Spinal Cord Injury: Basic and Clinical Aspects. Second Edition

Author: Xu Shaoting et al.
Publisher:
Publish Date: 2002-05-01
Features: Since the publication of Basic and Clinical Aspects of Spinal Cord Injury in 1993, research and treatment of spinal cord injury have made significant progress in the 1990s. In experimental research, the study of secondary injury has gradually deepened, and drug therapy has shown remarkable effects. Breakthrough progress has been achieved in restoring motor function after complete spinal cord transection. In clinical aspects, a deeper understanding of the pathology of human spinal cord injury has been gained. Early methylprednisolone treatment for acute spinal cord injury has shown significant effects on motor function recovery. For late-stage quadriplegic patients, hand function reconstruction has enabled patients to regain some hand function, improving their ability to perform daily activities. These developments demonstrate the necessity of revising the second edition of this book, making it a necessity of the times. The rich data available have made this revision possible. The authors spent one year extensively revising and supplementing the first edition. The second edition of Basic and Clinical Aspects of Spinal Cord Injury remains divided into four parts, but the number of chapters has increased from 21 in the first edition to 30 in the second.
In Part I, the histology and embryonic development of the spinal cord have been added. In Part II, methods for observing experimental models of spinal cord injury have been included, providing an in-depth systematic introduction to secondary injury after spinal cord trauma. Limited recovery can be achieved through the treatment of secondary injury, while improved spinal cord repair methods, such as the use of axon regeneration inhibitors and antibodies, have enabled the restoration of motor function and corticospinal tract conduction in animal models. These advancements in experimental treatment and spinal cord repair have been introduced. Gene therapy, a technique that has developed in recent years, has been given a dedicated section.
Part III focuses on clinical aspects and includes prevention and emergency treatment of spinal cord injury. The International Spinal Cord Injury Society emphasizes this issue, and developed countries have strengthened prevention and emergency treatment of spinal cord injury, significantly reducing the incidence of complete spinal cord injury and enabling patients to be transported to treatment centers within hours. Early methylprednisolone and surgical treatment have improved functional recovery. In the 1990s, the American Spinal Injury Association (ASIA) revised the definitions and Frankel grading of spinal cord injury. International reports on pathological changes in human spinal cord injury have emerged, and we have also reported on the pathology of ascending spinal ischemia. These have deepened the understanding of human spinal cord injury. The reference value of somatosensory and motor evoked potentials, as well as MRI changes in the spinal cord, for predicting outcomes have been included in Chapters 17-19. A substantial amount of information has been added on the diagnosis and treatment of cervical, thoracic, and lumbar spinal cord injuries. The discussion on whether surgical treatment is appropriate, whether early or late surgery is better, and the authors' own experiences have been thoroughly addressed. The management of spinal gunshot wounds and late spinal deformities in children with spinal cord injury have also been introduced in this chapter.
Part IV covers functional reconstruction and rehabilitation. Quadriplegic patients often experience loss of hand function, making it difficult for them to perform daily activities. In developed countries, extensive experience has been accumulated in reconstructing hand function for quadriplegic patients, enabling partial recovery of hand function. This has been detailed in Chapter 26. Urinary dysfunction is one of the most painful and life-threatening problems for spinal cord injury patients. The classification of neurogenic bladder and its relationship with different spinal cord injury levels, as well as how to reconstruct its function, have been discussed in Chapter 27.