The effect of surgically implanted metallic bullet fragments on the intervertebral disc using a canine model☆.

Purpose: To characterize the gross, histologic, and systemic changes caused by implantation of metal fragments commonly used in commercial bullets into the intervertebral disc.

Background Context: Long-term complications of retained bullet fragments in the spine have been documented in the literature; however, the impact of different metal projectiles on the intervertebral disc has not been described. This study was performed to assess the local effects of the metallic bullet fragments on the intervertebral disc and their systemic effects regarding metal ion concentrations in serum and solid organs.

Hypothermia in patients with chronic spinal cord injury.

Design: Retrospective analysis of medical records.

Background/objectives: To determine frequency and degree of hypothermic episodes in patients with chronic spinal cord injury (SCI).

Setting: Veterans Administration Medical Center.

Thromboprophylaxis in medical and surgical patients undergoing physical medicine and rehabilitation: consensus recommendations.

Venous thromboembolism (deep venous thrombosis with or without its major complication, pulmonary embolism) commonly occurs in patients undergoing rehabilitative therapy for various surgical or traumatic conditions and in patients with incapacitating medical illnesses. Thromboprophylaxis utilizes medications that interfere with the coagulation process and mechanical measures such as graded elastic stockings and intermittent pneumatic compression. To obtain a range of expert opinion on the optimal use of the numerous antithrombotic modalities now available, a consortium comprising clinical directors at a number of rehabilitative centers in south Florida met to review the literature on thromboprophylaxis in rehabilitation patients and to discuss the strategies followed at their respective facilities.

C-reactive protein and erythrocyte sedimentation rate in patients with heterotopic ossification after spinal cord injury.

Background/objective: Formation of heterotopic ossification (HO) in soft tissue after spinal cord injury (SCI) is associated with various degrees of inflammation. Recent studies have shown that inhibition of inflammatory reaction with nonsteroidal anti-inflammatory drugs is an effective prevention of HO after SCI. The goal of this study was to monitor the activity of the most widely used indicators of acute inflammation--namely, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)--in patients with HO.

Prevention and treatment of heterotopic ossification after spinal cord injury.

Background/objectives: Heterotopic ossification (HO) is a frequent, irreversible complication after spinal cord injury (SCI). The objective of this article is to explain the etiology of HO; present new advances in prevention, diagnosis, and management of this complication; and provide a suggested algorithm for clinical management.

Etiology: Although still hypothetical, trauma and overexpression of bone morphogenic protein(s) in traumatized soft tissue appear to play important roles as initiating factors of HO.