Paraspinal compartment syndrome is a rare cause of lower back pain that remains under-recognized and under-treated and which can result in prolonged and debilitating pain. We present the case of a young female with paramyotonia congenita due to sodium chanelopathy, who developed acute paraspinal compartment syndrome after ingestion of an ephedrine containing proprietary weight loss product. We highlight the challenges in diagnosis and management and review potential precipitating factors and mechanisms underlying the clinical features.

Sexual and reproductive health is important for quality of life and has a significant influence on patient satisfaction. Spinal cord pathology occurs from trauma, deformity, and degenerative disease processes may be leads to damage sexual function and reproductive system. There are two control systems situated in the spinal cord associated with erection; parasympathetic and sympathetic nervous systems. The parasympathetic center is in sacral segments S2–S4 and is responsible for reflexogenic erection and the sympathetic center is placed in T11–L2 segments of the spinal cord, which is responsible for psychogenic erection. Approximately 10-20% of erectile dysfunction (ED) is of neurological origin. The neurogenic ED is classified into 3 groups, as supraspinal, spinal (sacral and suprasacral) and peripheral.

The purpose of this study was to report the improvement of walking ability using Hybrid Assistive Limb (HAL) training in a case of severe thoracic myelopathy caused by ossification of the posterior longitudinal ligament (OPLL). The patient received HAL training 2-3 times per week (10 sessions) beginning on the thirteenth postoperative day. The patient’s walking ability and lower muscles strength were significantly improved. It suggests that HAL training in the early postoperative phase has the potential to be an effective rehabilitation tool to improve functional ambulation in surgically-treated thoracic OPLL patients with inability of walk.

This article deals with the respiratory management of acute spinal cord injury patients discussing the mechanics of respiration, assessment and management strategies, respiratory care in the acute stage, invasive mechanical ventilation and weaning including survival following spinal cord injury.
The importance of the care in supine position, physiological instability of the injured cord effect of hypoxia and hypovolaemia is also discussed.
A review of relevant literature has been done to try and answer whether early mobilization following acute spinal cord injury is better than active physiological conservative care including slow weaning, reflecting the ethos of treatment for these problems at Oswestry.

Spinal cord injury (SCI) is a devastating injury resulting in changes in the spinal cord’s motor, sensory, or autonomic functions. Following SCI, an inhibitory environment develops at the injury site for neural regeneration. In this review, we summary the strategies to rebuild the regenerative microenvironment with functional biomaterials for SCI repair mainly based on our research. We have developed a functional biomaterial consisting of collagen scaffolds and biologically active molecules (neurotrophic factor or the antagonists to myelin-associated inhibitor), and stem cells to rebuild a nerve regeneration microenvironment. Specifically, (1) the linear ordered collagen scaffold (LOCS) was used to guide the neural regeneration along its fibers and decrease the formation of glial scars, (2) collagen binding neurotrophic factors were incorporated into the scaffolds to promote neuronal survival and neural fiber regeneration, (3) antagonists to myelin-associated inhibitors were added to the scaffold to direct the neuronal differentiation of the native or transplanted neural stem cells at the injury site, (4) mesenchymal stem cells (MSCs) were also added to the scaffold to reduce the acute inflammatory response due to SCI. These strategies were found to promote neural regeneration and functional recovery in SCI animals. In addition, the endogenous neural stem cells (NSCs) or implanted NSCs could be differentiated into neurons, which re-established the neuronal circuits to improve SCI repair under the favorable environment.

This article deals with the main issues of management of traumatic spinal cord injury discussing - physiological instability, prognostic determinants of recovery, natural history, care in supine position, mobilization, canal encroachment, cord compression, and indications for surgery.
A review of relevant literature has been done including the STASCIS study to try and explore whether early or late surgery for traumatic spinal cord injury is better than conservative management.
It reflects the ethos of Active Physiological Conservative Management for these patients at RJ&AH Orthopaedic Hospital.
Considering the lack of credible evidence demonstrating superiority of outcome with surgery compared to early active management of the traumatic spinal injury, patients should be encouraged to make an informed choice.

Pediatric spinal cord injury is a complex process that is associated with significant morbidity and mortality. While this injury is rare, knowledge of the unique aspects of the pediatric spine can aid in making a prompt diagnosis which can lead to faster treatment and functional recovery.

Cauda equina syndrome is characterised by disturbed function of multiple sacral and lumbar nerve roots in the lumbar vertebral canal resulting in impairment of bladder, bowel, or sexual function. Since the sacral roots are more at midline in lumbar dural sac a central disc herniation of large size can be a cause. The large central herniation causing cauda equina syndrome stretches the roots. Best results are obtained by decompression.