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Cover of Spinal Cord Medicine

Spinal Cord Medicine

Principles and Practice

Vernon W Lin, MD, PhD, Editor-In-Chief; Associate Editors: Diana D Cardenas, MD, MHA, Nancy C Cutter, MD, PT, Frederick S Frost, MD, Margaret C Hammond, MD, Laurie B Lindblom, MD, Inder Perkash, MD, FACS, FRCS, Robert Waters, MD, and Robert M Woolsey, MD.

New York: Demos Medical Publishing; .
ISBN-10: 1-888799-61-7


Spinal Cord Medicine consists of 74 chapters in 10 sections. It begins with a review of anatomy and physiology, spinal cord imaging, and epidemiology, and is followed by a comprehensive discussion of acute spinal cord injury management that covers prehospital management, emergency room evaluation and intensive care, and considerations relating to spine surgery. This is followed by sections that cover various aspects of medical management, and the management of bladder, bowel, and sexual dysfunctions. A section on the neurologic aspects of spinal cord care considers topics that include the neurologic assessment of SCI, electrophysiologic evaluation of the spinal tracts, myelopathies, multiple sclerosis, spasticity and pain management, autonomic dysfunction, and concomitant SCI and traumatic brain injury. The musculoskeletal care section addresses overuse injuries, osteoporosis and long bone fractures, and interdisciplinary approaches to upper extremity and pressure ulcer management. The rehabilitation section covers wheelchair and seating assessment, orthotics, activity of daily living training, vocational and driving training, and functional electrical stimulation. This is followed by discussions of recent advances in spinal cord research, including functional magnetic stimulation, spinal cord regeneration and repair strategies, and body weight supported ambulation. Special topics on aging, women’s issues, pediatric care, and SCI prevention are also reviewed. The final section considers psychosocial issues, cost of care, SCI systems of care, and various supportive environments for SCI and SCD care.


  • Contributors
  • Preface
    Vernon W Lin, M.D., Ph.D.
  • Dedication
  • Foreword
    Robert M Woolsey, M.D.
  • I. Introduction
    • 1. History of Spinal Cord Medicine
      Ibrahim M Eltorai, M.D.
      • Ancient Egypt
      • Ancient India
      • Ancient Greece
      • Ancient Rome
      • The Middle Ages (700–1400 A.D.)
      • The Early Renaissance
      • The Later Renaissance
      • Seventeenth and Eighteenth Centuries
      • Nineteenth Century
      • Twentieth Century
      • Surgery
      • Rehabilitation
      • Education
      • Spinal Cord Regeneration
      • Spinal Shock
      • Autonomic Dysreflexia
      • Heterotopic Ossification
      • Urodynamics
      • Pharmacotherapy
      • Pressure Ulcers
      • Conclusion
      • References
    • 2. Anatomy and Function of the Spinal Cord
      Harry G Goshgarian, Ph.D.
      • Gross Anatomy
      • Neuroanatomic Organization of the Spinal Gray and White Matter
      • Blood Supply of the Spinal Cord
      • References
    • 3. Imaging of the Spinal Cord
      Roland R Lee, M.D. and Blaine L Hart, M.D.
      • Spinal Imaging Techniques
      • Fast-Scanning Techniques: Rationale
      • Congenital Abnormalities
      • Degenerative Disease and Postoperative Spinal Imaging
      • Inflammation and Demyelination
      • Spinal Infections
      • Vascular Lesions and Ischemia
      • Spinal Tumors
      • Technique
      • References
    • 4. Epidemiology of Spinal Cord Injury
      Michael J DeVivo, Dr.P.H.
      • Overall Incidence
      • Risk Factors
      • Etiology of Injury
      • Prevalence
      • Conclusion
      • References
    • 5. Outcomes Following Spinal Cord Injury
      Ien Sie, M.S., P.T. and Robert L Waters, M.D.
      • Motor Recovery
      • Functional Recovery
      • Conclusion
      • References
  • II. Acute Spinal Cord Injury Management and Surgical Considerations
    • 6. Prehospital Management of Spinal Cord Injured Patients
      William Whetstone, M.D.
      • Evaluation
      • Resuscitation
      • Immobilization
      • Extrication and Transportation
      • References
    • 7. Acute Medical Management of Spinal Cord Injury
      Cristina Barboi, M.D. and William T Peruzzi, M.D.
      • Vertebral Column Stabilization
      • Pharmacologic Management of Spine Injuries
      • Corticosteroid Therapy
      • Axonal Regeneration
      • Minimizing the Secondary Injury
      • Airway Management
      • Respiratory Management
      • Cardiovascular Resuscitation
      • Acute Fluid and Electrolyte Disturbances
      • Gastrointestinal Care
      • Bladder Care
      • Skin Care
      • Deep Venous Thrombosis: Prevention and Treatment
      • Conclusion
      • References
    • 8. Factors Affecting Surgical Decision Making
      Patrick J Connolly, M.D.
      • Patient Evaluation
      • General Principles of Treatment
      • Imaging
      • Mechanism of Injury and Stability of the Fracture
      • Classification of Spinal Cord Injury
      • Spinal Cord Injury
      • Pharmacologic Treatment of Spinal Cord Injury
      • Role of Anaterior Decompression
      • Timing of Surgery
      • Gunshot Wounds
      • Pathologic Bone
      • Conclusion
      • References
      • Bibliography
    • 9. Cervical Injuries: Indications and Options for Surgery
      Christopher M Bono, M.D., Michael J Vives, M.D., and Christopher P. Kauffman, M.D.
      • Preoperative Evaluation
      • Spinal Stability
      • Surgical Treatment Options
      • Specific Injuries
      • Postoperative Care
      • Complications
      • Conclusion
      • References
    • 10. Surgical Management for Thoracolumbar Spinal Injuries
      Paul E Savas, M.D. and Alexander R Vaccaro, M.D.
      • Clinical Evaluation
      • Radiographic Evaluation
      • Spinal Anatomy
      • Spinal Stability
      • Nonoperative Treatment
      • Operative Treatment
      • Indications and Operative Techniques for Thoracolumbar Injuries
      • Conclusion
      • References
  • III. Medical Management
    • 11. Respiratory Dysfunction in Spinal Cord Disorders
      Catherine S.H Sassoon, M.D. and Ahmet Baydur, M.D., F.A.C.P., F.C.C.P.
      • Pathophysiology
      • Management of Respiratory Complications
      • References
    • 12. Sleep Disorders in Spinal Cord Injury
      Lawrence J Epstein, M.D. and Robert Brown, M.D.
      • Normal Sleep
      • Sleep Patterns in SCI
      • Sleep Disorders in SCI
      • Conclusion
      • References
    • 13. Cardiovascular Dysfunction in Spinal Cord Disorders
      Sunil Sabharwal, M.D.
      • Low Baseline Blood Pressure
      • Orthostatic Hypotension
      • Bradycardia and Cardiac Arrest
      • Autonomic Dysreflexia
      • Reduced Cardiovascular Fitness and Altered Exercise Capacity
      • Coronary Heart Disease
      • Venous Thromboembolism
      • Peripheral Arterial Disease
      • Drug-Related Cardiovascular Adverse Effects
      • References
    • 14. Thromboembolism in Spinal Cord Disorders
      David Chen, M.D.
      • Pathophysiology and Risk Factors
      • Clinical Presentation and Diagnostic Modalities
      • Treatment and Management of Thromboembolism
      • Preventive Management of Thromboembolism
      • References
    • 15. Infection and Spinal Cord Injury
      Rabih O Darouiche, M.D.
      • Urinary Tract Infection (UTI)
      • Infections of Soft Tissue and Underlying Bone
      • Respiratory Tract Infections
      • References
    • 16. Thermoregulation in the SCI Patient
      Thomas C Cesario, M.D. and Rabih O Darouiche, M.D.
      • Mechanics of Temperature Regulation in Normal Individuals
      • Temperature Regulation in Spinal Cord Disease
      • Fever in Spinal Cord Disease
      • References
    • 17. The Immune System and Inflammatory Response in Persons with SCI
      Frederick S Frost, M.D. and Lily C Pien, M.D.
      • Inflammatory and Immunologic Responses in the Normal Host
      • The Inflammatory and Immune Response after SCI
      • References
    • 18. 18 Endocrine and Metabolic Consequences of Spinal Cord Injuries
      James K Schmitt, M.D. and Diane L Schroeder, M.D.
      • Effects of Sympathetic Denervation
      • The Spectrum of Endocrine Abnormalities after SCI
      • Pituitary Disorders
      • Thyroid Disorders
      • Sick Euthyroid Syndrome
      • Adrenocortical Hormones
      • Adrenal Medulla
      • Diabetes Mellitus
      • Hypoglycemia
      • Reactive Hypoglycemia
      • Lipid Disorders
      • Reproductive Function in Spinal Cord Injury Patients
      • Conclusion
      • Acknowledgments
      • References
    • 19. Primary Care for Persons with Spinal Cord Injury
      James K Schmitt, M.D., Jennifer James, M.D., Meena Midha, M.D., Brent Armstrong, M.D., and John McGurl, M.D.
      • Primary Care of SCI Patients Vs. Ambulatory Patients
      • Periodic Evaluation of the Spinal Cord Injury Patient
      • Pulmonary Evaluation
      • Cardiovascular Disorders
      • Hypertension
      • Laboratory Values
      • Diabetes Mellitus
      • Depression
      • Colorectal Cancer Screening
      • Genitourinary System
      • Substance Abuse
      • Women's Health Issues
      • Nutritional Evaluation
      • Pain
      • Spasticity
      • Musculosketal Disorders
      • Prevention of Accidents and Violence
      • Conclusion
      • References
    • 20. Spinal Cord Injury: The Role of Pharmacokinetics in Optimizing Drug Therapy
      J. Steven Richardson, Ph.D. and Jack L Segal, M.D., F.A.C.P.
      • Pharmacotherapy
      • Pharmacokinetic Changes Induced by Spinal Cord Injury
      • Pharmacokinetics and Pharmacotherapy in Two Common Clinical Problems in SCI Patients
      • Conclusion
      • References
  • IV. Management of the Bladder, Bowel, and Sexual Dysfunction
    • 21. Normal and Abnormal Micturition
      John Wheeler, M.D.
      • Basic Neurourology
      • Neurourologic Evaluation
      • Neurourologic Treatment
      • Conclusion
      • References
    • 22. Renal Insufficiency in Patients with Spinal Cord Injury
      Cyril H Barton, M.D. and N.D. Vaziri, M.D., M.A.C.P.
      • Acute Renal Failure (ARF)
      • Acute Interstitial Nephritis (AIN) and Hypersensitivity Vasculitis
      • Crystalluria, Tubular Obstruction, and ARF
      • Chronic Renal Insufficiency
      • Conclusion
      • References
    • 23. Urologic Management in Spinal Cord Injury
      Donald R Bodner, M.D. and Inder Perkash, M.D.
      • Neurologic Control of Micturition
      • Changes with Spinal Cord Injury
      • Urologic Evaluation
      • Bladder Management
      • Pharmacologic Management of the Neurogenic Bladder
      • Autonomic Dysreflexia
      • Conclusion
      • References
    • 24. Urolithiasis in Spinal Cord Disorders
      Daniel Culkin, M.D. and Michael V Binins, M.D.
      • History of Urolithiasis in SCI Population
      • Natural History and Epidemiology
      • Risk Factors
      • Etiologies of Stone Formation
      • Morphology and Location
      • Clinical Presentation
      • Diagnosis
      • Treatment
      • Pharmacologic Therapy
      • Conclusion
      • References
    • 25. The Gastrointestinal System after Spinal Cord Injury
      Steven A Stiens, M.D., M.S., Noel R Fajardo, M.D., and Mark A Korsten, M.D.
      • Gastrointestinal Dysfunction: Symptoms, Impairments, Activity Limitations, and Barriers to Participation
      • Oral Cavity: Tartar, Caries and Occlusion Problems
      • The Esophagus: Reflux
      • Stomach and Duodenum: Incomplete Emptying and Peptic Ulcer Disease
      • The Pancreas: Increased Risk for Pancreatitis
      • The Gallbladder: Stasis and Increased Stone Incidence
      • The Ileum and Jejunum: Ileus Adynamic
      • The Colon: Fecal Storage, Desiccation, and Elimination
      • Acknowledgments
      • References
    • 26. Sexual Dysfunction and Infertility in Men with Spinal Cord Disorders
      Stacy Elliott, M.D.
      • Overview of Changes in Male Sexual Function Following SCI
      • Sexual Neurophysiology of the Able-Bodied Male
      • Erection
      • Presentation and Evaluation of Sexual Concerns
      • Therapeutic Options for Male Sexual Dysfunctions
      • Fertility Following Spinal Cord Injury
      • Conclusion
      • Acknowledgments
      • References
  • V. Neurologic Aspects of Spinal Cord Care
    • 27. Neurologic Assessment of Spinal Cord Dysfunction
      Ralph Marino, M.D., M.S.
      • Purpose of Neurologic Assessment
      • Elements of Neurologic Assessment
      • Classification of Impairment: The 2000 Standards
      • Rapid Neurologic Assessment
      • Conclusion
      • References
    • 28. The Electrodiagnostic Examination in Spinal Cord Disorders
      Asa J Wilbourn, M.D.
      • Anatomy
      • Spinal Cord Disorders
      • The Electrodiagnostic Examination
      • Pathophysiology
      • Limitations of the Electrodiagnostic Examination
      • Advantages of the Electrodiagnostic Examination
      • Some Specific Spinal Cord Disorders
      • Conclusion
      • References
    • 29. Electrophysiologic Evaluation of the Spinal Tracts
      Mark A Lissens, M.D., Ph.D.
      • Somatosensory Evoked Potentials
      • Motor Evoked Potentials
      • References
    • 30. Acute Nontraumatic Myelopathies
      Robert M Woolsey, M.D. and David S Martin, M.D.
      • The Neurologic Manifestations of Spinal Cord Disease
      • Spinal Cord and Cauda Equina Syndromes
      • Diagnostic Procedures to Evaluate Spinal Cord Disease
      • Relapsing-Remitting Spinal Multiple Sclerosis
      • Spinal Cord Infarction
      • Intraspinal Hemorrhage
      • Decompression Sickness
      • Acute Transverse Myelitis
      • Intervertebral Disk Herniation
      • Spinal Epidural Absces
      • Simulated Paraplegia
      • References
    • 31. Chronic Nontraumatic Myelopathies
      Robert M Woolsey, M.D. and David S Martin, M.D.
      • Amyotrophic Lateral Sclerosis
      • Post-Polio Syndrome
      • Hereditary Spastic Paraplegia
      • Primary Lateral Sclerosis
      • HTLV-I Myelopathy
      • Myelopathy Induced by Electric Shock
      • Spondylolytic Compression of the Spinal Cord or Cauda Equina
      • Rheumatoid Arthritis of the Cervical Spine
      • Subacute Combined Degeneration
      • Friedrich’s Ataxia
      • Vacuolar Myelopathy
      • Vascular Malformations of the Spinal Cord
      • Primary Progressive Spinal Multiple Sclerosis
      • Arachnoiditis
      • Syringomyelia
      • Spinal Epidural Tumors
      • Intradural Extramedullary Tumors
      • Intramedullary Tumors
      • Radiation Myelopathy
      • References
    • 32. Multiple Sclerosis
      Jack Burks, M.D., G. Kim Bigley, M.D., and Haydon Hill, M.D.
      • Pathogenesis
      • Demographics and Risk Factors for Acquiring Multiple Sclerosis
      • Diagnosis of Multiple Sclerosis
      • Multiple Sclerosis Disease Courses
      • Immune Modulation Therapy
      • Experimental Therapy
      • Rehabilitation and Symptom Management
      • Comparing Multiple Sclerosis and Spinal Cord Injury Issues
      • Conclusion
      • References
    • 33. Pain Management in Persons with Spinal Cord Disorders
      Thomas N Bryce, M.D. and Kristjan T Ragnarsson, M.D.
      • Clinical Presentation
      • SCI Above-Level Nociceptive Pain
      • SCI Above-Level Neuropathic Pain
      • SCI At-Level Nociceptive Pain
      • SCI At-Level Neuropathic Pain
      • SCI Below-Level Nociceptive Pain
      • SCI Below-Level Neuropathic Pain
      • Neurobiology of Neuropathic Pain after SCI
      • Treatment
      • Nonpharmacologic and Nonpsychologic Interventions
      • Psychologic Interventions
      • Conclusion
      • References
    • 34. Management of Spasticity
      Patricia W Nance, M.D., F.R.C.P.C.
      • Etiology
      • Assessment
      • Pathophysiology of Spasticity
      • Goals of Treatment
      • Physical Modalities
      • Pharmacologic Treatments
      • Conclusions
      • Acknowledgments
      • References
    • 35. Autonomic Dysfunction in Spinal Cord Disease
      Brenda Mallory, M.D.
      • Anatomy of the Autonomic Nervous System
      • Spinal Cord Reflex Organization of the ANS
      • Autonomic Pharmacology
      • Cardiovascular Dysfunction in SCI
      • Hypotension
      • Renin-Angiotensin System and AVP
      • Autonomic Hyperreflexia
      • Treatment of Autonomic Hyperreflexia
      • Disorders of Micturition in SCI
      • Male Sexual Dysfunction in SCI
      • Female Sexual Dysfunction
      • Gastrointestinal Dysfunction in SCI
      • Upper Gastrointestinal Dysfunction
      • Pulmonary Dysfunction
      • Thermoregulatory Dysfunction
      • References
    • 36. Syringomyelia
      James W Little, M.D., Ph.D.
      • Posttraumatic Syringomyelia
      • Chiari Malformation Causing Syringomyelia
      • Conclusions
      • References
    • 37. Dual Diagnosis: Spinal Cord Injury and Brain Injury
      Ziyad Ayyoub, M.D., Fatima Badawi, M.A., C.C.C., S.L.P., Ann T Vasile, M.D., Deborah Arzaga, R.N., Amy Cassedy, M.D., and Vance Shaw, R.N.
      • Risk Factors for Concomitant Spinal Cord Injury and Brain Injury
      • Biomechanics of Dual Injury
      • Degrees of Brain Injury
      • Pathophysiology
      • Acute Interventions
      • Medical Complications
      • Cognitive Symptoms and Behavioral Problems of Brain Injury and Interventions
      • Rehabilitation of the Patient with Dual TBI and SCI
      • Pharmacologic Consideration
      • Outcomes
      • Conclusion
      • References
  • VI. Musculoskeletal Care
    • 38. Musculoskeletal Pain and Overuse Injuries
      Michael L Boninger, M.D., Rory A Cooper, Ph.D., Brian Fay, M.S., and Alicia Koontz, M.S.
      • Alternative Diagnoses
      • Shoulder Injuries
      • Elbow Injuries
      • Wrist Injuries
      • Musculoskeletal Back and Neck Problems
      • Treatment and Prevention of Musculoskeletal Injuries in SCI
      • Prevention
      • References
    • 39. Management of Long Bone Fractures
      Douglas Garland, M.D. and Leslie Shokes, M.D.
      • Fracture in Acute Spinal Cord Injury
      • Fractures in Chronic SCI (Pathologic Fractures)
      • Upper Extremity
      • Conclusion
      • References
    • 40. Bone Loss and Osteoporosis Following Spinal Cord Injury
      Beatrice Jenny Kiratli, Ph.D.
      • Changes in Bone Mass and Structure
      • Long Bone Fractures—Occurrence And Risk Factors
      • Therapeutic Interventions
      • Conclusion
      • References
    • 41. Functional Restoration of the Upper Extremity in Tetraplegia
      Vincent R Hentz, M.D. and Timothy R McAdams, M.D.
      • Historical Perspective
      • The Shoulder in the Tetraplegic Patient
      • Classification of the Tetraplegic Upper Extremity
      • Forming a Team
      • Palo Alto Experience
      • General Guidelines for Reconstruction
      • Orthoses
      • Surgical Reconstruction
      • Functional Neuromuscular Stimulation
      • Results and Conclusions
      • References
    • 42. The Medical Management of Pressure Ulcers
      Michael M Priebe, M.D., Melayne Martin, R.N., C.W.O.C.N., Lisa Ann Wuermser, M.D., Teodoro Castillo, M.D., and Jackie McFarlin, R.N., M.P.H.
      • Incidence and Prevalence
      • Pathophysiology
      • Normal Wound Healing
      • Principles of Pressure Ulcer Management
      • Adjunctive Treatment for Pressure Ulcers
      • A Brief Primer on Support Surfaces
      • Conclusions
      • References
    • 43. The Surgical Management of Pressure Ulcers
      Robert E Montroy, M.D., F.A.C.S. and Ibrahim Eltorai, M.D.
      • The Pressure Ulcer Dilemma
      • Factors in Cost Escalation
      • To Do Or Not To Do
      • The Pressure Ulcer as a Wound
      • Classification of Pressure Sore Severity
      • Complications of Pressure Sore Neglect
      • Indications for Intervention
      • Indications for Surgical Intervention
      • Basic Surgical Principles
      • The Evolution of Pressure Ulcer Surgical Principles
      • When a Gap, Swing a Flap
      • Postoperative Complications
      • Postoperative Care and Ambulation
      • Conclusions
      • References
    • 44. Heterotopic Ossification
      Robert Montroy, M.D., F.A.C.S.
      • The Genesis of Heterotopic Bone Formation
      • The Pathogenesis of Heterotopic Bone Formation
      • The Clinical Pathologic Process
      • The Benefits of Early Diagnosis
      • Prevention and Treatment
      • Conclusion
      • References
    • 45. Cardiovascular Fitness after Spinal Cord Injury
      Mark S Nash, Ph.D., F.A.C.S.M.
      • Altered Central and Peripheral Circulatory Functions after SCI
      • Exercise Reconditioning of the Circulatory System
      • Bipedal Ambulation Using Electrical Stimulation
      • Arm Endurance Training
      • Arm Resistance Exercise
      • Unique Exercise Complications and Caveats
      • Conclusions
      • References
  • VII. Rehabilitation
    • 46. Wheelchairs and Seating
      Rory A Cooper, Ph.D., Michael L Boninger, M.D., Rosemarie Cooper, M.P.T., P.T., and Tricia Thorman, M.O.T., O.T.R.
      • Manual Wheelchairs
      • The Wheelchair–User Interface
      • Electric Powered Wheelchairs
      • Robotic Wheeled Mobility Systems
      • Selection of Electric Powered Mobility
      • Access Devices
      • Wheelchair and Seating Measurement
      • Cushions
      • Seating Bases
      • Postural Supports
      • References
    • 47. Spinal Orthoses
      Ed Ayyappa, M.S., C.P.O. and Kelly Downs, B.S.
      • Emergency Spinal Trauma
      • Indicators for Mechanisms of Action
      • Terminology
      • CO Soft Collar
      • CO Plastic or Universal Collar
      • CO Philadelphia and Rigid Collars
      • Cervical Thoracic Orthosis
      • SOMI
      • Thoracolumabar Immobilization
      • Lumbar Orthoses
      • Conclusion
      • References
    • 48. Upper Limb Orthoses
      Michal Atkins, M.A., O.T.R., Darrell Clark, C.O., and Robert Waters, M.D.
      • Historic Background
      • Current Trends, Philosophy and Principles
      • Evaluation and Treatment Planning
      • Orthotic Design Principles by Functional Level
      • Orthotic Fitting
      • Patient Education and Training
      • Conclusion
      • Glossary
      • References
    • 49. Lower Limb Orthoses and Rehabilitation
      Ann Yamane.
      • Nomenclature
      • Patient Evaluation
      • Goals for AFO Intervention
      • Biomechanical Controls for AFOS
      • AFO Designs
      • Goals for KAFO Intervention
      • Biomechanical Controls for KAFOS
      • KAFO Designs
      • Reciprocating Gait Orthoses
      • Clinical Situations
      • Conclusion
      • References
    • 50. Activities of Daily Living
      Catherine LeViseur, O.T.R. and Sherry Sonka-Maarek, M.D.
      • Personal Independence Potential
      • Personal Independence Based on Other Factors
      • Challenges
      • Basic Self-Care
      • Instrumental Activities of Daily Living
      • Conclusion
      • References
    • 51. Recreation and Leisure Skills for People with Spinal Cord Disorders
      Jo Lemons, T.R. and Nancy C Cutter, M.D., P.T.
      • The Role of the Recreation Therapist and the Recreation Therapy Program
      • Conclusion
      • References
    • 52. Vocational Rehabilitation
      Kurt L Johnson, Ph.D.
      • Key Legislation
      • The Profession of Rehabilitation Counseling
      • The Vocational Rehabilitation Process
      • Vocational Rehabilitation Systems
      • Key Disability Benefit Systems
      • Conclusion
      • References
      • Bibliography
      • Additional Information
    • 53. Driving with a Spinal Cord Disorder
      Norman F Simoes, M.S.I.E. and Laurie Lindblom, M.D.
      • Physical Requirements
      • Adaptive Equipment
      • Driving Programs
      • Preparation for Driving
      • Wheelchair Selection
      • Conclusion
      • References
    • 54. Functional Electrical Stimulation
      Peter H Gorman, M.D.
      • Mechanism of FES Activation
      • Components of FES Systems
      • General Selection Criteria for FES Systems in SCI
      • Contraindications
      • FES Applications in Spinal Cord Dysfunction
      • Conclusion
      • References
  • VIII. Recent Advances in Spinal Cord Research
    • 55. Functional Magnetic Stimulation
      Vernon Lin, M.D., Ph.D. and Ian Hsiao, Ph.D.
      • Nerve Activation by Magnetic Stimulation
      • Magnetic Stimulator
      • Magnetic Coil
      • Clinical Applications in Patients with SCI
      • Transcranial Magnetic Stimulation
      • Safety Considerations
      • Conclusion
      • References
    • 56. Mechanisms and Natural History of Spinal Cord Injury
      Sandra K Kostyk, M.D., Ph.D., Phillip G Popovich, Ph.D., and Bradford T Stokes, Ph.D.
      • The Mechanism of Injury: Mechanics and Anatomic Relationships in SCI
      • Neuropathology of Human Spinal Cord Injuries
      • The Wound Healing Response of the Injured Spinal Cord
      • Chronic SCI
      • Conclusion
      • Acknowledgments
      • References
    • 57. Acute Treatment Strategies for Spinal Cord Injury
      Edward D Hall, Ph.D.
      • Secondary Injury: The Importance of Oxygen Radical Lipid Peroxidation
      • Protective Effects of the Lipid Peroxidation Inhibitor Alpha Tocopherol in Experimental SCI
      • High-Dose Methylprednisolone Therapy in Experimental Sci: Efficacy and Mechanisms
      • High-Dose Methylprednisolone Efficacy in NASCIS II
      • Duplication of Methylprednisolone's Antioxidant Effects with a Non-Glucocorticoid Steroid: Discovery of Tirilazad Mesylate
      • Comparison of 24- and 48-Hour Methylprednisolone and Tirilazad in NASCIS III
      • Future Approaches to Acute Pharmacotherapy of SCI
      • Conclusion
      • References
    • 58. Recent Advances in Neural Regeneration
      Hans S Keirstead, Ph.D. and Oswald Steward, Ph.D.
      • Effects of Injury
      • Regenerative Plasticity
      • Axonal Regeneration
      • Conclusion
      • References
    • 59. Spinal Cord Repair Strategies
      Henrich Cheng, M.D., Ph.D. and Yu-Shang Lee, M.S.
      • Pathologic Changes of Spinal Cord after Injury
      • Unfavorable Aspects for Regeneration in the Injured Mammalian Spinal Cord
      • Functional Recovery in a Patient with SCI
      • Strategy to Rescue Neurons from Death
      • Strategy to Replace Nerve Cells after Neuronal Death
      • Strategy to Reconnect and Recover Normal Function in Neural Pathways
      • Conclusion
      • References
    • 60. Retraining the Human Spinal Cord
      V. Reggie Edgerton, Ph.D., Susan J Harkema, Ph.D., and Bruce H Dobkin, M.D.
      • General Concepts: Control of Standing and Stepping
      • Sensory Information Monitored and Processed by the Spinal Cord
      • Central Pattern Generation
      • Is the Spinal Cord Smart?
      • Can the Spinal Cord Learn?
      • Plasticity of Interactions between the Spinal and Supraspinal Control Systems
      • Pharmacologic Interventions Following SCI
      • Rehabilitation Goals in Treating Skeletal Muscles
      • Rehabilitative Strategies for Ambulation
      • Conclusion
      • Acknowledgments
      • References
  • IX. Special Topics in Spinal Cord Medicine
    • 61. Spinal Cord Injury and Aging
      Susan Charlifue, M.A. and Daniel Lammertse, M.A.
      • Aging Theory
      • The Genitourinary System
      • The Gastrointestinal System
      • The Integument
      • The Nervous System
      • The Musculoskeletal System
      • The Immune System
      • Psychosocial Aspects of SCI and Aging
      • Looking to the Future
      • References
    • 62. Women’s Health Challenges after Spinal Cord Injury
      Amie Jackson, M.D.
      • Reproductive System
      • Gynecological Issues after SCI
      • Pregnancy
      • Sexual Function
      • Urologic Management
      • Menopausal Issues
      • Psychosocial Issues and Wellness
      • Conclusion
      • References
    • 63. Spinal Cord Disorders in Children and Adolescents
      Lawrence C Vogel, M.D., Randal R Betz, M.D., and Mary Jane Mulcahey, M.S., O.T.R./L.
      • Spinal Cord Injuries
      • Neural-Tube Defects
      • Lipomeningocele
      • Sacral Agenesis
      • References
    • 64. The Prevention of Spinal Cord Injury
      Russ Fine, Ph.D., M.S.P.H., Wendy Sykes-Horn, M.P.H., and Katherine Terry, M.P.H.
      • Injury Prevention and Control: A Frame of Reference for SCI Workers
      • The Science of Prevention
      • Costs of Spinal Cord Injury
      • Etiologically Driven Prevention Programs
      • Prevention-Oriented Programs for SCIS Resulting from Falls
      • The Case for Prevention
      • Prevention Efforts, Needs Assessment, Data Gathering
      • SCI Prevention Program Directory Update
      • Conclusion
      • Appendix: State Injury Prevention Programs
      • References
  • X. Psychosocial Issues and Support Environment
    • 65. Psychosocial Factors in Spinal Cord Injury
      Robert A Moverman, Ph.D.
      • Premorbid Psychologic Issues
      • Issues in the Rehab Phase
      • Issues in the Post-Rehab Phase
      • Psychotherapeutic Interventions
      • Conclusion
      • References
    • 66. Social Issues in Spinal Cord Injury
      Helen T Bosshart, A.C.S.W./L.C.S.W.
      • Family Relationships
      • Financial Issues
      • Productivity
      • Socioeconomic Status and Cultural Issues
      • Personal Assistance Services (PAS)
      • Community Reintegration
      • Quality of Life
      • Conclusion
      • References
    • 67. The Costs of Spinal Cord Injury
      Monroe Berkowitz, Ph.D.
      • Data Sources
      • Methodology
      • First-Year Costs
      • Annual Medical Care Costs
      • Medication and Supplies
      • Home Modifications
      • Vehicle Modifications
      • Wheelchairs
      • Personal Assistance
      • Indirect Costs
      • Conclusion
      • References
    • 68. Model Spinal Cord Injury Systems of Care
      Michael J DeVivo, Dr.P.H.
      • Mission
      • Model System Requirements
      • Collaborative Research
      • Organizational Structure
      • Conclusion
      • References
    • 69. VA Spinal Cord Injury System of Care
      Margaret C Hammond, M.D.
      • Mission
      • Structure
    • 70. Consortium for Spinal Cord Medicine Clinical Practice Guidelines
      Dawn M Sexton, Kenneth C Parsons, M.D., and J. Paul Thomas.
      • History
      • Clinical Practice Guidelines
      • Consortium Guideline Development Process
      • Consortium Successes
      • New Initiatives
      • Conclusion
      • References
    • 71. Subspecialty Certification in Spinal Cord Injury Medicine
      Margaret C Hammond, M.D.
    • 72. CARF: The Rehabilitation Accreditation Commission
      Peggy S Neale, M.A., M.B.A.
      • Accreditation and Quality
      • Spinal Cord Injury Standards
      • The CARF Survey Process
      • Conclusion
      • References
    • 73. Architectural Considerations for Improving Access
      Ian Hsiao, Ph.D. and Thomas Hodne, A.I.A.
      • Background
      • Operating Environment for Mobility Aids
      • Outdoor Environments and Accessibility
      • Indoor Accessibility
      • Kitchens and Bathrooms
      • Entrances and Garages
      • Conclusion
      • References
    • 74. Health Industry and Product Information
      Pamela E Wilson, M.D. and Gerald H Clayton, Ph.D.
      • Scientific Journals
      • General Information
      • Adaptive Technology Resources
      • Organizations Whose Goal Is to Provide Support and Education for SCI Individuals and/or Fund SCI-Directed Research

By agreement with the publisher, this book is accessible by the search feature, but cannot be browsed.

Copyright © 2003, Demos Medical Publishing, Inc.
Bookshelf ID: NBK8850


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