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Study design:A prospective, non-randomized clinical series trial.Objective:To evaluate the effect of autogenous undifferentiated stem cell infusion for the treatment of patients with chronic spinal cord injury (SCI) on somatosensory evoked potentials (SSEPs).Setting:A public tertiary hospital in São Paulo, Brazil.Methods:Thirty-nine consecutive patients with diagnosed complete cervical and thoracic SCI for at least 2 years and with no cortical response in the SSEP study of the lower limbs were included in the trial. The trial patients underwent peripheral blood stem cell mobilization and collection. The stem cell concentrate was cryopreserved and reinfused through arteriography into the donor patient. The patients were followed up for 2.5 years and submitted to SSEP studies to evaluate the improvement in SSEPs after undifferentiated cell infusion.Results:Twenty-six (66.7%) patients showed recovery of somatosensory evoked response to peripheral stimuli after 2.5 years of follow-up.Conclusion:The 2.5-year trial protocol proved to be safe and improved SSEPs in patients with complete SCI.Sponsorship:None. [ABSTRACT FROM AUTHOR]

Unlabelled: Controversial data suggest that patients with type 2 diabetes mellitus have an increased risk of fractures despite having, in some studies, higher bone mineral density., Methods: The aim of this study was to determine the prevalence of osteoporosis and morphometric vertebral fractures in 148 postmenopausal diabetic women, aged 61.87±7.85 years, and their relationship with clinical and metabolic factors and chronic complications of the disease., Results: The prevalence of osteoporosis was 30.4% at lumbar spine (LS) and 9.5% at femoral neck (FN). The prevalence of vertebral fractures was 23%, mostly mild and located at the thoracic spine. Patients with fractures were older (P<.001), had been in the menopause for a long period (P=.005), had lower creatinine clearance (P=.026) had and lower bone mineral density at LS (P=.01) and FN (P=.042). The frequency of fractures increased with age (P<.001), with the duration of the disease (P=.037) and with the presence of retinopathy (P=.030). In patients with fractures, the prevalence of osteoporosis increased to 40% at LS (P=.004) and to 35.7% at FN (P=.049). After logistic regression adjustment, it was observed that the likelihood of presenting vertebral fractures was significantly increased at the age of 60 years or older (P<.001) and with the presence of osteoporosis at LS (P=.006), irrespective of blood glucose control., Conclusion: We found a high prevalence of osteoporosis and vertebral fractures in postmenopausal women with type 2 diabetes mellitus, irrespective of blood glucose control, and these conditions were more frequent in long-standing disease and in patients with retinopathy and impaired renal function., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Study Design: Retrospective study., Objective: Evaluate the relationship among the neurologic status, the Thoracolumbar Injury Classification System (TLICS) score, and the Magerl/AO classification system., Summary of the Background Data: A wide range of classification schemes for thoracic and lumbar spine trauma have been described, but none has achieved widespread acceptance. A recent system proposed by Vaccaro et al has been developed to improve injury classification and guide surgical decision making., Methods: Analysis of 49 patients treated surgically for thoracic and lumbar spine trauma from 2003 to 2009 in 2 spine trauma centers. Clinical and radiologic data were evaluated, classifying the trauma according to American Spinal Injury Association status, the Magerl/AO classification for fractures, and the TLICS score., Results: The mean age was 37 years (range, 17-72). Thirty-five (71%) patients had a thoracolumbar fracture (T11-L2). A posterior approach was used in all the cases. American Spinal Injury Association status remained unchanged in 44 (4 had some improvement and 1 worsened). A total of 61.1% of the patients with a type A fracture were neurologically intact compared with 80% with complete neurologic deficit for type C fractures. The TLICS score range from 2 to 9 (average of 6.2). Forty-seven of 49 (96%) patients had a TLICS score greater than 4, suggesting surgical treatment. Seventy percentage of the patients with a TLICS score from 4 to 6 were neurologically intact compared with 87.5% of complete neurologic deficits in patients with TLICS 7 to 9. A statistic correlation was established between the neurologic status and AO type fracture (P = 0.0041) and the TLICS score (P < 0.0001). An association between the AO type fracture and the TLICS score was also found (P = 0.0088)., Conclusion: The TLICS score treatment recommendation matched surgical treatment in 47 of 49 patients (96%). The TLICS was found to correlate to the AO classification. This suggests that the TLICS can be used to classify thoracolumbar trauma and can accurately predict surgical management.

Fractures are the main problems related to bone fragility in postmenopausal women and account for the increase in the risk of new fractures, mortality, and costs. This study's objective was to verify the occurrence of vertebral fragility fracture and correlate it with demographic, behavioral, and clinical factors in a Brazilian population. The cross-sectional study was based on a random sample of elderly women living in Chapecó, Santa Catarina State, Brazil. The sample consisted of 186 white women over 60 years of age. Of these, 48.9% had asymptomatic vertebral fractures, with higher prevalence in T11-12 and L4-5. Adjusted analysis showed a gradient between age and vertebral fracture, while fracture prevalence was 2.3 times higher in women over 80 years. Fracture prevalence was 1.44 times higher in sedentary as compared to non-sedentary women. Due to the high prevalence of asymptomatic vertebral fractures, the authors suggest the use of spinal x-rays in elderly women for fracture screening and prevention.

We describe the incidence, causes, management and prognosis of traumatic fractures of the thoracic spine from T1 to T10 in surgical cases of traumatic fractures of spine during the period from June 1994 to June 2003 studied retrospectively. The type of fracture was determined according to the Gertzbein classification, and the degree of stability using the Denis classification. The neurological picture at admission and 30 days after surgery was evaluated using the ASIA/IMSOP classification. Surgery was performed in patients with complete spinal cord injury (n=7) for the purpose of stabilization using the posterior approach. In cases without spinal cord injury or incomplete injury (n=12), the surgical procedure was performed aiming to decompress the nerve tissue, to correct the alignment of the spine and to stabilize the spine.