Spinal Cord Injury
- 1st Edition, Volume 109 - November 21, 2012
- Latest edition
- Editors: Joost Verhaagen, John W. McDonald
- Language: English
Handbook of Clinical Neurology: Spinal Cord Injury summarizes advances in the clinical diagnosis, monitoring, prognostication, treatment, and management of spinal cord injuries.… Read more
Handbook of Clinical Neurology: Spinal Cord Injury summarizes advances in the clinical diagnosis, monitoring, prognostication, treatment, and management of spinal cord injuries. More specifically, it looks at new and important developments in areas such as high-resolution noninvasive neuroimaging, surgery, and electrical stimulation of motor, respiratory, bladder, bowel, and sexual functions. It also reviews the latest insights into spontaneous regeneration and recovery of function following rehabilitation, with emphasis on novel therapeutic strategies, such as gene therapy, transcranial stimulation, brain-machine interfaces, pharmacological approaches, molecular target discovery, and the use of olfactory ensheathing cells, stem cells, and precursor cells.
Organized in five sections, the book begins with an overview of the development, maturation, biomechanics, and anatomy of the spinal cord before proceeding with a discussion of clinical diagnosis and prognosis as well as natural recovery, ambulation, and function following spinal cord injury. It then examines clinical neurophysiology in the prognosis and monitoring of traumatic spinal cord injury; medical, surgical and rehabilitative management of spinal cord trauma; and some new approaches for improving recovery in patients, including restoration of function by electrical stimulation, locomotor training, and the use of robotics. Other chapters cover cell transplantation, artificial scaffolds, experimental pharmacological interventions, and molecular and combinatorial strategies for repairing the injured spinal cord. This volume should be of interest to neuroscience and clinical neurology research specialists and practicing neurologists.
- Comprehensive coverage of the latest scientific understanding of spinal cord injuries
- Detailed coverage of current treatment best practices and potential future treatments
- Connects leading edge research programs to future treatment opportunities
Neuroscience and Clinical Neurology research specialists and practicing neurologists
Handbook of Clinical Neurology 3rd Series
Foreword
Preface
List of contributors
Chapter 1. Development and maturation of the spinal cord
Gross embryology
Cellular and molecular embryology of the spine
Spinal cord maldevelopment
Conclusion
References
Chapter 2. Anatomy and biomechanics of the spinal column and cord
Introduction
Biomechanics: the basic concepts
Biomechanics of spinal column failure
Biomechanics of spinal cord injury
Conclusions
References
Chapter 3. Clinical diagnosis and prognosis following spinal cord injury
Introduction
Assessing injury severity following spinal cord injury
Natural recovery following traumatic spinal cord injury
Ambulation and function following spinal cord injury
The role of imaging for prognosis and functional recovery
References
Chapter 4. Clinical neurophysiology in the prognosis and monitoring of traumatic spinal cord injury
Introduction
Evaluation of sensory function
Evaluation of motor function
Autonomic evaluation
Conclusions
References
Chapter 5. Concepts of aging with paralysis
Introduction
Pathophysiology of the aging nervous system
Etiology and clinical presentation of spinal cord injury in elderly subjects
Complications and mortality
Influence of age on outcome and length of stay for rehabilitation
Aging following a spinal cord injury
References
Chapter 6. Advanced MRI strategies for assessing spinal cord injury
Introduction
Assessment of macromolecular composition, tissue orientation, and organization
Functional and metabolic markers for tissue health
What to do when the therapeutic intervention requires placement of metal hardware for stabilization
Final comments – sensitivity/specificity
Conclusion
References
Glossary of acronyms and abbreviations
Chapter 7. Advances in the management of spinal cord and spinal column injuries
Epidemiology
Initial Management and Evaluation
Neurological Examination
Imaging
Classifications of Injuries to the Spine
Medical Management of Spinal Cord Injuries
Pharmacological Adjuncts in Spinal Cord Injury: Nascis and Sygen® Studies
Surgical Management of Spinal Cord and Spinal Column Injuries
Surgical Treatment of Spinal Cord Injuries
Surgical Treatment of Spinal Column Injuries
Advances in Surgical Treatment of Spinal Cord and Spinal Column Injury
Conclusion
References
Chapter 8. Spinal cord injuries in children and adolescents
Epidemiology
Pathophysiology
Medical issues
Psychosocial issues and sexuality
Surgical
Summary
References
Chapter 9. The changing landscape of spinal cord injury
Methylprednisolone trials during acute spinal cord injury
Early spinal decompression and stabilization
Spinal cord injury-related complications
Pulmonary dysfunction
Autonomic nervous system disruption
Venous Thrombosis And Thromboembolism
Hypercalcemia After Spinal Cord Injury
Bone Loss
Heterotopic Ossification
Pressure Ulcers
Conclusion
References
Chapter 10. Surgical treatments to restore function control in spinal cord injury
Introduction
Spinal cord lesions and implications for reconstruction
Desirable patterns of hand usage
Example objectives for hand and upper limb reconstruction
Reconstructive procedures
Management of contracture
Contracture release and osteotomy examples
Surgical restoration of function
Functions to restore
Concepts in surgical restoration
Shoulder function
Elbow function
Forearm function (rotation)
Lateral pinch (key pinch)
Palmar grasp and release
Two-staged hand reconstruction
Current clinical and research trends
Evaluation of clinical outcome
Conclusions
References
Chapter 11. Advances in the rehabilitation management of acute spinal cord injury
Introduction
Trauma rehabilitation
Cardiovascular and pulmonary assessment and management
Musculoskeletal sequelae and treatment
Early management of pain
Bladder, bowel, and sexual function
Mobilization and functional training
Adaptive technology
Adjustment and support to the patient and family in the acute phase
References
Chapter 12. Spasticity
Introduction
Clinical signs: passive condition
Nonfunctional movement: active muscle
Functional movement: walking
Therapeutic consequences
Specific treatment approaches
Conclusions
References
Chapter 13. Disordered cardiovascular control after spinal cord injury
Overview of the clinical problem: from the acute to the chronic phases
Pathophysiology of cardiovascular dysfunction after spinal cord injury
Characteristics and causes of orthostatic hypotension after spinal cord injury
Causes and characteristics of autonomic dysreflexia
Cardiovascular control during sexual activity after spinal cord injury
Cardiovascular responses to exercise after spinal cord injury
New recognition of the need for autonomic evaluations following spinal cord injury
References
Chapter 14. New concepts in the prevention of pressure sores
Introduction
Assessing risk factors before pressure sores develop
Devices to prevent pressure sores
Clinical care to prevent pressure sores
Summary
References
Further reading
Chapter 15. Functional electrical stimulation for bladder, bowel, and sexual function
Introduction
Physiological principles
Clinical practice
Combined control of voiding and continence
Future prospects for restoring full control of bladder, bowel, and sexual function
References
Chapter 16. Evidence-based therapy for recovery of function after spinal cord injury
Physical rehabilitation
Locomotor training
Locomotor training using robotic assistance
Functional electrical stimulation during walking in individuals with spinal cord injury
Summary
References
Chapter 17. Functional electrical stimulation
Introduction
Indications
Surgical techniques
Weaning from the ventilator with a pacer: key points
Results
Conclusion
References
Chapter 18. Spinal cord stimulation
General introduction
Epidural electrical spinal cord stimulation
Intraspinal microstimulation
Summary
Acknowledgments
References
Chapter 19. Promoting optimal functioning in spinal cord injury
Introduction
Key principles and models in psychological care of persons with spinal cord injury
Areas of clinical focus
Assessment
Psychological intervention
Implications for neurologists and rehabilitation professionals
References
Chapter 20. The changing field of rehabilitation
Introduction
Activity
Activity-based restoration therapies
Future directions
References
Chapter 21. The longitudinal spinal cord injury
Introduction
Experimental injuries
Clinical injury
Comments
References
Chapter 22. Post-traumatic syringomyelia
Introduction and clinical manifestations
Theories and pathogenesis
Diagnosis
Treatment
Conclusion
References
Chapter 23. Post-traumatic deformity
Introduction
Epidemiology
Patient presentation
Surgical considerations
Outcome
Pediatric deformities
Conclusion
References
Chapter 24. Spinal cord injury clinical trials translational process, review of past and proposed acute trials with reference to recommended trial guidelines
Goals for therapeutic interventions after spinal cord injury
Preclinical discovery and translational process
Spinal cord injury clinical trial process
Past spinal cord injury clinical trials
Lessons learned from previous spinal cord injury trials
Current early phase spinal cord injury trials
General principles for the conduct of valid clinical trials
Concluding remarks
References
Chapter 25. Translating preclinical approaches into human application
Introduction
Regeneration-inducing treatments
Appropriateness of animal spinal cord injury models
Combined damage of peripheral nervous system
Neuronal dysfunction in chronic complete spinal cord injury
What is needed for the future?
References
Chapter 26. Translational spinal cord injury research
Introduction
The translational path
Overview of core translational spinal cord injury research guidelines
Basic preclinical experimental design: guideline considerations
Special design considerations for acute/subacute preclinical spinal cord injury studies
Subacute/chronic injury experimental design issues
Preclinical guidelines and clinical trials past and present
Summary and conclusions
References
Chapter 27. Brain–machine interfaces and transcranial stimulation
Introduction
Cortical brain–machine interfaces
Magnetoencephalography
Transcranial magnetic stimulation
Discussion
References
Chapter 28. Approaches to repairing the damaged spinal cord: overview
Introduction
Targets for repair
Enhancing spontaneous regeneration
Neuroprotection strategies
Gene therapy
Bridges and barriers
Replacing cells
Remyelination
Axonal regeneration
Toward the future
References
Chapter 29. Limiting spinal cord injury by pharmacological intervention
Introduction
Pathophysiology of spinal cord injury
Biochemical changes
Neuroprotective agents
Conclusions
References
Chapter 30. Harmful and beneficial effects of inflammation after spinal cord injury
Introduction
Inflammatory response after spinal cord injury
Harmful and beneficial effects of inflammation
Immunomodulatory drugs for treatment of spinal cord injury
Conclusions
References
Chapter 31. Defeating inhibition of regeneration by scar and myelin components
Introduction
Inhibitory molecules in the central nervous system, and methods to overcome them
Stimulation of long tract axon regeneration
Recovery of function through plasticity
Combinatorial treatments and future prospects
References
Chapter 32. Realizing the maximum potential of Schwann cells to promote recovery from spinal cord injury
Background
Schwann Cells Diminish Cavitation Following Contusion Injury
Schwann Cells Promote Regeneration of Sensory and Propriospinal Axons Following Complete Transection
Schwann Cells Require Additional Interventions to Promote Supraspinal Axon Regeneration and for Axons to Exit the Graft and Re-Enter the Spinal Cord Following Complete Transection
Spinal and Sensory Axons Also Enter Schwann Cell Implants in the Contusion Model
Schwann Cells Require Additional Interventions to Promote Brainstem Axon Growth and for Axons to Exit the Graft and Re-Enter the Spinal Cord Following Contusion Injury
Schwann Cells Myelinate Graft Axons and Remyelinate Denuded Axons
Polysialylated Neural Cell Adhesion Molecule-Engineered Schwann Cells Promote More Repair Than Control Schwann Cells
Schwann Cell Survival Following Implantation Needs Improvement
Olfactory Ensheathing Cells May Aid Schwann Cells in Repairing the Injured Spinal Cord
An Olfactory Ensheathing Cell-Secreted Protein Improves Schwann Cell Function
Immature or Undifferentiated Schwann Cells May be More Effective in Spinal Cord Repair Than Adult-Derived Schwann Cells
Schwann Cells Migrate Into and Within the Glial-Deficient Central Nervous System
Schwann Cells Migrate and Promote Axon Growth in the Minimally Injured Central Nervous System
Autologous Human Schwann Cell Transplantation is Anticipated
Autologous Human Schwann Cells are Currently in Clinical Trial
Summary
References
Chapter 33. Repair of central nervous system lesions by transplantation of olfactory ensheathing cells
Introduction
Properties of olfactory ensheathing cells
Prospects for autologous transplantation of olfactory ensheathing cells as a clinical therapy
References
Chapter 34. Cell transplantation
Introduction
Stem cells for spinal cord injury repair
Stem cells grafts for neuronal replacement
Stem cell grafts to replace oligodendrocytes
Stem cell grafts to enhance axonal regeneration
Stem cell grafts to engender host tissue repair
Conclusions
References
Chapter 35. Gene therapy, neurotrophic factors and spinal cord regeneration
Introduction
Cell and tissue transplantation for axonal regeneration
Ex vivo growth factor gene delivery
Axonal bridging across a spinal cord lesion site
Combinatorial treatments to enhance axonal regeneration
Axonal sprouting, regeneration and functional recovery
Neurotrophic factor gene transfer and axonal regeneration in the chronically injured spinal cord
Conclusions
Acknowledgments
References
Chapter 36. Scaffolds to promote spinal cord regeneration
When are scaffolds necessary and when could they be used?
Types of scaffold used in spinal cord injury models
Biocompatibility of scaffolds and integration with host spinal cord tissue
Strategies to promote sustained axonal regeneration within scaffolds
Axonal guidance, oriented growth and myelination
Exit of axons from scaffolds and the re-establishment of functional connections
Assessment of effectiveness of scaffolds after spinal cord injury
Some requirements for an effective design strategy
References
Chapter 37. Molecular target discovery for neural repair in the functional genomics era
Introduction
Gene expression profiling studies
Future directions
Conclusion
Acknowledgement
References
Chapter 38. Combination therapies
Will combination therapies be necessary to repair the spinal cord?
Single treatments with multiple outcomes
Combinations of treatments
Rehabilitation in combination therapies
Combination therapies: considerations
Summary and conclusions
References
Index
- Edition: 1
- Latest edition
- Volume: 109
- Published: November 21, 2012
- Language: English
JV
Joost Verhaagen
Affiliations and expertise
Laboratory for Neuroregeneration, Netherlands Institute for Neuroscience, Amsterdam, The NetherlandsJM
John W. McDonald
Affiliations and expertise
Executive Vice President and Director, The International Center for Spinal Cord Injury, Baltimore, MD, USARead Spinal Cord Injury on ScienceDirect