ObjectiveNeck muscle dysfunction is associated with cervical vertigo. This study evaluated the clinical effect of “Spinal Manipulation Combined with Cervical Kinetic Chain Training” on neck muscle function in cervical vertigo.MethodsData were collected from August 2023 to October 2024. 50 cervical vertigo patients were divided into a test group (n = 25) receiving spinal manipulation combined with cervical kinetic chain training, and a control group (n = 25) receiving conventional treatment. Assessments at baseline included vertigo severity (Visual Analog Scale, VAS; Dizziness Handicap Inventory, DHI), cervical muscle magnetic resonance imaging (MRI), and Shear Wave Elastography (SWE). Follow-ups at 4 weeks repeated VAS, DHI, and SWE. At 12 weeks, vertigo severity and muscle strength were assessed, with the test group undergoing repeat MRI.ResultsDHI and VAS scores decreased significantly in both groups at 4 and 12 weeks compared to baseline. At 12 weeks, scores in the test group were significantly lower than at 4 weeks (P = 0.003), whereas the control group showed no difference (PDHI = 0.677; PVAS = 0.885). The test group's DHI was significantly lower than the control group's at 12 weeks (P = 0.001), and its VAS was lower at both 4 and 12 weeks. SWE showed the elastic modulus of bilateral splenius capitis muscles increased in the control group at 4 weeks (P left = 0.032; P right = 0.033), but remained unchanged in the test group (P > 0.05). At 4 weeks, the test group had a significantly lower elastic modulus in the right splenius capitis and obliquus capitis inferior than the control group (Right musculus splenius capitis, P = 0.031; Right obliquus capitis inferior, P = 0.031). At 12 weeks, the test group demonstrated a significant increase in the cross-sectional area (CSA) and oblique diameter compared to pre-treatment, the test group showed significant improvements in all the aforementioned metrics compared to baselines. The test group’s muscle strength of all directions were significantly better to those of control group.ConclusionsSpinal Manipulation Combined with Cervical Training enhances neck muscle strength, reduces suboccipital muscle tension compared to traditional treatment, and is an effective treatment for cervical vertigo.Clinical Trial Registrationhttps://www.chictr.org.cn/, Identifier ChiCTR2300075144.

BackgroundIntrathecal baclofen (ITB) acts as a selective GABAB receptor agonist to modulate spinal inhibitory pathways. While effective for severe spasticity, the pharmacotherapeutic efficacy and safety profile across distinct neurological etiologies—cerebral palsy (CP), spinal cord injury (SCI), and brain injury (BI)—remain poorly characterized from a comparative pharmacological perspective.Methods and findingsWe systematically searched five global databases (up to August 2025) for trials evaluating ITB therapy. Random-effects models were employed to synthesize efficacy data, focusing on dose-response relationships and clinical outcomes. 15 studies (6 RCTs, 9 observational) were analyzed. Our results demonstrate that ITB significantly reduced Ashworth Scale scores across all subgroups, but with marked etiology-specific variations in effective dosage requirements. Specifically, SCI patients exhibited the most significant reduction in spasm frequency. Safety pharmacology analysis revealed that pharmacological adverse events (AEs), such as somnolence and respiratory depression, were dose-dependent and more prevalent in BI populations. In contrast, hardware-related complications (e.g., catheter malfunction) were idiosyncratic but clinically severe.ConclusionITB therapy provides robust anti-spasticity effects mediated through its targeted action on spinal inhibitory circuits. However, the heterogeneity in dosage efficacy suggests etiology-driven differences in GABAB receptor sensitivity or drug distribution. These findings underscore the necessity for precision titration strategies based on patient-specific pathophysiology and highlight the importance of differentiating between pharmacodynamic side effects and mechanical complications to optimize the therapeutic index of ITB.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251112388, identifier CRD420251112388.

Objective: A thoracolumbar active resistance rehabilitation trainer was developed, aiming to verify its activation effect on the core muscles of the lumbar and abdominal regions in spinal cord injury (SCI) cases and explore the difference in therapeutic efficacy between this trainer and traditional bridge exercises. Methods: A prospective, assessor-blinded randomized controlled trial of 40 SCI inpatients. Participants were allocated to two groups, both alongside conventional rehabilitation. The experimental group received 8 weeks of training with the trainer, while the control group underwent 8 weeks of bridge exercises training. The assessment indicators include surface electromyography, Spinal Cord Independence Measure-III, Walking Index for Spinal Cord Injury, and Japanese Orthopaedic Association scores. Results: The experimental group demonstrated superior abdominal muscle activation versus controls at 8 weeks. Clinically, the experimental group showed greater improvement in functional independence (t=2.599, P=0.019, Cohen'd=1.225), exceeding the minimal clinically important difference (MCID). Both groups achieved MCID in walking ability (WISCI) and lumbar function (JOA), with no significant between-group differences. The trainer was safe and rated higher for convenience and usability. Conclusion: The trainer is safe and more effective than bridge exercises for functional independence in SCI rehabilitation, offering practical advantages for diverse settings.

High‑frequency spinal cord stimulation (HF‑SCS) is an effective method for treating neuropathic pain (NP), but its specific mechanism of action in treating spinal cord injury (SCI) remains unclear. The present study aimed to explore the therapeutic effect of early HF‑SCS in a rat model of SCI and its potential molecular mechanism. A Sprague‑Dawley rat model of T10 spinal cord contusion was established and stimulation electrodes were implanted epidurally, which was followed by HF‑SCS treatment (40% movement threshold at a frequency of 10 kHz). Through behavioral assessments, histopathological analysis and immunofluorescence staining, the present study demonstrated that HF‑SCS markedly alleviated post‑SCI NP, facilitated functional recovery and accelerated axonal regeneration and myelin repair. Mechanistic studies employing RNA sequencing, western blotting and immunofluorescence further revealed that HF‑SCS exerted its neuroprotective effect by downregulating the reactive oxygen species/p38 MAPK/NF‑κB signaling pathway to reduce microglial activation and decrease the release of proinflammatory factors; simultaneously, it inhibited the activation of the C‑X‑C motif chemokine ligand 10/C‑X‑C motif chemokine receptor 3 axis to alleviate central sensitization. These findings suggest that early HF‑SCS intervention can improve the functional prognosis after SCI by suppressing neuroinflammation and reducing central sensitization, thereby providing a theoretical basis for the treatment of SCI with HF‑SCS.

IntroductionNeuropathic pain (NP) after spinal cord injury (SCI) is intractable with limited efficacy of single treatments. This study investigated the additive analgesic effect and molecular mechanisms of Bumetanide (Bu, a NKCC1 inhibitor) combined with medial ganglionic eminence (MGE) cell transplantation on SCI-induced NP.MethodsNinety adult female C57BL/6N mice were randomly divided into 5 groups (Sham, SCI, Bu, Mge, Bu+Mge). A T10 moderate spinal cord contusion model was established, with treatments (Bu intraperitoneal injection and MGE orthotopic transplantation) on day 10 post-surgery. Behavioral assessments, ELISA, Western blotting, qRT-PCR, and immunofluorescence staining were used.ResultsCompared with monotherapy, Bu+Mge significantly relieved SCI-induced NP. Mechanistically, it alleviated inflammation by inhibiting NF-κB pathway and microglia activation, rectified spinal cord and dorsal root ganglion NKCC1/KCC2 imbalance, increased GABA-A receptors and GAD65/67 mRNA, reduced glial scarring, and protected neurons, axons and myelin sheaths.DiscussionBu combined with MGE cell transplantation relieves SCI-induced NP via multiple additive mechanisms, providing a novel theoretical basis and potential clinical strategy for NP treatment.

Abstract Background Percutaneous vertebroplasty (PVP) is highly effective treatment for osteoporotic vertebral compression fractures (OVCF). There is no clear conclusion regarding the common locations of fractures, and whether recurrent fractures are related to surgery, or changes in local spinal alignment. Methods A total of 164 patients with thoracolumbar OVCF from June 2020 to June 2024 were enrolled. The segmental distribution with initial and recurrent fractures were collected. The impact of surgery on recurrent fractures was analyzed by comparing the segmental distribution of recurrent fractures between groups. 84 patients with T11-L2 OVCF were divided into two groups based on recurrent fractures or not. The gender, age, trauma of patients were measured, imaging indicators including bone cement distribution type, T11-L2 Cobb angle, Cobb angle and height recovery rate of fractured vertebra, and vertebral CT value were measured at the time of initial fracture, immediately after surgery, and recurrent fracture. The influencing factors of recurrent OVCF were explored through inter-group comparative analysis. Results Both initial and recurrent fractures mostly occurred in the T11-L3, accounting for 80.4% and 63.1%, respectively. In the non-surgical group, the recurrent fractures were found mostly at L1 and L2 levels, accounting for 21.6%; while in the surgical group, the fractures occurred mostly at L1 level, accounting for 14.0%. In 84 patients with T11-L2 OVCF, among surgical patients, average age in the recurrent fracture group was 8.4 years older(P<0.001), and the average CT value was 22.9 HU lower (P =0.012) than that in the non-recurrent group. For each 1-year increase in age, the risk of recurrent fractures increased by 7.1%; for each 1 HU decrease in CT value, the risk of recurrent fractures increased by 2.1%. In addition, 78.6% of patients with initial fractures had a history of trauma, and 64.7% of patients with recurrent fractures had a history of trauma. Conclusions Initial and recurrent OVCF of the thoracolumbar spine commonly occurred in T11 to L3 segments. The segment of initial fracture and surgical treatment were not associated with recurrent fracture location or risk. Advanced age and decreased CT value are risk factors for recurrent fractures. The occurrence of the fracture, mostly depends on the presence of trauma. Registry www.chictr.org.cn, TRN: ChiCTR2500105987, Registration date: 27 June 2025.

Spinal cord injury (SCI) triggers neuropathic pain through inflammatory secondary injury. Olfactory ensheathing cells (OECs) hold therapeutic promise, but their pain-relieving mechanisms are unclear. This study investigated whether OEC transplantation alleviates pain by modulating macrophage extracellular trap (MET) formation and Na + –K + –Cl − cotransporter 1 (NKCC1) expression. Following ethical approval, a rat contusive SCI model was established. OEC-treated rats received a cell transplant post-injury. Motor and sensory functions were assessed over 35 days. Tissue was analyzed for NKCC1, CD68, and the MET marker H3Cit. In vitro, RAW264.7 macrophages were stimulated with TNF-α to induce METs. OEC transplantation significantly improved functional recovery and reduced mechanical/thermal hypersensitivity. Histology showed preserved tissue structure. Critically, OEC treatment suppressed MET formation (reduced H3Cit/CD68) and downregulated NKCC1 in vivo. In vitro, OEC-conditioned medium inhibited TNF‑α‑induced MET formation and NKCC1 expression in macrophages. Thus, OECs alleviate neuropathic pain and promote recovery after SCI by coordinately suppressing macrophage extracellular traps and regulating NKCC1 expression, revealing a novel immunomodulatory‑ion transport axis for pain intervention.

BACKGROUND:Vertebral fractures are linked to significant disability and mortality risks. Yet, existing studies on their global burden are outdated and lack predictive foresight. METHODS:Public data from the 2021 GBD study were analyzed to assess the global burden and epidemiological trends of vertebral fractures. The annual percentage change (EAPC) was calculated to represent temporal trends from 1990 to 2021. Machine learning was used to predict the global burden of vertebral fractures over the next 30 years. RESULTS:From 1990 to 2021, the global burden of vertebral fractures significantly decreased. The age-standardized incidence rates (ASIR) showed the largest decline in Eastern Sub-Saharan Africa (EAPC: -1.5; 95% CI: -2.0 to -1.0), while North Africa and the Middle East were the only regions to report an increase (EAPC: 0.3; 95% CI: 0.1 to 0.5). For age-standardized prevalence rates (ASPR), High-income Asia Pacific saw the steepest decline (EAPC: -1.4; 95% CI: -1.5 to -1.2), while the Caribbean experienced the largest increase (EAPC: 0.8; 95% CI: 0.4 to 1.3). Similarly, in terms of age-standardized years lived with disability rates (ASYR), the most substantial reduction occurred in High-income Asia Pacific (EAPC: -1.4; 95% CI: -1.5 to -1.3), with the Caribbean again showing the greatest rise (EAPC: 0.8; 95% CI: 0.3 to 1.2). Males generally exhibited higher age-standardized rates (ASRs) than females, although females aged 65-70 years old surpassed males. Predictive models suggest continued declines in global ASIR, ASPR, and ASYR by 2050. CONCLUSIONS:Our study shows a steady reduction in the global burden of vertebral fractures from 1990 to 2021. Nevertheless, disparities remain across regions, with a positive correlation between ASRs with SDI.

Background:The incidence of pediatric acute hyperextension-induced spinal cord injury (PAHSCI) is increasing in China, with some cases complicated by acute transverse myelitis (ATM). As predictive tools are lacking, this study aims to develop a clinical-imaging nomogram to assess ATM risk and support precision diagnosis and treatment in PAHSCI. Methods:We retrospectively analyzed clinical data from patients under 14 years of age diagnosed with thoracic PAHSCI between January 2012 and January 2023. All patients underwent lumbar puncture, gadolinium-enhanced imaging, and whole-spine MRI. Clinical history and imaging findings were collected, and the diagnosis of ATM was determined according to the Transverse Myelitis Consortium Working Group criteria. Patients were randomly assigned to training and validation cohorts in a 7:3 ratio. Least absolute shrinkage and selection operator (LASSO) regression was used to identify potential risk factors for ATM, which were then incorporated into a multivariable logistic regression model to construct a predictive nomogram. Model discrimination and calibration were assessed using the area under the receiver operating characteristic curve (AUC), calibration plots, and Brier scores. Internal validation was performed via 1,000-bootstrap resampling to generate 95% confidence intervals. Model goodness-of-fit was evaluated with the Hosmer-Lemeshow test, and clinical utility was assessed using decision curve analysis (DCA). Results:LASSO regression and multivariate logistic regression identified five predictors: age, fall, latent activity, flow void, and pinprick sensation score, which were used to construct a nomogram for estimating the risk of ATM in PAHSCI patients. The model demonstrated strong discriminative performance, with AUCs of 0.876 (95% CI: 0.803-0.950) in the training set and 0.844 (95% CI: 0.709-0.979) in the validation set. Calibration was satisfactory in both cohorts, as evidenced by the Hosmer-Lemeshow test (training: χ 2 = 5.638, p = 0.776; validation: χ 2 = 9.666, p = 0.378) and low Brier scores (0.138 and 0.167, respectively). Decision curve analysis indicated substantial net clinical benefit within risk thresholds of 8%-99% in the training cohort and 6%-71% in the validation cohort. Conclusion:We developed a preliminary nomogram demonstrating strong predictive accuracy for estimating ATM risk in PAHSCI patients, thereby enabling clinicians to adopt individualized therapeutic strategies.

BackgroundThis study investigated the brain functional characteristics of patients with neuropathic pain (NP) following spinal cord injury (SCI) using functional near-infrared spectroscopy (fNIRS).MethodsA total of 35 subjects were enrolled, including 10 able-bodied controls, 12 patients with SCI and NP (SCI-NP), and 13 patients with SCI (without NP). fNIRS was used to detected blood oxygen signals during motor tasks and resting-state (RS) functional connectivity (FC) in the subjects. We also performed Pearson correlation analyses of pain scores (NPS) and the Pittsburgh Sleep Quality Index (PSQI) in patients with SCI-NP. Statistical analyses were performed using Shapiro-Wilk test for normality; paired t-test for intra-group differences; ANOVA (LSD post-hoc, Bonferroni-corrected) for multi-group comparisons; Cohen's d/partial η2 for effect size; independent samples t-test (FDR-corrected) for inter-group FC differences.ResultsDuring the task state, patients with SCI-NP activated bilateral primary somatosensory cortex (S1, L/R P = 0.044/0.032), bilateral supplementary motor area (SMA, L/R P = 0.041/0.037), right primary motor cortex and left parietal lobe (LPL, P = 0.047). Hemodynamic changes in the bilateral S1, secondary somatosensory cortex, SMA, and right prefrontal cortex of patients with SCI-NP were significantly stronger than those in the other two groups. During RS, the whole-brain and most inter/intra-regional FC strength trended able-bodied controls > patients with SCI > patients with SCI-NP. NPS strongly correlated with LPL (r = 0.977, P = 0.004); PSQI correlated with motor cortex HbO changes (r = 0.889−0.975, P = 0.005−0.043).ConclusionPatients with SCI-NP exhibit significant abnormal cerebral cortical excitation and reduced FC. HbO is a potential biomarker for evaluating NP. fNIRS supports objective assessment of SCI-NP and rehabilitation strategy formulation [ChiCTR2500097098].

BACKGROUND:Stroke is a highly prevalent and disabling acute cerebrovascular disease. Existing assessment methods for hemiplegic patients have subjectivity, and research on combining surface electromyography and color Doppler ultrasound (CDUS) to evaluate lower limbs of stroke patients is scarce. AIM:The study explored the correlation between quadriceps femoris muscle function and femoral artery hemodynamic parameters in hemiplegic patients after stroke for more accurate rehabilitation assessment. DESIGN:A prospective control study. SETTING:Hospital in-patient population. POPULATION:The sample comprised 20 post-stroke hemiplegic patients aged 18 - 80 years who met specific inclusion and exclusion criteria. Then the healthy side and the affected side were compared respectively. METHODS:The study chose surface electromyography and color Doppler ultrasound. Femoral artery hemodynamic parameters and quadriceps femoris electromyographic signals were detected before and after maximum isometric contraction. Differences between the affected and healthy sides and correlations were analyzed. RESULTS:The affected side had lower peak systolic velocity, arterial diameter, and surface electromyography indicators of the quadriceps femoris (except for increased end-diastolic velocity) (P<0.05). Significant differences were found in mean power frequency and median frequency of vastus medialis and vastus lateralis muscles (P<0.05). A positive correlation was found between the healthy side's quadriceps femoris median frequency and arterial diameter during contraction (r=0.489, P<0.05). CONCLUSIONS:Lower limb muscle function impairment in hemiplegic patients after stroke is closely related to hemodynamic abnormalities. Combining surface electromyography and CDUS provides comprehensive rehabilitation assessment. CLINICAL REHABILITATION IMPACT:This combined method can reduce subjective bias of traditional assessment, improve early assessment accuracy, and provide more precise references for stroke rehabilitation assessment and treatment.

PURPOSE:To investigate the incidence and influencing factors of bone loss in patients with spinal cord injury (SCI). METHODS:A retrospective case-control study was conducted. Patients with SCI in our hospital from January 2019 to March 2023 were collected. According to the correlation between bone mineral density (BMD) at different sites, the patients were divided into the lumbar spine group and the hip joint group. According to the BMD value, the patients were divided into the normal bone mass group (t > -1.0 standard deviation) and the osteopenia group (t ≤ -1.0 standard deviation). The influencing factors accumulated as follows: gender, age, height, weight, cause of injury, injury segment, injury degree, time after injury, start time of rehabilitation, motor score, sensory score, spasticity, serum value of alkaline phosphatase, calcium, and phosphorus. The trend chart was drawn and the influencing factors were analyzed. SPSS 26.0 was used for statistical analysis. Correlation analysis was used to test the correlation between the BMD values of the lumbar spine and bilateral hips. Binary logistic regression analysis was used to explore the influencing factors of osteoporosis after SCI. p < 0.05 was considered statistically significant. RESULTS:The incidence of bone loss in patients with SCI was 66.3%. There was a low concordance between bone loss in the lumbar spine and the hip, and the hip was particularly susceptible to bone loss after SCI, with an upward trend in incidence (36% - 82%). In this study, patients with SCI were divided into the lumbar spine group (n = 100) and the hip group (n = 185) according to the BMD values of different sites. Then, the lumbar spine group was divided into the normal bone mass group (n = 53) and the osteopenia group (n = 47); the hip joint group was divided into the normal bone mass group (n = 83) and the osteopenia group (n = 102). Of these, lumbar bone loss after SCI is correlated with gender and weight (p = 0.032 and < 0.001, respectively), and hip bone loss is correlated with gender, height, weight, and time since injury (p < 0.001, p = 0.015, 0.009, and 0.012, respectively). CONCLUSIONS:The incidence of bone loss after SCI was high, especially in the hip. The incidence and influencing factors of bone loss in the lumbar spine and hip were different. Patients with SCI who are male, low height, lightweight, and long time after injury were more likely to have bone loss.

We used 34-channel functional near infrared spectroscopy to investigate and compare changes in oxyhemoglobin concentration of brain networks in bilateral prefrontal cortex, sensorimotor cortex, and occipital lobe of 22 right-handed healthy adults during executive right-handed grasp (motor execution task) and imagined right-handed grasp (motor imagery task). Then calculated lateral index and functional contribution degree, and measured functional connectivity strength between the regions of interest. In the motor executive block task, there was a significant increase in oxyhemoglobin concentration in regions of interest except for right occipital lobe (P<0.05), while in the motor imagery task, all left regions of interest's oxyhemoglobin concentration increased significantly (P<0.05). Except the prefrontal cortex in motor executive task, the left side of the brain was dominant. Left sensorimotor cortex played a major role in these two tasks, followed by right sensorimotor cortex. Among all functional contribution degree, left sensorimotor cortex, right sensorimotor cortex and left occipital lobe ranked top three during these tasks. In continuous acquisition tasks, functional connectivity on during motor imagery task was stronger than that during motor executive task. Brain functions during two tasks of right-hand grasping movement were partially consistent. However, the excitability of brain during motor imagery was lower, and it was more dependent on the participation of left prefrontal cortex, and its synchronous activity of the whole brain was stronger. The trend of functional contribution degree was basically consistent with oxyhemoglobin concentration and lateral index, and can be used as a novel index to evaluate brain function. [ChiCTR2200063792 (2022-09-16)].

Objective: Being struck by an object is a major cause of traumatic spinal cord injury in China. This study aims to investigate epidemiological characteristics of spinal cord injury caused by object strike. Methods: This research analysed data from 435 cases of strike-induced spinal cord injury from 2013 to 2022. The collected information encompassed gender, age, level of neurological injury, surgical interventions, expense, occupation, and other relevant factors. χ2tests and Mann–Whitney U test were used with a statistical significance level of 0.05. Results: The male-to-female ratio was 11.8:1. The 30–44 age group was more likely to suffer from complete spinal cord injuries (70.5%). The predominant occupations were workers (58.9%) and farmers (15.2%). Manual labourers are usually injured in the workplace (89.4%) with a high surgical rate (95.3%). Conclusion: Young and middle-aged males engaged in manual work constitute the primary demographic for strike-induced spinal cord injury. Safety education in workplaces such as construction sites and mines should be emphasized to reduce the occurrence of spinal cord injuries caused by object strikes.

Objective: Hip subluxation is a common complication in children with spinal cord injury. This study aimed to investigate the incidence and influencing factors of hip subluxation and discuss prevention strategies.Methods: Medical records of children with spinal cord injury were reviewed. The inclusion criteria were as follows: (1) the patient was younger than 18 years old when injured; (2) absence of traumatic or congenital pathological changes of the hip at the time of injury. The migration percentage and acetabular index were selected to evaluate hip stability and acetabulum development. Influencing factors of sex, age, injury duration, severity, level, and spasticity were analyzed.Results: A total of 146 children were enrolled. Twenty-eight children presented with hip subluxation and were significantly younger at the time of injury than those with normal hips (P = 0.002). The incidence of hip subluxation increased with the prolonged injury duration. Injury before age 6, complete injury, and flaccid lower extremities were significant influencing factors (P = 0.003, 0.004, and 0.015, respectively). The risk of hip subluxation decreased by 18% for every year older in injury age (P = 0.031) and decreased by 85% in children with spasticity (P = 0.018) than those without. However, the risk of hip subluxation in children with injury duration longer than 1 year was 7.1 times higher than those with shorter injury duration (P < 0.001).Conclusions: The incidence of hip subluxation in children with spinal cord injury increased with the injury duration. Younger children had immature hip development. Due to complete injury and flaccid muscle, lack of protection around the hip may lead to subluxation. Follow-up and prevention of hip subluxation need the joint effort of medical staff and families.

Previous studies have confirmed the relationship between chloride homeostasis and pain. However, the role of sodium potassium chloride co-transporter isoform 1 (NKCC1) in dorsal horn and dorsal root ganglion neurons (DRGs) in spinal cord injury (SCI)-induced neuropathic pain (NP) remains inconclusive. Therefore, we aimed to explore whether suppression of NKCC1 in the spinal cord and DRGs alleviate the NP of adult rats with thoracic spinal cord contusion. Thirty adult female Sprague-Dawley rats (8 week-old, weighing 250–280 g) were randomly divided into three groups with ten animals in each group (sham, SCI, and bumetanide groups). The paw withdrawal mechanical threshold and paw withdrawal thermal latency were recorded before injury (baseline) and on post-injury days 14, 21, 28, and 35. At the end of experiment, western blotting (WB) analysis, quantitative real-time Polymerase Chain Reaction (PCR) and immunofluorescence were performed to quantify NKCC1 expression. Our results revealed that NKCC1 protein expression in the spinal cord and DRGs was significantly up-regulated in rats with SCI. Intraperitoneal treatment of bumetanide (an NKCC1 inhibitor) reversed the expression of NKCC1 in the dorsal horn and DRGs and ameliorated mechanical ectopic pain and thermal hypersensitivities in the SCI rats. Our study demonstrated the occurrence of NKCC1 overexpression in the spinal cord and DRGs in a rodent model of NP and indicated that changes in the peripheral nervous system also play a major role in promoting pain sensitization after SCI.

目的:观察综合康复治疗对创伤性颈脊髓中央损伤综合征(traumatic central cord syndrome,TCCS)患者神经功能和生活质量的改善情况,并进行多维度疗效评价.方法:回顾性分析2016年1月～2021年12月我院收治的90例TCCS患者,其中男74例,女16例,年龄27～85岁(56.6±10.7岁),根据综合康复治疗前是否接受了颈椎手术分为术后康复组(82例)和单纯康复组(8例).两组患者在年龄、性别、脊髓损伤程度等方面均无统计学差异(P＞0.05).所有患者均接受1～3个月的物理治疗、作业治疗、膀胱管理等综合康复治疗.收集患者入院和出院时的美国脊髓损伤协会(American Spinal Injury Assosication,ASIA)残损分级(ASIA impairment scale,AIS)和运动评分(motor score,MS)、国际功能分类康复组合(ICF-RS)评分,并进行组间比较;统计患者膀胱功能变化和并发症情况,全面评估TCCS患者的神经功能恢复情况,多维度评价康复措施的疗效.结果:综合康复治疗前AIS分级C级48例,D级42例,治疗后27例患者C级改善为D级(术后康复组23例,单纯康复组4例),余63例AIS分级无变化,但治疗后下肢和上肢的MS较治疗前显著提高(P＜0.05).组间MS评分无统计学差异(P＞0.05).患者ICF-RS所有条目中,"b280痛觉"、"d240控制应激和其他心理需求"评分变化治疗前后无统计学差异(P＞0.05);余条目评分均较治疗前有提高,且有统计学差异(P＜0.05),组间比较无统计学差异(P＞0.05).33例患者由导尿恢复至自主排尿.脊髓损伤并发症占比前2名的是痉挛(54.4％)和神经痛(23.3％),痉挛与MS恢复程度无显著相关性(P=-0.06).结论:综合康复治疗对TCCS患者神经功能恢复有明显促进作用,无论是术后康复还是单纯康复的TCCS患者其综合功能均获得了明显改善.ICF-RS条目细致,适于TCCS这一特殊类型脊髓损伤患者的评估.

OBJECTIVE To investigate the clinical characteristics of children with traumatic spinal cord injury (SCI) admitted to a research rehabilitation center between 2011 and 2020, with a view to generate crucial data for understanding and prevention of pediatric traumatic SCI. DESIGN Retrospective cohort study. SETTING The National Rehabilitation Research Center of China, Beijing, China. PARTICIPANTS Medical records and imaging data of children with traumatic SCI admitted to the rehabilitation research center from 2011 to 2020. INTERVENTIONS Not applicable. OUTCOME MEASURES Data on age, sex, cause of injury, neurological level of injury, impairment scale of SCI and details of spine fracture or dislocation were all collected and analyzed. RESULTS A total of 351 patients were included in the study, including 133 males (37.9%) and 218 females (62.1%). There were 231 cases (65.8%) without spine fracture or dislocation. SCI without fracture or dislocation (SCIWORA) was the most common in children between the age of 5 and 14 years (77.9%), and injuries caused by sports were the most common in girls (90.8%). Among sports injuries, those due to a special dance movement called "Xia-Yao" in Chinese, which involves hyperextension of the trunk, constituted the majority, with the neurological level of injuries located predominantly in the middle (34.6%) and lower (44.2%) thoracic levels. CONCLUSION Girls between the ages of 5 and 14 years constituted the majority of SCIWORA injuries at the thoracic levels, which were caused mainly by "Xia-Yao". Overall, careful attention should be paid to prevent this kind of injury in children.

The scales evaluating patients' neurological functions and quality of life are the basis of clinical evaluation and/or scientific research of nervous system diseases. Neurological functions of patients with spinal cord injury (SCI) are commonly assessed by using American Spinal Injury Association (ASIA) Impairment Scale or International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). Generally, the quality of life for SCI patients is evaluated by using several available evaluating scales. International Association of Neurorestoratology (IANR) Spinal Cord Injury Functional Rating Scale (IANR-SCIFRS) was designed as one single method to assess various items of quality of life related with SCI, including male sexual function. However, in clinical practice, the ability of returning to society is an important index of quality of life after SCI. Additionally, the female patients' sexual function after SCI that has been neglected in the past should be reconsidered following neurorestorative treatments. Even more, this scale also can be applied to assess the quality of life in patients with spinal cord dysfunction due to diseases or disorders. Thus, the IANR added the ability of returning to society and female patients' sexual function in the current revised version and renamed the scale as Spinal Cord Injury or Dysfunction Quality of Life Rating Scale (SCIDQLRS) (IANR 2022 version). Hopefully, this revised scale is widely used to expand enhanced improvements of quality of life following neurorestorative treatments in patients with SCI or spinal cord dysfunction.