Review
Health Care Sciences & Services
Guilian Chen, Tong Wang, Lirong Zhong, Xinghui He, Chunxia Huang, Yingmin Wang, Kun Li
Summary: Telemedicine is a feasible way to prevent pressure injuries among patients with spinal cord injuries. It can decrease the incidence and severity of pressure injuries and accelerate patients' healing without imposing an economic burden. It is best used in tandem with other, more conventional interventions.
JOURNAL OF MEDICAL INTERNET RESEARCH
(2022)
Review
Biochemistry & Molecular Biology
Rodrigo Montoto-Meijide, Rosa Meijide-Failde, Silvia Maria Diaz-Prado, Antonio Montoto-Marques
Summary: A systematic review shows that mesenchymal stem cell (MSC)-based cell therapy has significant efficacy and safety in the treatment of traumatic spinal cord injury (TSCI), leading to improvements in AIS grades, sensory scores, and to a lesser extent, motor scores. However, further research is needed to address the long-term safety and clinical implications due to limited scientific evidence available.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Review
Biotechnology & Applied Microbiology
Yuanpei Cheng, Yanbo Zhang, Han Wu
Summary: Polymeric fibers fabricated by electrospinning have shown promise in the treatment of SCI, with their ability to mimic the structure and function of nerve fibers and facilitate axon growth and drug delivery. However, challenges and future developments still need to be addressed.
FRONTIERS IN BIOENGINEERING AND BIOTECHNOLOGY
(2022)
Review
Pharmacology & Pharmacy
Li Deng, Jun Qiao Lv, Lin Sun
Summary: This study systematically analyzed the experimental treatments and their mechanisms for reducing blood spinal cord barrier (BSCB) injury in the early stage of traumatic spinal cord injury (t-SCI). BMSC-Exos, which inhibit matrix metalloproteinases (MMPs) expression, are currently the most effective therapeutic modality for alleviating BSCB damage. In addition, the regulation of MMPs, the Akt pathway, and the ER stress pathway play important roles in alleviating BSCB injury.
FRONTIERS IN PHARMACOLOGY
(2022)
Review
Medicine, General & Internal
Anja Maria Raab, Gabi Mueller, Simone Elsig, Simon C. Gandevia, Marcel Zwahlen, Maria T. E. Hopman, Roger Hilfiker
Summary: This systematic review provides an objective synthesis of the evidence on the incidence of pneumonia in patients with spinal cord injury (SCI). The review found large heterogeneity in the reporting of incidence, highlighting the need for caution when interpreting results. Further large-scale longitudinal studies with standardized reporting are required to investigate risk factors and focus on pneumonia prevention in ICU settings and patients with complete tetraplegia.
JOURNAL OF CLINICAL MEDICINE
(2022)
Review
Clinical Neurology
Roberta Costanzo, Lara Brunasso, Federica Paolini, Umberto Emanuele Benigno, Massimiliano Porzio, Giuseppe Roberto Giammalva, Rosa Maria Gerardi, Giuseppe Emmanuele Umana, Rina di Bonaventura, Carmelo Lucio Sturiale, Massimiliano Visocchi, Domenico Gerardo Iacopino, Rosario Maugeri
Summary: Magnetic resonance imaging is the most accurate examination to study the spinal cord, but diffusion tensor imaging (DTI) can provide additional details about spinal cord lesions. This literature review investigated the role, limitations, and potential use of DTI as a prognostic tool in spinal cord injury (SCI). The findings suggest that DTI parameters have promising utility as noninvasive biomarkers for SCI grade evaluation.
WORLD NEUROSURGERY
(2022)
Review
Cell Biology
Farihah Iqbal Khan, Zubair Ahmed
Summary: Spinal cord injury (SCI) is a complex and prolonged injury process that leads to loss of neurological functions. Current treatments are limited and novel treatments targeting ongoing injury processes are needed. In a systematic review of studies, combined tetrahedral framework nucleic acid with neural stem cells and Fortasyn (R) Connect supplementation showed significant improvements in functional recovery and attenuated secondary injury processes.
Review
Biochemistry & Molecular Biology
Ezra Valido, Gabriela Boehl, Joerg Krebs, Juergen Pannek, Stevan Stojic, Atanas G. Atanasov, Marija Glisic, Jivko Stoyanov, Athanasia Mouzaki
Summary: Individuals with spinal cord injury (SCI) have higher infection rates compared to those without SCI. This review investigated the immune status difference between individuals with SCI and without SCI by examining their peripheral immune cells and markers. The results showed that immune cells in individuals with SCI had lower functional capability and exhibited higher levels of leukocytes, neutrophils, C-reactive protein (CRP), and IL6.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Review
Clinical Neurology
Laurens Roolfs, Vanessa Hubertus, Jacob Spinnen, Lennard K. Shopperly, Michael G. Fehlings, Peter Vajkoczy
Summary: This article reviews the process of vascular injury and repair following spinal cord injury (SCI) and summarizes current experimental therapeutic approaches targeting spinal cord microvasculature. These approaches include the application of angiogenic factors, genetic engineering, physical stimulation, cell transplantation, and biomaterials carrying various factor delivery. Combinatorial approaches using implanted biomaterials and angiogenic factor delivery show promise for clinical translation.
Review
Medicine, General & Internal
Peter Francis Raguindin, Alessandro Bertolo, Ramona Maria Zeh, Gion Frankl, Oche Adam Itodo, Simona Capossela, Lia Bally, Beatrice Minder, Mirjam Brach, Inge Eriks-Hoogland, Jivko Stoyanov, Taulant Muka, Marija Glisic
Summary: Individuals with tetraplegia tend to have higher fat composition and higher indicators of central adiposity compared to those with paraplegia, while also exhibiting lower lean mass. This study suggests that anthropometric measures, such as body mass index, may not accurately reflect adiposity in individuals with SCI.
JOURNAL OF CLINICAL MEDICINE
(2021)
Review
Pediatrics
Natalia S. C. Cunha, Anahita Malvea, Sarah Sadat, George M. Ibrahim, Michael G. Fehlings
Summary: This review provides a concise overview of key aspects related to spinal cord injuries (SCIs) in children. It covers the etiology, epidemiology, unique challenges, clinical presentation, diagnostic methods, multidisciplinary management, emerging research, and innovative therapies of pediatric SCIs. The need for continued advancements in understanding and treating SCIs in children to improve their functional independence and overall quality of life is emphasized.
Review
Biochemistry & Molecular Biology
Lapo Bonosi, Manikon Poullay Silven, Antonio Alessandro Biancardino, Andrea Sciortino, Giuseppe Roberto Giammalva, Alba Scerrati, Carmelo Lucio Sturiale, Alessio Albanese, Silvana Tumbiolo, Massimiliano Visocchi, Domenico Gerardo Iacopino, Rosario Maugeri
Summary: This review provides an up-to-date summary of the current research status, challenges, and future directions for stem cell therapy in SCI models, with a focus on the therapeutic effect of stem cells differentiating into neuronal cells and releasing neurotrophic factors.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Review
Biochemical Research Methods
Daysi da Cruz Tobelem, Tamiris Silva, Tamires Araujo, Lucas Andreo, Taina Caroline dos Santos Malavazzi, Anna Carolina Ratto Tempestini Horliana, Kristianne Porta Santos Fernandes, Sandra Kalil Bussadori, Raquel Agnelli Mesquita-Ferrari
Summary: This systematic review investigated the effects of photobiomodulation using low-level laser therapy (LLLT) for the treatment of spinal cord injury (SCI) in experimental models. The review found that LLLT can serve as an adjunct therapy for SCI, providing neuroprotection, promoting functional recovery, and reducing pro-inflammatory cytokines. However, standardization of dosimetric parameters is needed.
JOURNAL OF BIOPHOTONICS
(2022)
Review
Biology
Sajad Fakhri, Mohammad Mehdi Gravandi, Sadaf Abdian, Seyed Zachariah Moradi, Javier Echeverria
Summary: Spinal cord injury (SCI) is a complex disease with no FDA-approved treatment. Flavonoids, especially quercetin, found in plant secondary metabolites, have the potential to combat SCI and have been extensively studied.
Review
Nutrition & Dietetics
Lei Wang, Jinlu Gan, Jingnan Wu, Yingchun Zhou, Deqiang Lei
Summary: Vitamin D (VitD) insufficiency is a common problem among spinal cord injury (SCI) patients, and low levels of VitD may impair functional restoration after SCI. Studies have shown a high prevalence of VitD insufficiency (81.6%) and deficiency (52.5%) after SCI, along with associations with skeletal diseases, venous thromboembolism, psychoneurological syndromes, and chest illness. Supplemental therapy with VitD has been suggested as a potential adjuvant treatment to accelerate rehabilitation in SCI patients. However, more well-designed trials and experimental research are needed to validate its therapeutic effect, elucidate its neuroprotective mechanism, and develop novel treatments.
FRONTIERS IN NUTRITION
(2023)
Article
Clinical Neurology
Scott L. Zuckerman, Meghan Cerpa, Lawrence G. Lenke, Christopher Shaffrey, Leah Y. Carreon, Kenneth M. C. Cheung, Michael P. Kelly, Michael G. Fehlings, Christopher P. Ames, Oheneba Boachie-Adjei, Mark B. Dekutoski, Khaled M. Kabeaish, Stephen J. Lewis, Yukihiro Matsuyama, Ferran Pellise, Yong Qiu, Frank J. Schwab, Justin S. Smith
Summary: After complex ASD surgery, significant improvements in patient-reported outcomes (PROs) were observed at the 5-year follow-up. However, no significant changes in PROs were seen during the 2 to 5-year postoperative period. Patients with major surgery-related complications showed similar PROs and proportion of patients achieving MCID compared to those without such complications.
GLOBAL SPINE JOURNAL
(2022)
Article
Clinical Neurology
Dimitri Tkatschenko, Sonja Hansen, Julia Koch, Christopher Ames, Michael G. Fehlings, Sigurd Berven, Lali Sekhon, Christopher Shaffrey, Justin S. Smith, Robert Hart, Han Jo Kim, Jeffrey Wang, Yoon Ha, Kenny Kwan, Yong Hai, Marcelo Valacco, Asdrubal Falavigna, Nestor Taboada, Alfredo Guiroy, Juan Emmerich, Bernhard Meyer, Frank Kandziora, Claudius Thome, Markus Loibl, Wilco Peul, Alessandro Gasbarrini, Ibrahim Obeid, Martin Gehrchen, Andrej Trampuz, Peter Vajkoczy, Julia Onken
Summary: This study provides an international overview of the heterogeneity of surgical site infection prevention strategies in spine surgery. The results demonstrate a significant variation in pre-, peri-, and postoperative measures to prevent surgical site infection. There is a need for developing universal guidelines and testing areas of controversy in prospective clinical trials.
GLOBAL SPINE JOURNAL
(2023)
Article
Clinical Neurology
Laureen D. Hachem, Mary Zhu, Bizhan Aarabi, Benjamin Davies, Anthony DiGiorgio, Nathan Evaniew, Michael G. Fehlings, Mario Ganau, Daniel Graves, James Guest, Yoon Ha, James Harrop, Christopher Hofstetter, Paul Koljonen, Shekar Kurpad, Rex Marco, Allan R. Martin, Narihito Nagoshi, Aria Nouri, Vafa Rahimi-Movaghar, Ricardo Rodrigues-Pinto, Valerie Ter Wengel, Lindsay Tetreault, Brian Kwon, Jefferson R. Wilson
Summary: This study aims to assess current practice patterns in the management of cervical spinal cord injury (SCI) and develop a simplified, practical classification system. The results show that spinal stability, cord compression, and neurological status are the most important factors influencing surgeons' decisions in the surgical management of cervical SCI.
GLOBAL SPINE JOURNAL
(2022)
Article
Clinical Neurology
Melanie Boeyer, Andrew Groneck, Ahmet Alanay, Kevin Neal, A. Noelle Larson, Stefan Parent, Peter Newton, Firoz Miyanji, Lawrence Haber, Daniel G. Harms Study Grp, Daniel Hoernschemeyer
Summary: The purpose of this study was to determine the perioperative characteristics associated with posterior spinal fusion (PSF) in adolescent idiopathic scoliosis patients previously treated with vertebral body tethering (VBT). The results showed no difference in operative time, estimated blood loss, and postoperative length of stay between the PSF-VBT and PSF-Only groups. However, the fusion construct length was found to be two levels longer in the PSF-VBT group compared to the PSF-Only group.
EUROPEAN SPINE JOURNAL
(2023)
Article
Oncology
Alexander C. Disch, Stefano Boriani, Aron Lazary, Laurence D. Rhines, Alessandro Luzzati, Ziya L. Gokaslan, Charles G. Fisher, Michael G. Fehlings, Michelle J. Clarke, Dean Chou, Nicole M. Germscheid, Klaus-Dieter Schaser, Jeremy J. Reynolds
Summary: Compared to secondary lesions, primary spinal tumors are rare. The effect of different resection strategies on local recurrence and survival in patients with benign primary spinal tumors under the age of 25 was studied. The results showed no correlation between the grade of aggressiveness in resection and local recurrence rates in this younger patient cohort. The most common tumors in young patients were osteoblastomas, osteoid osteomas, and aneurysmal bone cysts.
Article
Oncology
Alexander C. Disch, Stefano Boriani, Alessandro Luzzati, Laurence D. Rhines, Charles G. Fisher, Aron Lazary, Ziya L. Gokaslan, Dean Chou, Michelle J. Clarke, Michael G. Fehlings, Klaus-Dieter Schaser, Nicole M. Germscheid, Jeremy J. Reynolds
Summary: Extradural primary malignant spinal tumors in young patients are rare. This study reports the clinical outcomes of young patients who underwent surgery for these tumors. The results show that surgery, combined with adjuvant therapy, can achieve better overall survival and low local recurrence rates.
Article
Clinical Neurology
Raymond Wong, Nader Hejrati, Michael G. G. Fehlings
Summary: This article discusses several key challenges that clinical investigators evaluating novel therapeutic strategies to treat traumatic spinal cord injury (SCI) may face, and proposes potential solutions, including patient recruitment, patient follow-up, heterogeneity of patients, complex pathophysiology of SCI, capturing treatment effects, high costs, implementation of guidelines, demographic shifts, and navigating regulatory bodies.
EXPERT REVIEW OF NEUROTHERAPEUTICS
(2023)
Review
Cell & Tissue Engineering
Katarzyna Pieczonka, Michael G. Fehlings
Summary: Spinal cord injury (SCI) has a significant impact on quality of life and finances. Neural stem/progenitor cell (NSPC) transplantation shows promise for spinal cord regeneration, but the integration of transplanted cells remains a challenge. This review proposes various techniques, including molecular cues and alternative methods, to guide the integration of grafted cells towards specific circuits. Future research in these areas may improve outcomes for SCI patients.
STEM CELLS TRANSLATIONAL MEDICINE
(2023)
Article
Cell Biology
Katarzyna Pieczonka, Mohamad Khazaei, Michael G. G. Fehlings
Summary: In this study, the expression of Olig2 transcription factor was induced in tripotent neural progenitor cells (NPCs), leading to a significantly higher proportion of differentiated oligodendrocytes compared to NPCs. The induction of Olig2 was also associated with the upregulation of genes involved in oligodendrocyte development and function, and the downregulation of genes involved in other cell lineages. GO and GSEA analyses further confirmed the oligodendrocyte specification of the induced NPCs.
Article
Cell & Tissue Engineering
Katarzyna Pieczonka, Hiroaki Nakashima, Narihito Nagoshi, Kazuya Yokota, James Hong, Anna Badner, Jonathon C. T. Chio, Shinsuke Shibata, Mohamad Khazaei, Michael G. Fehlings
Summary: Traumatic spinal cord injury (SCI) causes the loss of neurons and glial cells. Current interventions for SCI lack regenerative solutions. Neural stem/progenitor cell (NPC) transplantation is a promising strategy for regeneration but inconsistent differentiation hinders functional recovery. This study generated oligodendrogenically biased NPCs (oNPCs) from human induced pluripotent stem cells (hiPSCs) and demonstrated their effectiveness in a rodent model of cervical SCI, showing enhanced tissue preservation, remyelination, and functional recovery without adverse effects. These findings highlight the therapeutic potential of oNPCs in cervical SCI and call for further investigation to optimize this approach.
STEM CELLS TRANSLATIONAL MEDICINE
(2023)
Article
Orthopedics
Nisaharan Srikandarajah, Mohammed Ali Alvi, Michael G. Fehlings
Summary: Traumatic spinal cord injury (SCI) is a serious disorder that leads to neurological impairment and disability, affecting the quality of life for patients. The pathophysiology involves primary and secondary phases, causing neurological damage. Current clinical management focuses on early decompressive surgery, optimizing arterial pressure, steroid therapy, and rehabilitation. Emerging therapies aim to repair the spinal cord through cell-based, gene, pharmacological, and neuromodulation approaches. Addressing both primary and secondary phases of SCI can enhance outcomes for patients.
JOURNAL OF ORTHOPAEDICS
(2023)
Review
Clinical Neurology
Ayesha Quddusi, Karlo M. M. Pedro, Mohammed Ali Alvi, Nader Hejrati, Michael G. G. Fehlings
Summary: Acute traumatic spinal cord injury (tSCI) is a severe event with global impact on morbidity and mortality. Early surgical intervention within 24 hours has been shown to improve prognosis and functional outcomes. This review explores the evidence, nuances, and challenges associated with timing of surgery, as well as the barriers to early surgical care for tSCI.
ACTA NEUROCHIRURGICA
(2023)
Review
Clinical Neurology
Nader Hejrati, Karlo Pedro, Mohammed Ali Alvi, Ayesha Quddusi, Michael G. Fehlings
Summary: Degenerative cervical myelopathy (DCM) includes age-related and genetically associated pathologies affecting the cervical spine. The RECODE-DCM consensus group has identified ten priority areas for translational research to improve the management and treatment of DCM. This article summarizes recent advancements in the field, including a refined definition, understanding of pathophysiology, assessment and diagnosis methods, treatment modalities, and genetic research opportunities.
ACTA NEUROCHIRURGICA
(2023)
Article
Public, Environmental & Occupational Health
Roger Wong, Margaret Anne Lovier
Summary: Older adults and people of colour are more vulnerable to COVID-19, and despite higher adherence to mitigation behaviours, minority older adults still have elevated odds of COVID-19. Research is needed to explore potential mechanisms for this disparity.
EPIDEMIOLOGY AND INFECTION
(2023)
Review
Oncology
Amr H. Saleh, Nardin Samuel, Kyle Juraschka, Mohammad H. Saleh, Michael D. Taylor, Michael G. Fehlings
Summary: This review discusses important biological features of ependymomas, including subgroup categorization and clinical implications, oncogenic and tumor suppressor signaling pathways, epigenetic dysregulation, as well as the limitations of current therapies and potential next-generation treatments.
NATURE REVIEWS CANCER
(2022)