Introduction: Spinal cord infarction (SCI) or ischemia is a rare but devastating complication of venoarterial extracorporeal membrane oxygenation (VA ECMO). The natural course and outcomes are poorly studied.
Methods: We completed a literature review on ischemic spinal cord injury in patients on VA ECMO and analyzed the published case reports and case series with individual patient characteristics. We also added 3 previously unpublished cases from our own experience.
Results: The final sample included 30 adult patients on VA ECMO for cardiogenic shock secondary to various etiologies. The mean age was 47.7 ± 17.8 years with equal distribution between men and woman. The total duration on ECMO ranged from 3 to 47 days with a median of 10 days. In all patients, ECMO was placed peripherally via an arterial cannula in the femoral artery. All 30 patients developed either paraplegia (27/90%) or weakness (3/10%) of both lower extremities. Magnetic resonance imaging of the spine was consistent with infarction in 88.5% and ischemia in the rest. On follow-up, there were no cases of complete recovery. Partial recovery with significant limitations of mobility was noted in half of them. The remaining half had no signs of neurological recovery. Survival to discharge was reported in 24 cases. Of these cases, 17/70.8% survived and 7/29.2% died.
Conclusion: Spinal infarction/ischemia on VA ECMO typically presents with paraplegia of lower extremities with low potential for even partial recovery. Because no treatment is currently available, the efforts should be focused on prevention. Several strategies have been proposed, but they need further testing under controlled settings.
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http://dx.doi.org/10.1053/j.jvca.2024.10.041 | DOI Listing |
J Med Case Rep
December 2024
Department of Neurosurgery, The First Affiliated Hospital of Henan University of Science and Technology, 24 JingHua Road, Luoyang, 471000, Henan, China.
Background: Spinal schwannomas presenting with an intraspinal hematoma or subarachnoid hemorrhage are extremely rare, and patients often have severe spinal cord compression symptoms. However, the mechanism underlying the bleeding remains unclear.
Case Presentation: We present the case of a 53-year-old Chinese female diagnosed with a T12 schwannoma accompanied by an intratumoral hematoma.
BMC Surg
December 2024
Department of Spine Surgery, Tianjin Union Medical Center, Tianjin, 300121, China.
Background: The best open side for unilateral open-door laminoplasty (UODL) to treat inconsistent cervical ossification of the posterior longitudinal ligament (OPLL) needs to be identified.
Methods: Thirty-one individuals with inconsistent OPLL who underwent UODL between January 2016 and December 2018 were retrospectively divided into two groups: when the side of the open door was consistent with the side of the larger ossification occupancy area, patients were placed in the Consistent group; when the side of the open door was contralateral to the side of the larger ossification occupancy area, patients were placed in the Contralateral group. The following parameters were evaluated: neck disability index (NDI) score, Japanese Orthopaedic Association (JOA) score, visual analog scale (VAS) score, postoperative laminoplasty opening width and angle, and spinal cord diameter ratio.
Clin Neurol Neurosurg
December 2024
Case Western Reserve University School of Medicine, Cleveland, OH, United States; Department of Neurological Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, United States. Electronic address:
Background: Degenerative cervical myelopathy is one of the most common causes of spinal cord dysfunction. Cervical laminoplasty is an excellent surgical procedure that address the underlying pathology along with motion preservation with various advantages over other surgical options. While the advantages are intuitive and are being proven in multiple recent studies, concerns regarding failure still remains precluding wider utilization despite evidence to the contrary.
View Article and Find Full Text PDFHealth Place
December 2024
Center for Outcomes and Assessment Research, Kessler Foundation, 1199 Pleasant Valley Way, West Orange, NJ, 07052, USA; Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, 183 South Orange Avenue- Suite F-1560, Newark, NJ, 07101, USA.
Exposure to nature is associated with better mental health in the general population, but prior evidence suggests that people living with severe, chronic mobility impairment from paralysis due to spinal cord injury (SCI) may not experience similar benefits. Since many people living with SCI use wheelchairs and other medical devices for mobility, further exploration of how people living with mobility disability experience greenspace is needed to achieve equity in access to all public places. We assessed experiences with accessing greenspace reported in a sample of people living with chronic SCI and the meanings they ascribe to these experiences for their health and quality of life.
View Article and Find Full Text PDFTissue Cell
December 2024
Department of Medical Laboratory, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia.
Traumatic spinal cord injury (TSCI) is a serious medical issue where there is a loss of sensorimotor function. Current interventions continue to lack the ability to successfully enhance these conditions, therefore, it is crucial to consider alternative effective strategies. Currently, we investigated the effects of fibrin scaffold encapsulated with epigallocatechin gallate (EGCG) microspheres in the recovery of SCI in rats.
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