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Clinical Advances in Spinal Cord Injury
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Clinical Advances in Spinal Cord Injury

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: closed (1 December 2024) | Viewed by 2713

Special Issue Editor

Dr. Masao Koda

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Guest Editor
Department of Orthopaedic Surgery, University of Tsukuba, Tsukuba, Japan
Interests: neck pain; cervical spine disorders; diagnosis; management; spine surgery; total disc replacement (TDR); novel rehabilitation strategy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In recent years, there has been a significant transformation in treatment approaches for spinal cord injury (SCI). The application of regenerative medicine and/or novel drugs to SCI in clinics had been reported by various experts. The effectiveness of early decompression surgery is becoming increasingly apparent and more widespread. Additionally, several new diagnostic and therapeutic approaches for SCI have been reported, including the application of AI as a prognostic prediction method, novel imaging modalities and innovative rehabilitation tools showing potential effectiveness to promote functional recovery in SCI patients.

In this Special Issue, we aim to summarize these recent advancements and try to provide insights into prospects and directions to move in.

Dr. Masao Koda
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • spinal cord injury
  • decompression surgery
  • fusion surgery
  • regenerative medicine

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Published Papers (3 papers)

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Research

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10 pages, 205 KiB  
Article
On-Line Survey About Autonomic Dysreflexia in Individuals with Spinal Cord Injury in Croatia
by Dean Markić, Željka Minić, Josip Šimičić, Karin Kuljanić, Josip Strčić, David Bonifačić, Ivan Marin Sušanj, Ante Jakšić, Helena Sveško Visentin, Robert Ehrman and Marin Marinović
J. Clin. Med. 2025, 14(3), 670; https://doi.org/10.3390/jcm14030670 - 21 Jan 2025
Viewed by 432
Abstract
Background/Objectives: Autonomic dysreflexia (AD) is a clinical syndrome affecting persons with spinal cord injury (SCI). The aim of the study was to present the experience of individuals with SCI and AD in Croatia. Single-center questionnaire study. Setting: Faculty of Medicine, University of Rijeka, [...] Read more.
Background/Objectives: Autonomic dysreflexia (AD) is a clinical syndrome affecting persons with spinal cord injury (SCI). The aim of the study was to present the experience of individuals with SCI and AD in Croatia. Single-center questionnaire study. Setting: Faculty of Medicine, University of Rijeka, Rijeka, Croatia. Persons with SCI were divided into those with an SCI at T6 and above (n = 41) and those with an SCI at T7 and below (n = 29). Based on anamnestic data, patients with an SCI at T6 and above were further divided into those with and without self-reported clinical symptoms of AD (respectively: n = 33 and n = 8). Methods: The online survey included 23 questions of various types. It consisted of a general (demographic) section, section with specific questions about AD, and a section on self-assessment and quality of life. Based on the answers, the experience and knowledge of AD among individuals with an SCI in Croatia was assessed. Results: A total of 70 individuals with an SCI completed the whole survey. The average age was 40.6 years. The patients were predominantly male (72.9%) and mostly with a traumatic SCI (84.3%). Of the 70 individuals with an SCI, 35 (50%) reported they were familiar with AD, with the majority indicating that the internet was their primary source of information. Among those with an SCI who were unaware of AD, most (34/35 = 97.1%) wanted to learn about AD. The self-assessed quality of life was insignificantly better in patients with an SCI below T6 than in those with higher lesions. Patients with AD reported different symptoms and the most frequently reported symptom was a headache (70%). In 64% of participants, the primary trigger of AD were issues with the urinary bladder. In most individuals (55%), symptoms were not recognized by the healthcare providers. The individuals with AD were dissatisfied with the information about AD they received from doctors or nurses. Overall, 61% of all participants with AD rated their quality of life as good. Conclusions: Persons with an SCI are not adequately informed about AD. In most persons with AD, their symptoms are not properly recognized by healthcare providers. Our results suggest the need for more education of healthcare professionals about AD. Full article
(This article belongs to the Special Issue Clinical Advances in Spinal Cord Injury)
12 pages, 1202 KiB  
Article
The Impact of Diffuse Idiopathic Skeletal Hyperostosis on Nutritional Status, Neurological Outcome, and Perioperative Complications in Patients with Cervical Spinal Cord Injury
by Tomoaki Shimizu, Kota Suda, Satoko Matsumoto Harmon, Miki Komatsu, Masahiro Ota, Hiroki Ushirozako, Akio Minami, Masahiko Takahata, Norimasa Iwasaki, Hiroshi Takahashi and Masashi Yamazaki
J. Clin. Med. 2023, 12(17), 5714; https://doi.org/10.3390/jcm12175714 - 1 Sep 2023
Viewed by 1218
Abstract
This retrospective study aimed to investigate the characteristics of patients with cervical spinal cord injuries (CSCI) with diffuse idiopathic skeletal hyperostosis (DISH). We included 153 consecutive patients with CSCI who underwent posterior decompression and fusion surgery. The patients were divided into two groups [...] Read more.
This retrospective study aimed to investigate the characteristics of patients with cervical spinal cord injuries (CSCI) with diffuse idiopathic skeletal hyperostosis (DISH). We included 153 consecutive patients with CSCI who underwent posterior decompression and fusion surgery. The patients were divided into two groups based on the presence of DISH. Patient characteristics, neurological status on admission, nutritional status, perioperative laboratory variables, complications, neurological outcomes at discharge, and medical costs were compared between the groups. The DISH group (n = 24) had significantly older patients (72.1 vs. 65.9, p = 0.036), more patients with low-impact trauma (62.5% vs. 34.1%, p = 0.009), and a lower preoperative prognostic nutritional index on admission (39.8 vs. 42.5, p = 0.014) than the non-DISH group (n =129). Patients with DISH had significantly higher rates of ventilator management (16.7% vs. 3.1%, p = 0.022) and pneumonia (29.2% vs. 8.5%, p = 0.010). There was no significant difference in medical costs and neurological outcomes on discharge. Patients with CSCI and DISH were older, had poor nutritional status, and were prone to postoperative respiratory complications, while no differences were found between the neurological outcomes of patients with CSCI with and without DISH. Full article
(This article belongs to the Special Issue Clinical Advances in Spinal Cord Injury)
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Review

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14 pages, 243 KiB  
Review
Vasopressor Use in Acute Spinal Cord Injury: Current Evidence and Clinical Implications
by Mazen Taman, Hael Abdulrazeq, Carlin Chuck, Rahul A. Sastry, Rohaid Ali, Clark C. Chen, Athar N. Malik, Patricia Leigh Zadnik Sullivan, Adetokunbo Oyelese, Ziya L. Gokaslan and Jared S. Fridley
J. Clin. Med. 2025, 14(3), 902; https://doi.org/10.3390/jcm14030902 - 29 Jan 2025
Viewed by 529
Abstract
Acute spinal cord injury (SCI) often results in severe neurologic deficits, with hemodynamic instability contributing to secondary ischemic damage. Beyond surgical decompression, maintaining adequate mean arterial pressure (MAP) is key to enhancing spinal cord perfusion and oxygenation. Vasopressor therapy is frequently used to [...] Read more.
Acute spinal cord injury (SCI) often results in severe neurologic deficits, with hemodynamic instability contributing to secondary ischemic damage. Beyond surgical decompression, maintaining adequate mean arterial pressure (MAP) is key to enhancing spinal cord perfusion and oxygenation. Vasopressor therapy is frequently used to achieve hemodynamic stability, but optimal MAP targets and vasopressor selection remain controversial. This review explores updated guidelines and current evidence regarding MAP management and the use of vasopressors in SCI, focusing on their impact on spinal cord perfusion and neurologic outcomes. Recent studies highlight the role of durotomy in directly improving spinal cord perfusion pressure (SCPP) by reducing intraspinal pressure (ISP), offering a complementary mechanical intervention as part of pharmacologic therapies. Recent guidelines suggest an MAP range of 75–80 mmHg as a lower limit and 90–95 mmHg as an upper limit for 3–7 days post-injury, highlighting the need for personalized hemodynamic management. Norepinephrine is commonly preferred due to its balanced effects on peripheral vascular resistance and spinal cord perfusion pressure (SCPP), though dopamine, phenylephrine, and dobutamine each offer unique hemodynamic profiles suited to specific clinical scenarios. Despite their benefits, vasopressors carry significant risks, including arrhythmias and potential myocardial strain, necessitating careful selection based on individual patient factors. Further research is needed to refine vasopressor use and establish evidence-based protocols that optimize neurologic recovery, alongside continued exploration of SCPP as a potential therapeutic target. Full article
(This article belongs to the Special Issue Clinical Advances in Spinal Cord Injury)
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