Home > Search Results

Results: 1 to 20 of 60

Steroids for acute spinal cord injury

Every year, about 40 million people worldwide suffer a spinal cord injury. Most of them are young men. The results are often devastating. Various drugs have been given to patients in attempts to reduce the extent of permanent paralysis. Steroids have probably been used more for this purpose than any other type of drug. The review looked for studies that examined the effectiveness of this treatment in improving movement and reducing the death rate. Nearly all the research, seven trials, has involved just one steroid, methylprednisolone. The results show that treatment with this steroid does improve movement but it must start soon after the injury has happened, within no more than eight hours. It should be continued for 24 to 48 hours. Different dose rates of the drug have been given and the so‐called high‐dose rate is the most effective. The treatment does not, however, give back the patient a normal amount of movement and more research is necessary with steroids, possibly combining them with other drugs.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Spinal immobilisation for trauma patients

Spinal cord damage from injury causes long‐term disability and can dramatically affect quality of life. The current practice of immobilising trauma patients before hospitalisation to prevent more damage may not always be necessary, as the likelihood of further damage is small. Means of immobilisation include holding the head in the midline, log rolling the person, the use of backboards and special mattresses, cervical collars, sandbags and straps. These can cause tissue pressure and discomfort, difficulty in swallowing and serious breathing problems.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Still not clear whether people with a spinal cord injury should go straight to a specialist centre

Spinal cord injury is a serious condition and the effects are usually permanent. In several countries, specialist centres have been set up, where patients can be taken within a few hours of their injury, but even in these countries many patients are dealt with in non‐specialist hospitals. This review tried to answer the question: does immediate referral to an SIC result in a better outcome than delayed referral? However, a comprehensive search failed to find any controlled studies and so it is not yet possible to answer the question. The reviewers call for appropriate research to be done.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Not enough evidence about the effects of drugs used to try and reduce spasticity in the limbs after spinal cord injury

A major problem after spinal cord injury is muscle resistance to having the arms or legs moved (spasticity). There can also be spasms. This can severely limit a person's mobility and independence, and can cause pain, muscle problems, and sleep difficulties. Treatments to try and reduce spasticity include exercise, and drugs to try and decrease the muscle tone. The review found there was not enough evidence from trials to assess the effects of the range of drugs used to try and relieve spasticity after spinal cord injury. The authors of the review call for more research and make recommendations as to how this research should be conducted.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

No evidence that treatment with gangliosides reduces death rate or improves life for survivors after spinal cord injury

Injuries to the spinal cord are often devastating. Worldwide there are up to 40 million such injuries a year. People who survive often have severe disabilities. Gangliosides are substances that occur naturally in nerve cells. They can be manufactured and there have been studies to see whether they can be used to treat various conditions where nerves have been damaged. This review found two studies where a ganglioside had been used to treat people with spinal cord injury. The treatment did not produce a lower death rate and there was no evidence that movement, feeling or quality of life was improved for those who lived.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Providing locomotor training to people with spinal cord injury to improve walking ability

A traumatic spinal cord injury (SCI) is a lesion of neural elements of the spinal cord that can result in any degree of sensory and motor deficit, autonomic or bowel dysfunction. Locomotor training for walking is used in rehabilitation after spinal cord injury (SCI) and might help to improve a person's ability to walk. However, many strategies exist to improve this function, such as treadmill training with and without bodyweight support, robotic‐assisted gait training and electrical stimulation.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Training the muscles used for breathing after a spinal cord injury

After an injury at a high point on the spinal cord (a cervical injury), the muscles responsible for breathing are paralysed or weakened. This weakness reduces the volume of the lungs (lung capacity), the ability to take a deep breath and cough, and puts them at greater risk of lung infection. Just like other muscles of the body, it is possible to train the breathing (respiratory) muscles to be stronger; however, it is not clear if such training is effective for people with a cervical spinal cord injury. This review compared any type of respiratory muscle training with standard care or sham treatments. We reviewed 11 studies (including 212 people with cervical spinal cord injury) and suggested that for people with cervical spinal cord injury there is a small beneficial effect of respiratory muscle training on lung volume and on the strength of the muscles used to take a breath in and to breathe air out and cough. No effect was seen on the maximum amount of air that can be pushed out in one breath, or shortness of breath. An insufficient number of studies had examined the effect of respiratory muscle training on the frequency of lung infections or quality of life, so we could not assess these outcomes in the review. We identified no adverse effects of training the breathing muscles for people with a cervical spinal cord injury.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Treatments other than medication for people with chronic pain after spinal cord injury

Many people living with spinal cord injury (SCI) have chronic pain. Besides pain medication, other treatment possibilities are commonly offered. This systematic review aims to summarise available evidence on the effectiveness and possible side effects of other forms of treatment.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

The benefits and harms of spinal fixation surgery for people with spinal cord injury due to trauma are not known at the moment

This review found no controlled trials of spinal fixation surgery for the patient group. The quality of the existing evidence is too poor to include in the review, as it is likely to be unreliable. Good quality controlled trials are needed to answer this question.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Techniques for preventing hypotension during spinal anaesthesia for caesarean section

The incidence of hypotension during spinal anaesthesia for caesarean section is reduced by administering intravenous fluids, the drugs ephedrine or phenylephrine, or by leg compression.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Combined spinal‐epidural versus epidural analgesia in labour

Regional analgesia has been shown to be effective in providing pain relief in labour. Regional analgesia can be an epidural, a spinal or a combination of the two. An epidural is when the pain‐relieving drugs are injected into the part of the body which surrounds the spinal column (epidural space). It is most common for these drugs to be infused through a very fine tube (catheter) positioned in the epidural space. Traditionally, high concentrations of local anaesthetic drugs were used. These numbed the woman from the waist downwards giving pain relief for most women. However, it also caused leg weakness, poor mobility and difficulty for the mother giving birth. This led to increased instrumental vaginal births with subsequent increased bruising, pain and incontinence later on for the mother. More recently with epidurals, low‐dose local anaesthetic drugs have been used in combination with opioid drugs. Here there is less numbing of the woman's legs but the opioid drugs cross the placenta and may make the baby sleepy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Regional (spinal, epidural, caudal) versus general anaesthesia in preterm infants undergoing inguinal herniorrhaphy in early infancy

Background: babies born preterm (before 37 weeks) often have serious health problems and sometimes need surgery. Inguinal hernia (IH) (where the intestine protrudes through the abdominal wall) is the commonest condition where surgery is needed. General anaesthetics for surgery can disrupt breathing and cause other complications in preterm babies. Regional anaesthetics including spinal block (injection) might avoid complications such as pauses in breathing in the first 24 hours after surgery. Whether this improves outcomes for preterm babies having surgery is unclear because no trials have looked at the effects of anaesthetics on brain function in older children.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Surgical versus conservative management for an odontoid fracture (a serious neck injury)

The seven bones making up the neck region of the backbone are called the cervical vertebrae. The first vertebra, called the atlas, supports the skull. Underneath this is the axis or second vertebra, which has a upward pointing process called the odontoid process around which the atlas can rotate, enabling the head to be turned. Fracture of the odontoid process is a serious injury and is often fatal. In survivors there is a risk of ongoing damage to the spinal cord and paralysis. People with these fractures are often treated conservatively, which entails stabilisation of the neck in devices such as a 'Halo' (external frame) and/or rigid collar for several months. Another option is surgical stabilisation of the fractured parts. The review aimed to examine the evidence from randomised controlled trials comparing surgical versus conservative treatment for these fractures to find if either approach gave a better outcome. Despite a comprehensive search, the review authors found no evidence from completed randomised controlled trials to inform the choice between surgical and conservative management.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Surgical approaches for dislocations of the neck bones

The part of the back bone found in the neck is called the cervical spine. It consists of seven bones (or vertebrae). The relative movement of these vertebrae is mainly via small joints (called facet joints) located between each vertebrae. The facet joints in the cervical spine facilitate good movement of the neck, but they are vulnerable to dislocation. Typically, cervical spine facet dislocations are caused by high‐energy traumas such as road traffic accidents or violent attacks. Approximately half of people with such dislocations sustain an injury to the spinal cord carried within the spine. This can result in significant impairment of function (e.g. paralysis). Surgery is usually needed for these serious injuries in order to keep the neck bones in place.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Preventing death from blood clots, the formation of blood clots and blood clots in the lungs in people who have had physical trauma

Thromboembolism (unwanted clotting of the blood) is a frequent complication in people who have experienced physical trauma and is also an important cause of death. The type of trauma, association with vascular injuries, and prolonged hospital bed rest are known risk factors for the development of deep vein thrombus (clot in veins of lower extremities) that can travel (embolize) to the lungs and cause death. Because of this it is usually recommended that people who have had major trauma are given mechanical or pharmacological treatments to prevent their blood forming unwanted blood clots. Mechanical interventions can include compression stockings, an air‐filled plastic tube that presses around the leg, a metal blood clot filter placed inside a vein; pharmaceutical drugs include unfractionated heparin, low weight molecular heparin, anticoagulants (e.g. warfarin), antiplatelet drugs (e.g. aspirin) and others. Sixteen studies involving 3,005 people are included in this review. We did not find strong evidence that either mechanical or pharmacological interventions reduce death or clots travelling to the lungs, but we found some evidence that they can prevent clots from forming in the legs.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Surgical versus non‐surgical treatment for thoracolumbar burst fractures without neurological deficit

The thoracolumbar region of the spine is composed of the thoracic (middle back) and lumbar (lower back) spine. One type of spinal injury is the burst fracture where a vertebra (one of several bones making up the spine) is fractured (broken) such that it loses height on both its back and front sides. This sort of fracture occurs most frequently in the bones situated at the junction of the thoracic and lumbar spine. These injuries are usually the result of a high‐velocity accident such as a motor vehicle crash. These are serious injuries, particularly when the spinal cord is also damaged as this may result in the partial or complete loss of sensory and motor function in the legs, and bladder or bowel dysfunction. This review only included people whose nerve tissue was not damaged, although later damage could not be ruled out. People are treated in hospital either conservatively by being placed in a lying position that reduces strain on that part of the spine followed by fitting a cast or brace so that they can move around, or surgically by stabilising the affected part of the spine using various implants and procedures.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Neck pain: Overview

Neck pain can make it difficult to move your head, and may radiate into your arms and head. The pain usually goes away after a few days or weeks, but can last much longer in some people.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: December 17, 2015

Management of faecal incontinence and constipation in adults with central nervous system diseases

Individuals with central nervous system disease or injury have a much higher risk of loss of bowel control and severe constipation than other people. This is called neurogenic bowel dysfunction (NBD). It can be very difficult to treat constipation without causing bowel leakage, or to prevent bowel leakage without causing constipation. The time spent on emptying the bowel is nearly always much greater for these individuals. Bowel problems like this cause a lot of anxiety and distress and can reduce the quality of life of those who suffer them. This review of research about NBD could be of interest to individuals with any damage to the central nervous system caused by disease or injury, or present at birth, which has a long term effect on how their bowel works.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Hydrogel dressings for treating pressure ulcers

Pressure ulcers, also known as bedsores, decubitus ulcers and pressure injuries, are areas of injury to the skin or the underlying tissue, or both. Pressure ulcers can be painful, may become infected, and affect quality of life. Those at risk of pressure ulcers include those with spinal cord injuries and people who are immobile or who have limited mobility such as some elderly people and people with acute or chronic conditions. In 2004 the total annual cost of treating pressure ulcers in the UK was estimated as being GBP 1.4 to 2.1 billion, which was equivalent to 4% of the total NHS expenditure. Pressure ulcers have been shown to increase length of hospital stay and the associated hospital costs. Figures from the USA suggest that 'pressure ulcer' was noted as a diagnosis for half a million hospital stays in 2006; for adults, the total hospital costs of these stays was USD 11 billion.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Negative pressure wound therapy for treating pressure ulcers

Pressure ulcers, also known as bedsores, decubitus ulcers and pressure injuries, are areas of injury to the skin, the tissue that lies underneath, or both. Pressure ulcers can be painful, may become infected, and affect people's quality of life. People at risk of developing pressure ulcers include those with spinal cord injuries, and those who are immobile or who have limited mobility.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...