![]() ![]() ![]() Although clinically relevant functional improvement can be achieved with neurorehabilitation, its effect size is limited, which explains the need for adjunct neuromodulatory interventions. At the current state the only proven treatments for augmentation of functional recovery are intensive, task-oriented neurorehabilitative therapies activating neural plasticity at different levels of the central nervous system. However, the translation of preclinical results of neuroregenerative approaches to clinical application represents a huge challenge still lacking evidence for efficacy in humans. Worldwide, intensive research activities aim to develop restorative therapies, which foster regeneration of the damaged/injured spinal cord, thus promoting recovery of sensorimotor and autonomic function beyond natural recovery. Rehabilitative efforts aiming at improvement of motor function are often compromised by SCI associated complications such as high levels of pain, spasticity or cardiovascular dysfunction such as orthostatic hypotension or autonomic dysreflexia. In people with sensorimotor complete SCI and limited spontaneous neurological recovery, the aim of rehabilitation is to compensate for the permanently lost voluntary function by assistive devices such as wheelchairs or other walking aids. In people with acute incomplete SCI and a high potential for neurological recovery, medical (causal treatment of acute non-traumatic causes, decompression surgery in acute traumatic SCI) and rehabilitative interventions aim to promote sensorimotor improvements and restoration of grasping/reaching and standing/walking function. Beyond these symptoms, which become apparent immediately after injury, secondary disease conditions such as neuropathic pain evolve, which in addition affect the wellbeing and quality of life in SCI patients. In addition, SCI patients present with more or less pronounced autonomic dysfunction including bladder and bowel control as well as cardiovascular malfunction. Proc Natl.Acad Sci U.S.Spinal cord injury either due to a traumatic or non-traumatic cause severely affects sensorimotor function in upper and lower extremities depending on the neurological level of injury and injury severity. (1999) A visceral pain pathway in the dorsal column of the spinal cord. Willis W D, Al Chaer E D, Quast M J et al. Wang CC, Willis WD, Westlund KN (1999) Ascending projections from the area around the spinal cord central canal: A Phaseolus vulgaris leucoagglutinin study in rats. Rustioni A (1973) Non-primary afferents to the nucleus gracilis from the lumbar cord of the cat. Petit D (1972) Postsynaptic fibres in the dorsal columns and their relay in the nucleus gracilis. Case report and review of the literature. (1997) Surgical interruption of a midline dorsal column visceral pain pathway. ![]() Kim YS, Kwon SJ (2000) High thoracic midline dorsal column myelotomy for severe visceral pain due to advanced stomach cancer. Honda CN, Lee CL (1985) Immunohistochemistry of synaptic input and functional characterizations of neurons near the spinal central canal. Honda CN (1985) Visceral and somatic afferent convergence onto neurons near the central canal in the sacral spinal cord of the cat. Hitchcock E (1970) Stereotactic cervical myelotomy. (1996) Is there a pathway in the posterior funiculus that signals visceral pain? Pain 67:291–305 Hirshberg RM, Al Chaer ED, Lawand NB et al. Gildenberg PL, Hirshberg RM (1984) Limited myelotomy for the treatment of intractable cancer pain. Evidence against an important role in nociception. Giesler GJ Jr, Cliffer KD (1985) Postsynaptic dorsal column pathway of the rat. Giesler GJ Jr, Nahin RL, Madsen AM (1984) Postsynaptic dorsal column pathway of the rat. (1983) Receptive field organization and response properties of spinal neurones with axons ascending the dorsal columns in the cat. J Neurophysiol 76:2675–2690īrown AG, Brown PB, Fyffe RE et al. (1996) Pelvic visceral input into the nucleus gracilis is largely mediated by the postsynaptic dorsal column pathway. Al-Chaer ED, Lawand NB, Westlund KN et al. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |