Fibrocartilaginous embolic myelopathy: demographics, clinical presentation, and functional outcomes
| Autor: | Anna M. Batterson, Marianne T. Luetmer, Ronald K. Reeves, Brittany J. Moore |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male 030506 rehabilitation Pediatrics medicine.medical_specialty Adolescent Population Embolism Bowel management Spinal Cord Diseases 03 medical and health sciences Myelopathy Young Adult 0302 clinical medicine medicine Humans education Child Spinal cord injury Aged Retrospective Studies Aged 80 and over education.field_of_study business.industry Retrospective cohort study General Medicine Middle Aged medicine.disease Functional Independence Measure Treatment Outcome Neurology Spinal Cord Infarction Vascular myelopathy Female Neurology (clinical) 0305 other medical science Paraplegia business Cartilage Diseases 030217 neurology & neurosurgery |
| Zdroj: | Spinal cord. 56(12) |
| ISSN: | 1476-5624 |
| Popis: | Retrospective cohort study. To describe the demographics, clinical presentation, and functional outcomes of fibrocartilaginous embolic myelopathy (FCEM). Academic inpatient rehabilitation unit in the midwestern United States. We retrospectively searched our database to identify patients admitted between January 1, 1995 and March 31, 2016, with a high probability of FCEM. Demographic, clinical, and functional outcome measures, including Functional Independence Measure (FIM) information was obtained by chart review. We identified 31 patients with findings suggestive of FCEM (52% male), which was 2% of the nontraumatic spinal cord injury population admitted to inpatient rehabilitation. The age distribution was bimodal, with peaks in the second and sixth-to-seventh decades. The most common clinical presentation was acute pain and rapid progression of neurologic deficits consistent with a vascular myelopathy. Only three patients (10%) had FCEM documented as a diagnostic possibility. Most patients had paraplegia and neurologically incomplete injuries and were discharged to home. Nearly half of the patients required no assistive device for bladder management at discharge, but most were discharged with medications for bowel management. Median FIM walking locomotion score for all patients was 5, but most patients were discharged using a wheelchair for primary mobility. Median motor FIM subscale score was 36 at admission and 69 at discharge, with a median motor efficiency of 1.41. FCEM may be underdiagnosed and should be considered in those with the appropriate clinical presentation, because their functional outcomes may be more favorable than those with other causes of spinal cord infarction. |
| Databáze: | OpenAIRE |
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