, Youyidong Road, Xi'an, 710000, Shaanxi Province, China
| | - Chao Jiang
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiao Tong University, Youyidong Road, Xi'an, 710000, Shaanxi Province, China
| | - Jianhua Lin
- Department of Spine Surgery, The First Affiliated Hospital of Fujian Medical University, Fujian, China
| | - Bin Lin
- Department of Orthopaedic, The No. 909 Hospital of the People's Liberation Army, Zhangzhou, China
| | - Shunwu Fan
- Department of Orthopaedic, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Lin Nie
- Department of Spine Surgery, Qilu Hospital of Shandong University, Shandong, China
| | - Jiefu Song
- Department of Orthopaedic, Shanxi Provincial People's Hospital, Taiyuan, China
| | - Xun Ma
- Department of Orthopaedic, Shanxi Bethune Hospital, Taiyuan, China
| | - Zengwu Shao
- Department of Orthopaedic, Union Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Yanzheng Gao
- Department of Orthopaedic, Henan Provincial People's Hospital, Zhengzhou, China
| | - Zhong Guan
- Department of Spine Surgery, Qinghai University Affiliated Hospital, Xining, China
| | - Yueming Song
- Department of Spine Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Weihu Ma
- Department of Spine Surgery, Ningbo No. 6 Hospital, Ningbo, China
| | - Qixin Chen
- Department of Orthopaedic, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
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Shen K, Sun G, Chan L, He L, Li X, Yang S, Wang B, Zhang H, Huang J, Chang M, Li Z, Chen T. Anti-Inflammatory Nanotherapeutics by Targeting Matrix Metalloproteinases for Immunotherapy of Spinal Cord Injury. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2021; 17:e2102102. [PMID: 34510724 DOI: 10.1002/smll.202102102] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 07/26/2021] [Indexed: 05/24/2023]
Abstract
Neuroinflammation is critically involved in the repair of spinal cord injury (SCI), and macrophages associated with inflammation propel the degeneration or recovery in the pathological process. Currently, efforts have been focused on obtaining efficient therapeutic anti-inflammatory drugs to treat SCI. However, these drugs are still unable to penetrate the blood spinal cord barrier and lack the ability to target lesion areas, resulting in unsatisfactory clinical efficacy. Herein, a polymer-based nanodrug delivery system is constructed to enhance the targeting ability. Because of increased expression of matrix metalloproteinases (MMPs) in injured site after SCI, MMP-responsive molecule, activated cell-penetrating peptides (ACPP), is introduced into the biocompatible polymer PLGA-PEI-mPEG (PPP) to endow the nanoparticles with the ability for diseased tissue-targeting. Meanwhile, etanercept (ET), a clinical anti-inflammation treatment medicine, is loaded on the polymer to regulate the polarization of macrophages, and promote locomotor recovery. The results show that PPP-ACPP nanoparticles possess satisfactory lesion targeting effects. Through inhibited consequential production of proinflammation cytokines and promoted anti-inflammation cytokines, ET@PPP-ACPP could decrease the percentage of M1 macrophages and increase M2 macrophages. As expected, ET@PPP-ACPP accumulates in lesion area and achieves effective treatment of SCI; this confirmed the potential of nano-drug loading systems in SCI immunotherapy.
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Affiliation(s)
- Kui Shen
- Department of Orthopedics, The First Affiliated Hospital, and Department of Chemistry, Jinan University, Guangzhou, Guangdong, 510632, China
| | - Guodong Sun
- Department of Orthopedics, The First Affiliated Hospital, and Department of Chemistry, Jinan University, Guangzhou, Guangdong, 510632, China
- The Fifth Affiliated Hospital (Heyuan Shenhe People's Hospital), Jinan University, Heyuan, 517000, China
| | - Leung Chan
- Department of Orthopedics, The First Affiliated Hospital, and Department of Chemistry, Jinan University, Guangzhou, Guangdong, 510632, China
| | - Lizhen He
- Department of Orthopedics, The First Affiliated Hospital, and Department of Chemistry, Jinan University, Guangzhou, Guangdong, 510632, China
| | - Xiaowei Li
- Zhuhai Precision Medical Center, Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University), Jinan University, Zhuhai, Guangdong, 519000, P. R. China
- The Biomedical Translational Research Institute, Jinan University Faculty of Medical Science, Jinan University, Guangzhou, 510632, P. R. China
| | - Shuxian Yang
- Department of Orthopedics, The First Affiliated Hospital, and Department of Chemistry, Jinan University, Guangzhou, Guangdong, 510632, China
- The Biomedical Translational Research Institute, Jinan University Faculty of Medical Science, Jinan University, Guangzhou, 510632, P. R. China
| | - Baocheng Wang
- Tsinghua-Berkeley Shenzhen Institute, Tsinghua University, Shenzhen, 518055, China
| | - Hua Zhang
- Zhuhai Precision Medical Center, Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University), Jinan University, Zhuhai, Guangdong, 519000, P. R. China
- The Biomedical Translational Research Institute, Jinan University Faculty of Medical Science, Jinan University, Guangzhou, 510632, P. R. China
| | - Jiarun Huang
- Department of Orthopedics, The First Affiliated Hospital, and Department of Chemistry, Jinan University, Guangzhou, Guangdong, 510632, China
| | - Minmin Chang
- College of Traditional Chinese Medicine, Jinan University, Guangzhou, 510632, China
| | - Zhizhong Li
- Department of Orthopedics, The First Affiliated Hospital, and Department of Chemistry, Jinan University, Guangzhou, Guangdong, 510632, China
- The Fifth Affiliated Hospital (Heyuan Shenhe People's Hospital), Jinan University, Heyuan, 517000, China
| | - Tianfeng Chen
- Department of Orthopedics, The First Affiliated Hospital, and Department of Chemistry, Jinan University, Guangzhou, Guangdong, 510632, China
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Epidemiological characteristics of traumatic cervical spinal cord injury in Chongqing, China, from 2009 to 2018. Spinal Cord Ser Cases 2021; 7:70. [PMID: 34349097 DOI: 10.1038/s41394-021-00434-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 11/08/2022] Open
Abstract
STUDY DESIGN Hospital-based retrospective epidemiological research. OBJECTIVES To describe the epidemiological and demographic features of patients with traumatic cervical spinal cord injury in Chongqing, China from 2009 to 2018. SETTING Army Military Medical University Xinqiao Hospital in Chongqing. METHODS All patients diagnosed traumatic CSCI admitted to Xinqiao hospital from 2009 to 2018 were retrospectively reviewed. Data elements referred from the International SCI Core Data Set, included date of birth, date of injury, gender, etiology of injury, vertebral injury, associated injury, ventilatory assistance, and neurological status were collected. RESULTS A total of 503 patients with TCSCI met the criteria. The mean age of patients with TCSCI was 50.3 ± 13.9 years (15-85 years), and the male-to-female ratio was 4.7:1. Fall (67.2%) was the leading cause of injury, followed by transport (22.3%). The most common neurologic level of injury (NLI) was C5, accounting for 38.2%. The number of AIS D was the largest, accounting for 42%. CONCLUSIONS The results indicated that TCSCI occurred most frequently in the middle age and fall was the leading cause of injury. The number of patients with TCSCI was larger in male than in female. The most common NLI occurred in C5, and AIS D had the largest numbers.
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Li J, Li QP, Yang BH. Participatory continuous nursing using the WeChat platform for patients with spinal cord injuries. J Int Med Res 2021; 49:3000605211016145. [PMID: 34038208 PMCID: PMC8161871 DOI: 10.1177/03000605211016145] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective The study aim was to analyse the effect of participatory continuous nursing using the WeChat platform on the complications, family function and compliance of patients with spinal cord injuries. Methods This was a randomized controlled trial. Seventy-eight patients with stable disease treated by internal fixation were enrolled in the study from August 2017 to August 2019 and assigned equally to an observation group and a control group. The control group received regular care from the time of discharge. The observation group used the WeChat platform to participate in continuous care. Results Six months after discharge, the continuous nursing group had a significantly lower incidence of pressure ulcers, urinary tract infections, joint contractures and muscle atrophy than the control group. The continuous nursing group showed a significant improvement in family function level and compliance behaviour at 3 and 6 months after discharge. Conclusion A participation-based continuous nursing intervention using the WeChat platform can reduce the incidence of pressure ulcers, urinary tract infections, joint contracture and muscle atrophy; improve patient family function; and promote healthy compliance behaviour.
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Affiliation(s)
- Jing Li
- Department of Spine Surgery, Lishui Central Hospital, Lishui, China
| | - Qiao-Ping Li
- Department of Spine Surgery, Lishui Central Hospital, Lishui, China
| | - Bi-Hong Yang
- Department of Spine Surgery, Lishui Central Hospital, Lishui, China
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Lin J, Huang T, Gao T, Zheng X. [Experimental study of endothelial progenitor cells derived small extracellular vesicles for spinal cord injury repair in mice]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2021; 35:488-495. [PMID: 33855835 DOI: 10.7507/1002-1892.202009130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective To explore the potential therapeutic effects of endothelial progenitor cells derived small extracellular vesicles (EPCs-sEVs) on spinal cord injury in mice. Methods EPCs were separated from femur and tibia bone marrow of 20 C57BL/6 male mice, and identified by double fluorescence staining and flow cytometry. Then the EPCs were passaged and the cell supernatants from P2-P4 generations EPCs were collected; the EPCs-sEVs were extracted by ultracentrifugation and identified by transmission electron microscopy, nanoflow cytometry, and Western blot. Forty C57BL/6 female mice were randomly divided into 4 groups ( n=10). The mice were only removed T 10 lamina in sham group, and prepared T 10 spinal cord injury models in the model group and the low and high concentration intervention groups. After 30 minutes, 3 days, and 7 days of operation, the mice in low and high concentration intervention groups were injected with EPCs-sEVs at concentrations of 1×10 9 and 1×10 10cells/mL through the tail vein, respectively. The behavioral examinations [Basso Mouse Scale (BMS) score, inclined plate test, Von Frey test] , and the gross, HE staining, and immunohistochemical staining were performed to observe the structural changes of the spinal cord at 4 weeks after operation. Another 3 C57BL/6 female mice were taken to prepare T 10 spinal cord injury models, and DiR-labeled EPCs- sEVs were injected through the tail vein. After 30 minutes, in vivo imaging was used to observe whether the EPCs-sEVs reached the spinal cord injury site. Results After identification, EPCs and EPCs-sEVs derived from mouse bone marrow were successfully obtained. In vivo imaging of the spinal cord showed that EPCs-sEVs were recruited to the spinal cord injury site within 30 minutes after injection. There was no significant difference in BMS scores and the maximum angle of the inclined plate test between two intervention groups and the model group within 2 weeks after operation ( P>0.05), while both were significantly better than the model group ( P<0.05) after 2 weeks. The Von Frey test showed that the mechanical pain threshold of the two intervention groups were significantly higher than that of model group and lower than that of sham group ( P<0.05); there was no significant difference between two intervention groups ( P>0.05). Compared with the model group, the injured segment of the two intervention groups had smaller spinal cord tissue defects, less mononuclear cells infiltration, more obvious tissue structure recovery, and more angiogenesis, and these differences were significant ( P<0.05); there was no significant difference between the two intervention groups. Conclusion EPCs-sEVs can promote the repair of spinal cord injury in mice and provide a new plan for the biological treatment of spinal cord injury.
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Affiliation(s)
- Junqing Lin
- Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, 200233, P.R.China
| | - Tengli Huang
- Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, 200233, P.R.China
| | - Tao Gao
- Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, 200233, P.R.China
| | - Xianyou Zheng
- Department of Orthopedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, 200233, P.R.China
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Toluse AM, Adeyemi TO. Epidemiology and clinical outcomes of spinal cord injuries at a level II trauma centre in Nigeria: a longitudinal five year study. INTERNATIONAL ORTHOPAEDICS 2021; 45:665-671. [PMID: 33443597 DOI: 10.1007/s00264-020-04898-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 12/03/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Spinal cord injuries (SCIs) are devastating consequences of traumatic injuries with far-reaching health and socioeconomic implications. The objectives of this study were to describe the epidemiological characteristics of traumatic SCI and to analyse these epidemiological and clinical characteristics. METHODS This study was a retrospective observational study. We extracted data from the medical records of all cases of acute traumatic SCI that presented at the hospital between January 2013 and December 2017. RESULTS We recorded 99 cases of traumatic SCI over the study period. The patients' mean age was 37.15 ± 13.5 years with a male predominance (68.7%). Working age group accounted for 83.9% of cases. Motor vehicular accident (MVA) and falls accounted for 62.6% and 22.2% respectively. About a third of the cases (32.3%) presented within 24 hours of injury. The most frequently affected level was the cervical spine (63.6%), and complete tetraplegia was the most prevalent clinical pattern (31.3%). American Spinal Injury Association impairment scale (AIS) improved in 31.3% of cases. Twenty-nine patients (30.2%) had morbidity, with 21.2% developing pressure sores. Mortality accounted for 3%. CONCLUSIONS Motor vehicular crash and fall-related traumatic SCI affected mostly males and the working age group with complete tetraplegia as the predominating clinical pattern. There is a need for strategic interventions to reduce MVA and improve pre-hospital care and health policies to ensure early definitive care.
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Affiliation(s)
- Adetunji M Toluse
- Department of Orthopaedic and Trauma Surgery, National Orthopaedic Hospital, PMB 2009, Igbobi, Yaba, Lagos, Nigeria.
| | - Taofeek O Adeyemi
- Department of Orthopaedic and Trauma Surgery, National Orthopaedic Hospital, PMB 2009, Igbobi, Yaba, Lagos, Nigeria
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Xiong LL, Qin YX, Xiao QX, Jin Y, Al-Hawwas M, Ma Z, Wang YC, Belegu V, Zhou XF, Xue LL, Du RL, Liu J, Bai X, Wang TH. MicroRNA339 Targeting PDXK Improves Motor Dysfunction and Promotes Neurite Growth in the Remote Cortex Subjected to Spinal Cord Transection. Front Cell Dev Biol 2020; 8:577. [PMID: 32793586 PMCID: PMC7386314 DOI: 10.3389/fcell.2020.00577] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 06/15/2020] [Indexed: 02/05/2023] Open
Abstract
Spinal cord injury (SCI) is a fatal disease that can cause severe disability. Cortical reorganization subserved the recovery of spontaneous function after SCI, although the potential molecular mechanism in this remote control is largely unknown. Therefore, using proteomics analysis, RNA interference/overexpression, and CRISPR/Cas9 in vivo and in vitro, we analyzed how the molecular network functions in neurological improvement, especially in the recovery of motor function after spinal cord transection (SCT) via the remote regulation of cerebral cortex. We discovered that the overexpression of pyridoxal kinase (PDXK) in the motor cortex enhanced neuronal growth and survival and improved locomotor function in the hindlimb. In addition, PDXK was confirmed as a target of miR-339 but not miR-124. MiR-339 knockout (KO) significantly increased the neurite outgrowth and decreased cell apoptosis in cortical neurons. Moreover, miR-339 KO rats exhibited functional recovery indicated by improved Basso, Beattie, and Bresnehan (BBB) score. Furthermore, bioinformatics prediction showed that PDXK was associated with GAP43, a crucial molecule related to neurite growth and functional improvement. The current research therefore confirmed that miR-339 targeting PDXK facilitated neurological recovery in the motor cortex of SCT rats, and the underlying mechanism was associated with regulating GAP43 in the remote cortex of rats subjected to SCT. These findings may uncover a new understanding of remoting cortex control following SCI and provide a new therapeutic strategy for the recovery of SCI in future clinical trials.
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Affiliation(s)
- Liu-Lin Xiong
- Institute of Neurobiological Disease, Department of Anesthesiology, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China.,National Traditional Chinese Medicine Clinical Research Base and Western Medicine Translational Medicine Research Center, Department of Cardiac and Cerebral Diseases, Department of Anesthesiology, Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, China.,School of Pharmacy and Medical Sciences, Sansom Institute, Division of Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Yan-Xia Qin
- Department of Histology and Neurobiology, College of Preclinic and Forensic Medicine, Sichuan University, Chengdu, China
| | - Qiu-Xia Xiao
- National Traditional Chinese Medicine Clinical Research Base and Western Medicine Translational Medicine Research Center, Department of Cardiac and Cerebral Diseases, Department of Anesthesiology, Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, China
| | - Yuan Jin
- Animal Zoology Department, Institute of Neuroscience, Kunming Medical University, Kunming, China
| | - Mohammed Al-Hawwas
- School of Pharmacy and Medical Sciences, Sansom Institute, Division of Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Zheng Ma
- Animal Zoology Department, Institute of Neuroscience, Kunming Medical University, Kunming, China
| | - You-Cui Wang
- Institute of Neurobiological Disease, Department of Anesthesiology, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China
| | - Visar Belegu
- International Center for Spinal Cord Injury, Kennedy Krieger Institute, Baltimore, MD, United States.,Department of Neurology and Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Xin-Fu Zhou
- School of Pharmacy and Medical Sciences, Sansom Institute, Division of Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Lu-Lu Xue
- Animal Zoology Department, Institute of Neuroscience, Kunming Medical University, Kunming, China
| | - Ruo-Lan Du
- Institute of Neurobiological Disease, Department of Anesthesiology, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jia Liu
- Animal Zoology Department, Institute of Neuroscience, Kunming Medical University, Kunming, China
| | - Xue Bai
- National Traditional Chinese Medicine Clinical Research Base and Western Medicine Translational Medicine Research Center, Department of Cardiac and Cerebral Diseases, Department of Anesthesiology, Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, China
| | - Ting-Hua Wang
- Institute of Neurobiological Disease, Department of Anesthesiology, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China.,Animal Zoology Department, Institute of Neuroscience, Kunming Medical University, Kunming, China.,Department of Histology and Neurobiology, College of Preclinic and Forensic Medicine, Sichuan University, Chengdu, China
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Wang ZM, Zou P, Yang JS, Liu TT, Song LL, Lu Y, Guo H, Zhao YT, Liu TJ, Hao DJ. Epidemiological characteristics of spinal cord injury in Northwest China: a single hospital-based study. J Orthop Surg Res 2020; 15:214. [PMID: 32517761 PMCID: PMC7285705 DOI: 10.1186/s13018-020-01729-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 05/25/2020] [Indexed: 11/10/2022] Open
Abstract
Background While the cities in China in which spinal cord injury (SCI) studies have been conducted previously are at the forefront of medical care, northwest China is relatively underdeveloped economically, and the epidemiological characteristics of SCI have rarely been reported in this region. Methods The SCI epidemiological survey software developed was used to analyze the data of patients treated with SCI from 2014 to 2018. The sociodemographic characteristics of patients, including name, age, sex, and occupation, were recorded. The following medical record data, obtained from physical and radiographic examinations, were included in the study: data on the cause of injury, fracture location, associated injuries, and level of injury. Neurological function was evaluated using the American Spinal Injury Association (ASIA) impairment scale. In addition, the treatment and complications during hospitalization were documented. Results A total of 3487 patients with SCI with a mean age of 39.5 ± 11.2 years were identified in this study, and the male to female ratio was 2.57:1. The primary cause of SCI was falls (low falls 47.75%, high falls 37.31%), followed by traffic accidents (8.98%), and impact with falling objects (4.39%). Of all patients, 1786 patients (51.22%) had complications and other injuries. According to the ASIA impairment scale, the numbers of grade A, B, C, and D injuries were 747 (21.42%), 688 (19.73%), 618 (17.72%), and 1434 (41.12%), respectively. During the hospitalization period, a total of 1341 patients experienced complications, with a percentage of 38.46%. Among all complications, pulmonary infection was the most common (437, 32.59%), followed by hyponatremia (326, 24.31%), bedsores (219, 16.33%), urinary tract infection (168, 12.53%), deep venous thrombosis (157, 11.71%), and others (34, 2.53%). Notably, among 3487 patients with SCI, only 528 patients (15.14%) received long-term rehabilitation treatment. Conclusion The incidence of SCI in northwest China was on the rise with higher proportion in males; fall and the MCVs were the primary causes of SCI. The occupations most threatened by SCI are farmers and workers. The investigation and analysis of the epidemiological characteristics of SCI in respiratory complications are important factors leading to death after SCI, especially when the SCI occurs in the cervical spinal cord. Finally, the significance of SCI rehabilitation should be addressed.
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Affiliation(s)
- Zhi-Meng Wang
- Department of Spinal Surgery, Honghui Hospital, Xi'an Jiaotong University, No.76, Nanguo Road, Beilin District, Xi'an, 710054, Shaanxi, China.,Xi'an Medical University, Xi'an, Shaanxi, China.,Department of Orthopaedics and Trauma, Honghui Hospital, Xi'an Jiaotong University, No.76, Nanguo Road, Beilin District, Xi'an, 710054, Shaanxi, China
| | - Peng Zou
- Xi'an Medical University, Xi'an, Shaanxi, China
| | - Jun-Song Yang
- Department of Spinal Surgery, Honghui Hospital, Xi'an Jiaotong University, No.76, Nanguo Road, Beilin District, Xi'an, 710054, Shaanxi, China.
| | - Ting-Ting Liu
- Department of Pediatric, Northwest Women's and Children's Hospital, Xi'an, Shaanxi, China
| | | | - Yao Lu
- Department of Orthopaedics and Trauma, Honghui Hospital, Xi'an Jiaotong University, No.76, Nanguo Road, Beilin District, Xi'an, 710054, Shaanxi, China
| | - Hao Guo
- Department of Spinal Surgery, Honghui Hospital, Xi'an Jiaotong University, No.76, Nanguo Road, Beilin District, Xi'an, 710054, Shaanxi, China
| | - Yuan-Ting Zhao
- Department of Spinal Surgery, Honghui Hospital, Xi'an Jiaotong University, No.76, Nanguo Road, Beilin District, Xi'an, 710054, Shaanxi, China
| | - Tuan-Jiang Liu
- Department of Spinal Surgery, Honghui Hospital, Xi'an Jiaotong University, No.76, Nanguo Road, Beilin District, Xi'an, 710054, Shaanxi, China
| | - Ding-Jun Hao
- Department of Spinal Surgery, Honghui Hospital, Xi'an Jiaotong University, No.76, Nanguo Road, Beilin District, Xi'an, 710054, Shaanxi, China.
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Chang F, Zhang Q, Xie H, Yang Y, Sun M, Wu A, Wu J, Chen G, Shen F, Li C, Lu J. Effects of a rehabilitation program for individuals with chronic spinal cord injury in Shanghai, China. BMC Health Serv Res 2020; 20:298. [PMID: 32293434 PMCID: PMC7158161 DOI: 10.1186/s12913-020-05181-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 04/01/2020] [Indexed: 12/15/2022] Open
Abstract
Background Specialized Institution-Based Rehabilitation (SIBR) is the cornerstone of care and treatment for individuals with spinal cord injury, but most people with chronic spinal cord injury (CSCI) living in China have no SIBR experience after acute care hospital discharge. In 2009, an SIBR facility was set up in Shanghai (China) to fill this important gap in care. The purpose of the study was to evaluate the effectiveness of an integrated rehabilitation training program among individuals with CSCI living in Shanghai. Methods A within-subject pre-posttest design was used to evaluate the SIBR. The sample included 455 individuals ≥1 year post-SCI, who were older than 18 years of age and were enrolled in a rehabilitation center in Shanghai, China, between 2013 and 2019. The data included individuals’ sociodemographic and injury characteristics, and twenty-three indicators were used as outcome measurements to evaluate basic life skills and their applications in family and social life. Multivariate linear regression was conducted to determine which factors might have influenced the effectiveness of the SIBR. Results All basic life skills and their applications in family and social life were improved, but with variations across socio-demographics. Female individuals with CSCI had better outcomes in basic life skills than did males. In terms of basic life skills and their applications in family and social life, individuals with a low level (thoracic or lumbosacral) of injury achieved more significant functional gains than those with a higher level (cervical). The baseline score was also a relevant factor in functional outcome. Conclusions Even for individuals with a long SCI history, SIBR training can improve basic life skills and the applications of those skills in family and social life settings.
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Affiliation(s)
- Fengshui Chang
- China Research Center on Disability, School of Public Health, Fudan University, Shanghai, China
| | - Qi Zhang
- School of Community and Environmental Health, Old Dominion University, Norfolk, VA, USA
| | - Haixia Xie
- Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Shanghai, China
| | - Yuhui Yang
- China Research Center on Disability, School of Public Health, Fudan University, Shanghai, China
| | - Mei Sun
- China Research Center on Disability, School of Public Health, Fudan University, Shanghai, China
| | - Airong Wu
- Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Shanghai, China
| | - Jinghua Wu
- Shanghai Disabled Persons' Federation, Shanghai, China
| | - Gang Chen
- China Research Center on Disability, School of Public Health, Fudan University, Shanghai, China
| | - Feng Shen
- Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Shanghai, China
| | - Chengyue Li
- China Research Center on Disability, School of Public Health, Fudan University, Shanghai, China
| | - Jun Lu
- China Research Center on Disability, School of Public Health, Fudan University, Shanghai, China.
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15
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The effects of two periods of rehabilitation for people with spinal cord injury from Shanghai, China. Spinal Cord 2019; 58:216-223. [PMID: 31477810 DOI: 10.1038/s41393-019-0349-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 08/21/2019] [Accepted: 08/21/2019] [Indexed: 01/05/2023]
Abstract
STUDY DESIGN Retrospective cohort study. OBJECTIVES To evaluate the effects of two periods of rehabilitation among people with spinal cord injury (SCI). SETTING Shanghai Sunshine Rehabilitation Center (SSRC), China. METHODS A total of 130 people with SCI who received two periods of rehabilitation participated in the study. Outcome measures included basic life skills (15 items) and their applications in family and social life (8 items). Six factors were identified from the 23 items by factor analysis: self-care and transfer skills; basic life skills application in social life; cognition and emotion; basic life skills application in family life; walking and climbing stairs; and wheelchair skills. Standardized scores ranging from 0 to 100 were used to show the rehabilitation outcome in a histogram. RESULTS Median scores for self-care and transfer skills, wheelchair skills, cognition and emotion, and their applications in family and social life improved significantly (7-80%, p < 0.01) over the first rehabilitation period, while no improvement was observed in walking and climbing stairs. Five factors showed a significant sustained effect (p < 0.01) upon admission to the second rehabilitation period, except walking and climbing stairs. By enrolling in the second period of rehabilitation, participants acquired significant additional improvement (5-43%, p < 0.01) in rehabilitation outcomes, except in cognition and emotion, walking and climbing stairs. CONCLUSIONS Two periods of rehabilitation were efficacious at increasing the abilities of basic life skills and their applications in family and social life. The potential benefits of continuous rehabilitation merit further research.
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Somatosensory evoked potential changes and decompression timing for spinal cord function recovery and evoked potentials in rats with spinal cord injury. Brain Res Bull 2019; 146:7-11. [DOI: 10.1016/j.brainresbull.2018.12.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 12/01/2018] [Accepted: 12/07/2018] [Indexed: 12/27/2022]
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17
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Ageing, Disability, and Spinal Cord Injury: Some Issues of Analysis. Curr Gerontol Geriatr Res 2018; 2018:4017858. [PMID: 30581466 PMCID: PMC6276527 DOI: 10.1155/2018/4017858] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 11/06/2018] [Indexed: 01/10/2023] Open
Abstract
Spinal cord injury is a disabling disorder, worldwide spread, with important consequences on functioning and health conditions and impacts on physical, psychological, and social well-being. The consequences are related to the lesion itself and to other complications related to the lesion. In the last decades, there have been an increasing of the mean ages of onset and also an increase in life expectancy after the lesion. So, differently from the past, people with spinal cord injury can age after the lesion. Taking into account the need to share data and information about specific disabling conditions and their relationship with ageing, this paper aims to discuss some issues from recent literature on the relationship between aging and disability in the spinal cord injury, according to a narrative review approach. A narrative review of the literature on ageing and spinal cord injury was undertaken. Search was based on the following electronic databases: PubMed/Medline and Ovid/PsychINFO. A combination of the following keywords was used: (1) “ageing” or “aging” and (2) “spinal cord injury” or “spinal cord lesion” and (3) disability. Data on consequences of the lesion in the life of aging people, secondary health conditions, life expectancy, participation, and quality of life are discussed. Then, a brief discussion of clinical issues and the role of interventions aimed to promote wellbeing, health, quality of life, and participation of people with spinal cord injury is proposed.
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Yuan S, Shi Z, Cao F, Li J, Feng S. Epidemiological Features of Spinal Cord Injury in China: A Systematic Review. Front Neurol 2018; 9:683. [PMID: 30186222 PMCID: PMC6113592 DOI: 10.3389/fneur.2018.00683] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 07/30/2018] [Indexed: 12/19/2022] Open
Abstract
Background: Spinal cord injury (SCI) is a severe condition that disrupts patients' physiological, mental, and social well-being state and exerts great financial burden on patients, their families and social healthcare system. This review intends to compile studies regarding epidemiological features of SCI in China. Methods: Searches were conducted on PubMed, EMBASE, Web of Science and Cochrane Library for relevant studies published through January, 2018. Studies reported methodological and epidemiological data were collected by two authors independently. Results: Seventeen studies met the inclusion criteria. Two studies reported incidence of SCI that is 60.6 in Beijing (2002) and 23.7 in Tianjin (2004–2008). All studies showed male had a larger percentage in SCI compared to female except Taiwan (2000–2003). The average male and female ratio was 3–4:1 in China and the highest male and female ratio was 5.74: 1 in Tianjin (2004–2007). Farmers, laborers and unemployed people accounted for more than half of the SCI patients in China. Fall was the primary causation with exception of Heilongjiang (2009–2013), Beijing (2001–2010), and Taiwan (2002–2003), where motor vehicle collision (MCVs) was the leading causation. Pulmonary infection, urinary tract infection and bedsore were common complications, accounting for approximately 70% of SCI patients in China. Conclusion: This review shows that epidemiological features of SCI are various in different regions in China and prevention should be implemented by regions. The number of patients with SCI result from fall and MCVs may become a main public health problem because population aging and economic developing in China. However, because all included studies were retrospective and lacking a register system in China, some data were incomplete and some cases may be left out, so the conclusion may not be generalizable to the other regions.
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Affiliation(s)
- Shiyang Yuan
- Department of Orthopaedics, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhongju Shi
- Department of Orthopaedics, Tianjin Medical University General Hospital, Tianjin, China.,F.M. Kirby Neurobiology Center, Boston Children's Hospital and Department of Neurology, Harvard Medical School, Boston, MA, United States
| | - Fujiang Cao
- Department of Orthopaedics, Tianjin Medical University General Hospital, Tianjin, China
| | - Jiahe Li
- Department of Orthopaedics, Tianjin Medical University General Hospital, Tianjin, China
| | - Shiqing Feng
- Department of Orthopaedics, Tianjin Medical University General Hospital, Tianjin, China
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