[Update on current care guidelines: spinal cord injury]. / Selkäydinvamma.

Traumatic spinal cord injury is most common among men between 16 and 30 years. Prevention should be targeted both on traffic safety and individual behaviour Key issues in patient care are safe transfer from the place of injury to a hospital, diagnostic imaging (primarily CT, MRI if needed) and assessment of neurological injury by AIS-questionnaire, early surgical decompression and stabilisation for most cases, and treatment and rehabilitation starting from the emergency room and extending to life-long care carried out by a multi-professional team.

Sexual activity and satisfaction in men with traumatic spinal cord lesion.

OBJECTIVE: To estimate sexual activity and sexual satisfaction in men with spinal cord lesion. DESIGN: Cross-sectional study. SUBJECTS: All adult citizens in Helsinki with traumatic spinal cord lesion were identified. The final study group comprised 92 male subjects, corresponding to a participation rate of 79%. METHODS: A structured questionnaire was sent to all subjects and they were invited for a clinical visit. Clinical examination was based on the manual of the American Spinal Injury Association (ASIA). Examinations were performed on all subjects by the same experienced physician and physiotherapist. RESULTS: In total, 86% of the subjects experienced sexual desire and 68% had been sexually active during the last 12 months. A total of 65% of subjects reported experiencing orgasm since the injury, but most subjects rated it as weaker than before the injury. There were no statistically significant differences between the ASIA Impairment Scale groups. Men with paraplegia reported a more satisfactory sex life (p = 0.05) than those with tetraplegia. CONCLUSION: This study confirms the earlier findings that the ability to reach orgasm is deficient in men with spinal cord lesion. The completeness of the lesion had no effect. The more severe locomotory disability might adversely affect the sex life of persons with tetraplegia compared with those with paraplegia.

Health-related quality of life in persons with traumatic spinal cord lesion in Helsinki.

OBJECTIVE: To estimate the health-related quality of life (HRQoL) of persons with spinal cord lesion. DESIGN: The study design was cross-sectional. SUBJECTS: All adult citizens in Helsinki with traumatic spinal cord lesion were identified. The final study group comprised 117 subjects, corresponding to a participation rate of 77%. METHODS: HRQoL was assessed by a generic 15-dimensional self-administered instrument (15D). Clinical examination was based on the manual of the American Spinal Injury Association. Examinations were performed on all subjects by the same experienced physician and physiotherapist. RESULTS: The average 15D score of the study group was significantly lower (p<0.001) than that measured in the age-matched general population sample. Subjects with spinal cord lesion had significantly more problems due to the neurological lesion but also on the dimensions of sleeping, discomfort and symptoms and vitality. In regression analysis of the study group the only variable explaining HRQoL was the neurological level of the lesion. Spinal cord lesion caused more depression and distress in persons with motor incomplete lesion than those with motor complete lesion. CONCLUSION: Persons with spinal cord lesion had lower HRQoL than the population in general. The results indicate that spinal cord lesion may cause problems in the areas of sleeping, discomfort and symptoms or vitality, in particular. More attention should be paid to finding ways of improving the situation of persons with motor incomplete lesion, especially in terms of psychological function.

Functional independence in persons with spinal cord injury in Helsinki.

OBJECTIVE: To estimate the functional independence of persons with spinal cord injury according to the Functional Independence Measure motor items. DESIGN: The study design was cross-sectional. SUBJECTS: All adult citizens of Helsinki with traumatic spinal cord injury were identified. The final study group consisted of 121/152 subjects (80%). METHODS: Functional Independence Measure assessments and American Spinal Cord Association examinations were performed on all subjects by the same experienced group including a physician and a physiotherapist. RESULTS: The most assistance-craving items were climbing stairs and bladder management. There were no significant differences between the genders. Subjects with tetraplegia needed significantly more assistance in all motor items except walking/wheelchair locomotion, where there was no significant difference. Subjects with tetraplegia in American Spinal Injury Association Impairment Scale D had higher Functional Independence Measure scores, more functional independence, than subjects in American Spinal Injury Association Impairment Scale A-C, the difference being significant. CONCLUSION: Because of new information, the results of this study may provide better possibilities for planning and coordinating rehabilitation measures and social services.