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Case Studies01:22

Case Studies

There are many research methods available to psychologists in their efforts to understand, describe, and explain behavior and the cognitive and biological processes that underlie it.
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Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...

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Articles linked to this work by shared authors, journal, and citation graph.

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[Translated article] Efficacy of early versus delayed spinal cord decompression in neurological recovery after traumatic spinal cord injury: Systematic review and meta-analysis.

Revista espanola de cirugia ortopedica y traumatologia·2024
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SCIWORA in children. A rare clinical entity: Ambispective study.

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[Translated article] SCIWORA in children. A rare clinical entity: Ambispective study.

L M Romero-Muñoz1, M Peral-Alarma1, A Barriga-Martín1

  • 1Servicio de Cirugía Ortopédica y Traumatología, Hospital Nacional de Parapléjicos, Toledo, Spain.

Revista Espanola De Cirugia Ortopedica Y Traumatologia
|November 23, 2023
PubMed
Summary

Spinal Cord Without Radiographic Abnormality (SCIWORA) predominantly affects children and young men, often due to motor vehicle accidents. Functional recovery shows improvement, with 31% achieving improved neurological status (AIS grade D) within a year.

Keywords:
Edad pediátricaLesión medularMédula espinalPaediatricSCIWORASpinal cordSpinal cord injuryTraumaTraumatismo

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Area of Science:

  • Neurology
  • Traumatology
  • Epidemiology

Background:

  • Spinal Cord Without Radiographic Abnormality (SCIWORA) presents a diagnostic challenge due to its low incidence but significant functional impact.
  • Understanding the epidemiology and long-term functional outcomes of SCIWORA is crucial for effective patient management and rehabilitation strategies.

Purpose of the Study:

  • To investigate the epidemiological characteristics of SCIWORA.
  • To evaluate the functional outcomes of SCIWORA patients with a mean follow-up of 10 years.
  • To identify potential correlations between injury mechanisms, imaging findings, and patient demographics.

Main Methods:

  • An observational, longitudinal ambispective cohort study was conducted on thirteen SCIWORA patients.
  • Data collected included demographics, injury mechanisms, spinal cord MRI findings, and neurological status (ASIA Impairment Scale - AIS).
  • Functional outcomes were assessed using the Spinal Cord Independence Measure (SCIM III), and long-term quality of life was evaluated with the Neurogenic Determinants Inventory (NDI), Oswestry Disability Index, and Spinal Cord Injury Quality of Life Index (SV-QLI/SCI).

Main Results:

  • The study population comprised mostly men (77%) with a median age of 4 years; 54% of injuries affected the cervical spine.
  • Motor vehicle accidents were the most common cause (77%). Initial neurological status was predominantly AIS grade A or C (31% each).
  • Patients showed functional improvement from SCIM III scores of 28.5 at admission to 42 at discharge. Long-term assessments indicated moderate disability (NDI: 11.6, Oswestry: 15.3, SV-QLI/SCI: 17).

Conclusions:

  • SCIWORA disproportionately affects individuals under 8 years old and young men, with motor vehicle accidents being a primary cause.
  • A significant portion of patients (31%) demonstrated neurological improvement to AIS grade D within one year post-discharge, a status maintained at five years.
  • No statistically significant associations were found between injury mechanisms and MRI findings, or between age and MRI findings in SCIWORA patients.