UpToDate
Official reprint from UpToDate®
www.uptodate.com ©2017 UpToDate®

急性创伤性脊髓损伤

Authors
Robert R Hansebout, MD, FRCS(C), FACS
Edward Kachur, MD, FRCS(C)
Section Editors
Michael J Aminoff, MD, DSc
Maria E Moreira, MD
Deputy Editor
Janet L Wilterdink, MD
Translators
泮长存, 主治医师

引言

现代社会中，脊髓损伤已变得流行。尽管对其发病机制的理解取得了进展，其早期识别和治疗也有所改善，但是脊髓损伤仍属于毁灭性事件，经常会造成重度和永久性残疾。创伤性脊髓损伤(traumatic spinal cord injury, TSCI)，其发生率高峰出现在年轻成人中，对社会而言该疾病仍然是一项高花费问题；一位患者一生累计的直接医疗支出可达500,000到2,000,000美元[1]。

本专题总结了急性TSCI。脊髓疾病的解剖学及临床定位、累及脊髓的其他疾病以及脊髓损伤的慢性并发症将单独讨论。 (参见“脊髓病变的解剖学和定位”和“影响脊髓的疾病”和“脊髓损伤和脊髓疾病的慢性并发症”)

流行病学

在美国，大部分与TSCI相关的人口统计学和流行病学数据已由脊髓损伤模型诊疗系统收集，并由美国国家脊髓损伤统计中心发布[2]。在美国，TSCI的发生率约为每年40例/1,000,000人，截至2005年7月，美国TSCI的幸存患者数约为250,000例。加拿大报告了相近的数据[3]。

在美国，TSCI的病因有[2]：

  • 机动车事故：47%
  • 跌落：23%
  • 暴力(尤其是枪击伤)：14%
  • 体育运动事故：9%
  • 其他：7%

                                    

Subscribers log in here

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:
Literature review current through: 2017-06 . | This topic last updated: 2014-10-20.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc.
References
Top
  1. Sekhon LH, Fehlings MG. Epidemiology, demographics, and pathophysiology of acute spinal cord injury. Spine (Phila Pa 1976) 2001; 26:S2.
  2. The National Spinal Cord Injury Statistical Center. http://www.spinalcord.uab.edu/show.asp?durki=21446 (Accessed on May 11, 2007).
  3. Lenehan B, Street J, Kwon BK, et al. The epidemiology of traumatic spinal cord injury in British Columbia, Canada. Spine (Phila Pa 1976) 2012; 37:321.
  4. Ackery A, Tator C, Krassioukov A. A global perspective on spinal cord injury epidemiology. J Neurotrauma 2004; 21:1355.
  5. Canadian Paraplegic Association. http://www.canparaplegic.org/en/SCI_Facts_67/items/6.html (Accessed on May 11, 2007).
  6. Hasler RM, Exadaktylos AK, Bouamra O, et al. Epidemiology and predictors of cervical spine injury in adult major trauma patients: a multicenter cohort study. J Trauma Acute Care Surg 2012; 72:975.
  7. Vitale MG, Goss JM, Matsumoto H, Roye DP Jr. Epidemiology of pediatric spinal cord injury in the United States: years 1997 and 2000. J Pediatr Orthop 2006; 26:745.
  8. Myers ER, Wilson SE. Biomechanics of osteoporosis and vertebral fracture. Spine (Phila Pa 1976) 1997; 22:25S.
  9. Mirovsky Y, Shalmon E, Blankstein A, Halperin N. Complete paraplegia following gunshot injury without direct trauma to the cord. Spine (Phila Pa 1976) 2005; 30:2436.
  10. Ambrozaitis KV, Kontautas E, Spakauskas B, Vaitkaitis D. [Pathophysiology of acute spinal cord injury]. Medicina (Kaunas) 2006; 42:255.
  11. Hansebout RR. Spinal injury and spinal cord blood flow, The Effect of Early Treatment and Local Cooling. In: Spinal Cord Dysfunction: Intervention and Treatment, Illis LS (Ed), Oxford Press, 1992. Vol 2, p.58.
  12. Allen AR. Remarks on the histopathological changes in the spinal cord due to impact an experimental study. J Ner Ment Dis 1914; 41:141.
  13. Hansebout RR. The Neurosurgical Management of Cord Injuries. In: Management of Spinal Cord Injuries, Bloch R, Basbaum M (Eds), Williams and Wilkins, Rehabilitation Medicine Library, 1986. p.1.
  14. Janssen L, Hansebout RR. Pathogenesis of spinal cord injury and newer treatments. A review. Spine (Phila Pa 1976) 1989; 14:23.
  15. Tator CH. Update on the pathophysiology and pathology of acute spinal cord injury. Brain Pathol 1995; 5:407.
  16. Fehlings MG, Perrin RG. The role and timing of early decompression for cervical spinal cord injury: update with a review of recent clinical evidence. Injury 2005; 36 Suppl 2:B13.
  17. American Spinal Injury Association. International Standards for Neurological Classification of Spinal Cord Injury. American Spinal Injury Association, Chicago 2002.
  18. Morse SD. Acute central cervical spinal cord syndrome. Ann Emerg Med 1982; 11:436.
  19. Ishida Y, Tominaga T. Predictors of neurologic recovery in acute central cervical cord injury with only upper extremity impairment. Spine (Phila Pa 1976) 2002; 27:1652.
  20. Ditunno JF, Little JW, Tessler A, Burns AS. Spinal shock revisited: a four-phase model. Spinal Cord 2004; 42:383.
  21. Nanković V, Snur I, Nanković S, et al. [Spinal shock. Diagnosis and therapy. Problems and dilemmas]. Lijec Vjesn 1995; 117 Suppl 2:30.
  22. Cervical spine immobilization before admission to the hospital. Neurosurgery 2002; 50:S7.
  23. Gardner BP, Watt JW, Krishnan KR. The artificial ventilation of acute spinal cord damaged patients: a retrospective study of forty-four patients. Paraplegia 1986; 24:208.
  24. Hoffman JR, Mower WR, Wolfson AB, et al. Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma. National Emergency X-Radiography Utilization Study Group. N Engl J Med 2000; 343:94.
  25. Gonzalez RP, Cummings GR, Phelan HA, et al. Clinical examination in complement with computed tomography scan: an effective method for identification of cervical spine injury. J Trauma 2009; 67:1297.
  26. Halpern CH, Milby AH, Guo W, et al. Clearance of the cervical spine in clinically unevaluable trauma patients. Spine (Phila Pa 1976) 2010; 35:1721.
  27. Davis JW, Phreaner DL, Hoyt DB, Mackersie RC. The etiology of missed cervical spine injuries. J Trauma 1993; 34:342.
  28. Berne JD, Velmahos GC, El-Tawil Q, et al. Value of complete cervical helical computed tomographic scanning in identifying cervical spine injury in the unevaluable blunt trauma patient with multiple injuries: a prospective study. J Trauma 1999; 47:896.
  29. Daffner RH, Sciulli RL, Rodriguez A, Protetch J. Imaging for evaluation of suspected cervical spine trauma: a 2-year analysis. Injury 2006; 37:652.
  30. Antevil JL, Sise MJ, Sack DI, et al. Spiral computed tomography for the initial evaluation of spine trauma: A new standard of care? J Trauma 2006; 61:382.
  31. Brohi K, Healy M, Fotheringham T, et al. Helical computed tomographic scanning for the evaluation of the cervical spine in the unconscious, intubated trauma patient. J Trauma 2005; 58:897.
  32. Bailitz J, Starr F, Beecroft M, et al. CT should replace three-view radiographs as the initial screening test in patients at high, moderate, and low risk for blunt cervical spine injury: a prospective comparison. J Trauma 2009; 66:1605.
  33. Hennessy D, Widder S, Zygun D, et al. Cervical spine clearance in obtunded blunt trauma patients: a prospective study. J Trauma 2010; 68:576.
  34. Duane TM, Young A, Mayglothling J, et al. CT for all or selective approach? Who really needs a cervical spine CT after blunt trauma. J Trauma Acute Care Surg 2013; 74:1098.
  35. Demaerel P. Magnetic resonance imaging of spinal cord trauma: a pictorial essay. Neuroradiology 2006; 48:223.
  36. Radiographic assessment of the cervical spine in symptomatic trauma patients. Neurosurgery 2002; 50:S36.
  37. Stevens RD, Bhardwaj A, Kirsch JR, Mirski MA. Critical care and perioperative management in traumatic spinal cord injury. J Neurosurg Anesthesiol 2003; 15:215.
  38. White P, Seymour R, Powell N. MRI assessment of the pre-vertebral soft tissues in acute cervical spine trauma. Br J Radiol 1999; 72:818.
  39. Katzberg RW, Benedetti PF, Drake CM, et al. Acute cervical spine injuries: prospective MR imaging assessment at a level 1 trauma center. Radiology 1999; 213:203.
  40. Benzel EC, Hart BL, Ball PA, et al. Magnetic resonance imaging for the evaluation of patients with occult cervical spine injury. J Neurosurg 1996; 85:824.
  41. Miyanji F, Furlan JC, Aarabi B, et al. Acute cervical traumatic spinal cord injury: MR imaging findings correlated with neurologic outcome--prospective study with 100 consecutive patients. Radiology 2007; 243:820.
  42. Gargas J, Yaszay B, Kruk P, et al. An analysis of cervical spine magnetic resonance imaging findings after normal computed tomographic imaging findings in pediatric trauma patients: ten-year experience of a level I pediatric trauma center. J Trauma Acute Care Surg 2013; 74:1102.
  43. Spinal cord injury without radiographic abnormality. Neurosurgery 2002; 50:S100.
  44. Schoenfeld AJ, Bono CM, McGuire KJ, et al. Computed tomography alone versus computed tomography and magnetic resonance imaging in the identification of occult injuries to the cervical spine: a meta-analysis. J Trauma 2010; 68:109.
  45. Como JJ, Leukhardt WH, Anderson JS, et al. Computed tomography alone may clear the cervical spine in obtunded blunt trauma patients: a prospective evaluation of a revised protocol. J Trauma 2011; 70:345.
  46. Machino M, Yukawa Y, Ito K, et al. Can magnetic resonance imaging reflect the prognosis in patients of cervical spinal cord injury without radiographic abnormality? Spine (Phila Pa 1976) 2011; 36:E1568.
  47. Boese CK, Nerlich M, Klein SM, et al. Early magnetic resonance imaging in spinal cord injury without radiological abnormality in adults: a retrospective study. J Trauma Acute Care Surg 2013; 74:845.
  48. Management of acute spinal cord injuries in an intensive care unit or other monitored setting. Neurosurgery 2002; 50:S51.
  49. Jia X, Kowalski RG, Sciubba DM, Geocadin RG. Critical care of traumatic spinal cord injury. J Intensive Care Med 2013; 28:12.
  50. Vale FL, Burns J, Jackson AB, Hadley MN. Combined medical and surgical treatment after acute spinal cord injury: results of a prospective pilot study to assess the merits of aggressive medical resuscitation and blood pressure management. J Neurosurg 1997; 87:239.
  51. Levi L, Wolf A, Belzberg H. Hemodynamic parameters in patients with acute cervical cord trauma: description, intervention, and prediction of outcome. Neurosurgery 1993; 33:1007.
  52. Blood pressure management after acute spinal cord injury. Neurosurgery 2002; 50:S58.
  53. Lehmann KG, Lane JG, Piepmeier JM, Batsford WP. Cardiovascular abnormalities accompanying acute spinal cord injury in humans: incidence, time course and severity. J Am Coll Cardiol 1987; 10:46.
  54. Bilello JF, Davis JW, Cunningham MA, et al. Cervical spinal cord injury and the need for cardiovascular intervention. Arch Surg 2003; 138:1127.
  55. Silver JR. Early autonomic dysreflexia. Spinal Cord 2000; 38:229.
  56. DeVivo MJ, Kartus PL, Stover SL, et al. Cause of death for patients with spinal cord injuries. Arch Intern Med 1989; 149:1761.
  57. Wuermser LA, Ho CH, Chiodo AE, et al. Spinal cord injury medicine. 2. Acute care management of traumatic and nontraumatic injury. Arch Phys Med Rehabil 2007; 88:S55.
  58. Ball PA. Critical care of spinal cord injury. Spine (Phila Pa 1976) 2001; 26:S27.
  59. Yugué I, Okada S, Ueta T, et al. Analysis of the risk factors for tracheostomy in traumatic cervical spinal cord injury. Spine (Phila Pa 1976) 2012; 37:E1633.
  60. Velmahos GC, Kern J, Chan LS, et al. Prevention of venous thromboembolism after injury: an evidence-based report--part II: analysis of risk factors and evaluation of the role of vena caval filters. J Trauma 2000; 49:140.
  61. Merli GJ, Crabbe S, Paluzzi RG, Fritz D. Etiology, incidence, and prevention of deep vein thrombosis in acute spinal cord injury. Arch Phys Med Rehabil 1993; 74:1199.
  62. Slavik RS, Chan E, Gorman SK, et al. Dalteparin versus enoxaparin for venous thromboembolism prophylaxis in acute spinal cord injury and major orthopedic trauma patients: 'DETECT' trial. J Trauma 2007; 62:1075.
  63. Geerts WH, Pineo GF, Heit JA, et al. Prevention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004; 126:338S.
  64. Deep venous thrombosis and thromboembolism in patients with cervical spinal cord injuries. Neurosurgery 2002; 50:S73.
  65. Chung SB, Lee SH, Kim ES, Eoh W. Incidence of deep vein thrombosis after spinal cord injury: a prospective study in 37 consecutive patients with traumatic or nontraumatic spinal cord injury treated by mechanical prophylaxis. J Trauma 2011; 71:867.
  66. Simons RK, Hoyt DB, Winchell RJ, et al. A risk analysis of stress ulceration after trauma. J Trauma 1995; 39:289.
  67. Karlsson AK. Autonomic dysfunction in spinal cord injury: clinical presentation of symptoms and signs. Prog Brain Res 2006; 152:1.
  68. Lewin MG, Pappius HM, Hansebout RR. Effects of steroids on edema associated with injury of the spinal cord. In: Steroids and Brain Edema, Springer-Verlag, 1972. p.101.
  69. Lewin MG, Hansebout RR, Pappius HM. Chemical characteristics of traumatic spinal cord edema in cats. Effects of steroids on potassium depletion. J Neurosurg 1974; 40:65.
  70. Bracken MB, Shepard MJ, Collins WF Jr, et al. Methylprednisolone or naloxone treatment after acute spinal cord injury: 1-year follow-up data. Results of the second National Acute Spinal Cord Injury Study. J Neurosurg 1992; 76:23.
  71. Bracken MB, Shepard MJ, Holford TR, et al. Methylprednisolone or tirilazad mesylate administration after acute spinal cord injury: 1-year follow up. Results of the third National Acute Spinal Cord Injury randomized controlled trial. J Neurosurg 1998; 89:699.
  72. Bracken MB, Shepard MJ, Holford TR, et al. Administration of methylprednisolone for 24 or 48 hours or tirilazad mesylate for 48 hours in the treatment of acute spinal cord injury. Results of the Third National Acute Spinal Cord Injury Randomized Controlled Trial. National Acute Spinal Cord Injury Study. JAMA 1997; 277:1597.
  73. Bracken MB. Steroids for acute spinal cord injury. Cochrane Database Syst Rev 2012; 1:CD001046.
  74. Hurlbert RJ. Strategies of medical intervention in the management of acute spinal cord injury. Spine (Phila Pa 1976) 2006; 31:S16.
  75. Hurlbert RJ. Methylprednisolone for acute spinal cord injury: an inappropriate standard of care. J Neurosurg 2000; 93:1.
  76. Sayer FT, Kronvall E, Nilsson OG. Methylprednisolone treatment in acute spinal cord injury: the myth challenged through a structured analysis of published literature. Spine J 2006; 6:335.
  77. Eck JC, Nachtigall D, Humphreys SC, Hodges SD. Questionnaire survey of spine surgeons on the use of methylprednisolone for acute spinal cord injury. Spine (Phila Pa 1976) 2006; 31:E250.
  78. Bracken MB. Methylprednisolone and acute spinal cord injury: an update of the randomized evidence. Spine (Phila Pa 1976) 2001; 26:S47.
  79. Hurlbert RJ, Hadley MN, Walters BC, et al. Pharmacological therapy for acute spinal cord injury. Neurosurgery 2013; 72 Suppl 2:93.
  80. Canadian Association of Emergency Physicians. Position statement: Steroids in acute spinal cord injury. Available online at: www.caep.ca (Accessed on January 24, 2008).
  81. Hugenholtz H, Cass DE, Dvorak MF, et al. High-dose methylprednisolone for acute closed spinal cord injury--only a treatment option. Can J Neurol Sci 2002; 29:227.
  82. American Academy of Emergency Medicine. Position statement: Steroids in acute spinal cord injury. Available online at: www.aaem.org/positionstatements (Accessed on January 24, 2008).
  83. Consortium for Spinal Cord Medicine. Early Acute Management in Adults with Spinal Cord Injury: A Clinical Practice Guideline for Health-Care 2008; Paralyzed Veterans of America. Available online at: http://www.pva.org/site/News2?page=NewsArticle&id=8407/ (Accessed on August 24, 2008).
  84. Hurlbert RJ, Hamilton MG. Methylprednisolone for acute spinal cord injury: 5-year practice reversal. Can J Neurol Sci 2008; 35:41.
  85. Prendergast MR, Saxe JM, Ledgerwood AM, et al. Massive steroids do not reduce the zone of injury after penetrating spinal cord injury. J Trauma 1994; 37:576.
  86. Levy ML, Gans W, Wijesinghe HS, et al. Use of methylprednisolone as an adjunct in the management of patients with penetrating spinal cord injury: outcome analysis. Neurosurgery 1996; 39:1141.
  87. Heary RF, Vaccaro AR, Mesa JJ, et al. Steroids and gunshot wounds to the spine. Neurosurgery 1997; 41:576.
  88. Doran SE, Papadopoulos SM, Ducker TB, Lillehei KO. Magnetic resonance imaging documentation of coexistent traumatic locked facets of the cervical spine and disc herniation. J Neurosurg 1993; 79:341.
  89. Rizzolo SJ, Piazza MR, Cotler JM, et al. Intervertebral disc injury complicating cervical spine trauma. Spine (Phila Pa 1976) 1991; 16:S187.
  90. Grant GA, Mirza SK, Chapman JR, et al. Risk of early closed reduction in cervical spine subluxation injuries. J Neurosurg 1999; 90:13.
  91. Lu K, Lee TC, Chen HJ. Closed reduction of bilateral locked facets of the cervical spine under general anaesthesia. Acta Neurochir (Wien) 1998; 140:1055.
  92. Initial closed reduction of cervical spine fracture-dislocation injuries. Neurosurgery 2002; 50:S44.
  93. Bagnall AM, Jones L, Duffy S, Riemsma RP. Spinal fixation surgery for acute traumatic spinal cord injury. Cochrane Database Syst Rev 2008; :CD004725.
  94. Huang YH, Yang TM, Lin WC, et al. The prognosis of acute blunt cervical spinal cord injury. J Trauma 2009; 66:1441.
  95. Denis F. The three column spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine (Phila Pa 1976) 1983; 8:817.
  96. Vaccaro AR, Zeiller SC, Hulbert RJ, et al. The thoracolumbar injury severity score: a proposed treatment algorithm. J Spinal Disord Tech 2005; 18:209.
  97. Lewkonia P, Paolucci EO, Thomas K. Reliability of the thoracolumbar injury classification and severity score and comparison with the denis classification for injury to the thoracic and lumbar spine. Spine (Phila Pa 1976) 2012; 37:2161.
  98. Harrop JS, Vaccaro AR, Hurlbert RJ, et al. Intrarater and interrater reliability and validity in the assessment of the mechanism of injury and integrity of the posterior ligamentous complex: a novel injury severity scoring system for thoracolumbar injuries. Invited submission from the Joint Section Meeting On Disorders of the Spine and Peripheral Nerves, March 2005. J Neurosurg Spine 2006; 4:118.
  99. Fehlings MG, Perrin RG. The timing of surgical intervention in the treatment of spinal cord injury: a systematic review of recent clinical evidence. Spine (Phila Pa 1976) 2006; 31:S28.
  100. Dimar JR 2nd, Glassman SD, Raque GH, et al. The influence of spinal canal narrowing and timing of decompression on neurologic recovery after spinal cord contusion in a rat model. Spine (Phila Pa 1976) 1999; 24:1623.
  101. Carlson GD, Gorden CD, Oliff HS, et al. Sustained spinal cord compression: part I: time-dependent effect on long-term pathophysiology. J Bone Joint Surg Am 2003; 85-A:86.
  102. Rabinowitz RS, Eck JC, Harper CM Jr, et al. Urgent surgical decompression compared to methylprednisolone for the treatment of acute spinal cord injury: a randomized prospective study in beagle dogs. Spine (Phila Pa 1976) 2008; 33:2260.
  103. Furlan JC, Noonan V, Cadotte DW, Fehlings MG. Timing of decompressive surgery of spinal cord after traumatic spinal cord injury: an evidence-based examination of pre-clinical and clinical studies. J Neurotrauma 2011; 28:1371.
  104. Heiden JS, Weiss MH, Rosenberg AW, et al. Management of cervical spinal cord trauma in Southern California. J Neurosurg 1975; 43:732.
  105. Marshall LF, Knowlton S, Garfin SR, et al. Deterioration following spinal cord injury. A multicenter study. J Neurosurg 1987; 66:400.
  106. Wilmot CB, Hall KM. Evaluation of the acute management of tetraplegia: conservative versus surgical treatment. Paraplegia 1986; 24:148.
  107. Albert TJ, Kim DH. Timing of surgical stabilization after cervical and thoracic trauma. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004. J Neurosurg Spine 2005; 3:182.
  108. Papadopoulos SM, Selden NR, Quint DJ, et al. Immediate spinal cord decompression for cervical spinal cord injury: feasibility and outcome. J Trauma 2002; 52:323.
  109. Duh MS, Shepard MJ, Wilberger JE, Bracken MB. The effectiveness of surgery on the treatment of acute spinal cord injury and its relation to pharmacological treatment. Neurosurgery 1994; 35:240.
  110. Schinkel C, Anastasiadis AP. The timing of spinal stabilization in polytrauma and in patients with spinal cord injury. Curr Opin Crit Care 2008; 14:685.
  111. Dimar JR, Carreon LY, Riina J, et al. Early versus late stabilization of the spine in the polytrauma patient. Spine (Phila Pa 1976) 2010; 35:S187.
  112. Wilson JR, Forgione N, Fehlings MG. Emerging therapies for acute traumatic spinal cord injury. CMAJ 2013; 185:485.
  113. Bourassa-Moreau É, Mac-Thiong JM, Ehrmann Feldman D, et al. Complications in acute phase hospitalization of traumatic spinal cord injury: does surgical timing matter? J Trauma Acute Care Surg 2013; 74:849.
  114. Vaccaro AR, Daugherty RJ, Sheehan TP, et al. Neurologic outcome of early versus late surgery for cervical spinal cord injury. Spine (Phila Pa 1976) 1997; 22:2609.
  115. La Rosa G, Conti A, Cardali S, et al. Does early decompression improve neurological outcome of spinal cord injured patients? Appraisal of the literature using a meta-analytical approach. Spinal Cord 2004; 42:503.
  116. Fehlings MG, Rabin D, Sears W, et al. Current practice in the timing of surgical intervention in spinal cord injury. Spine (Phila Pa 1976) 2010; 35:S166.
  117. Wong SY, Wong KM, Chao AS, et al. Awake fiberoptic intubation for cesarean section in a parturient with odontoid fracture and atlantoaxial subluxation. Chang Gung Med J 2003; 26:352.
  118. Babinski MF. Anesthetic considerations in the patient with acute spinal cord injury. Crit Care Clin 1987; 3:619.
  119. Hansebout RR, Tanner JA, Romero-Sierra C. Current status of spinal cord cooling in the treatment of acute spinal cord injury. Spine (Phila Pa 1976) 1984; 9:508.
  120. Cappuccino A, Bisson LJ, Carpenter B, et al. The use of systemic hypothermia for the treatment of an acute cervical spinal cord injury in a professional football player. Spine (Phila Pa 1976) 2010; 35:E57.
  121. Shapiro S, Borgens R, Pascuzzi R, et al. Oscillating field stimulation for complete spinal cord injury in humans: a phase 1 trial. J Neurosurg Spine 2005; 2:3.
  122. Knoller N, Auerbach G, Fulga V, et al. Clinical experience using incubated autologous macrophages as a treatment for complete spinal cord injury: phase I study results. J Neurosurg Spine 2005; 3:173.
  123. Pitts LH, Ross A, Chase GA, Faden AI. Treatment with thyrotropin-releasing hormone (TRH) in patients with traumatic spinal cord injuries. J Neurotrauma 1995; 12:235.
  124. Geisler FH, Dorsey FC, Coleman WP. Recovery of motor function after spinal-cord injury--a randomized, placebo-controlled trial with GM-1 ganglioside. N Engl J Med 1991; 324:1829.
  125. Geisler FH, Coleman WP, Grieco G, et al. The Sygen multicenter acute spinal cord injury study. Spine (Phila Pa 1976) 2001; 26:S87.
  126. Chinnock P, Roberts I. Gangliosides for acute spinal cord injury. Cochrane Database Syst Rev 2005; :CD004444.
  127. Daverat P, Gagnon M, Dartigues JF, et al. Initial factors predicting survival in patients with a spinal cord injury. J Neurol Neurosurg Psychiatry 1989; 52:403.
  128. Claxton AR, Wong DT, Chung F, Fehlings MG. Predictors of hospital mortality and mechanical ventilation in patients with cervical spinal cord injury. Can J Anaesth 1998; 45:144.
  129. Tee JW, Chan PC, Gruen RL, et al. Early predictors of mortality after spine trauma: a level 1 Australian trauma center study. Spine (Phila Pa 1976) 2013; 38:169.
  130. Varma A, Hill EG, Nicholas J, Selassie A. Predictors of early mortality after traumatic spinal cord injury: a population-based study. Spine (Phila Pa 1976) 2010; 35:778.
  131. Marino RJ, Ditunno JF Jr, Donovan WH, Maynard F Jr. Neurologic recovery after traumatic spinal cord injury: data from the Model Spinal Cord Injury Systems. Arch Phys Med Rehabil 1999; 80:1391.
  132. Harrop JS, Naroji S, Maltenfort MG, et al. Neurologic improvement after thoracic, thoracolumbar, and lumbar spinal cord (conus medullaris) injuries. Spine (Phila Pa 1976) 2011; 36:21.
  133. van Middendorp JJ, Hosman AJ, Donders AR, et al. A clinical prediction rule for ambulation outcomes after traumatic spinal cord injury: a longitudinal cohort study. Lancet 2011; 377:1004.
  134. Failli V, Kopp MA, Gericke C, et al. Functional neurological recovery after spinal cord injury is impaired in patients with infections. Brain 2012; 135:3238.
  135. Tee JW, Chan PC, Fitzgerald MC, et al. Early predictors of functional disability after spine trauma: a level 1 trauma center study. Spine (Phila Pa 1976) 2013; 38:999.
  136. Waters RL, Adkins RH, Yakura JS, Sie I. Motor and sensory recovery following incomplete tetraplegia. Arch Phys Med Rehabil 1994; 75:306.
  137. Braddom R. Physical medicine and rehabilitation, 2nd, WB Saunders Company, Philadelphia 2000. p.1236.