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W S El Masri
Keele University, UK
Keynote: J Neurol Clin Neurosci
The incidence of traumatic spinal cord injuries (TSCI) is very small 10-50/million/year, however the effects: medical, physical, psychological, social, financial, vocational and environmental are dramatic & devastating for the patient, partner, and family members’ relationships. The multi-system physiological impairment and malfunction, inter-system reflex activity and its effects together with the inability of the patient to exhibit the expected clinical symptoms and physical signs of complications due to loss/impairment of sensation can be overwhelming to clinicians inexperienced in the management of these patients. Spontaneous Neurological Recovery (SNR) following TSCI was reported by Frankel et al in 1969 and repeatedly confirmed since then. This is provided that both the biomechanical instability of the injured spine and the Physiological Instability of the spinal cord are well managed and the medical complications are prevented. Clinical sparing of long tracts in the first few days of injury was first demonstrated by Frankel et at 1969 to be a good predictor of recovery irrespective of the severity of the fracture on X-rays. The correlation between the type of long tract spared and the degree of neuro-functional recovery was confirmed in the largest series of 612 patients treated and closely monitored under one roof and expressed in the Frankel classification which to date remains the most clinically meaningful classification. The development of CT & MRI resulted on increased emphasis on the management of the injured spine often on the expense of the management of the other effects of cord damage. This presentation will discuss the controversial issues around the management of patient and in particular the injured spine, the tools to evaluate the neurological outcomes. Also, it will demonstrate what determines the neurological outcome is the force of the impact on the cord at the time of injury and the quality of the comprehensive management of the patient and all the effects of cord damage to prevent complications and not the radiological manifestation of the injury.
Recent Publications:
1. Wagih El Masri, 5th April 2022 4(3)Traumatic Spinal Cord Injuries: Effects, Controversies in Management and Neurological Outcomes. DOI:10.31579/2694-0248/035 2.
2. W.S. El Masri, International Journal of Orthopedics and Rehabilitation, 2021, 8, 19-29 Spontaneous Neurological Recovery of Patients with Acute Traumatic Spinal Cord Injuries (ATSCI) without Intervention the Injured Cord DOI: https://doi. org/10.12974/2313-0954.2021.08.4.
W S El Masri is a Clinical professor of Spinal Injuries at Keele University. He is an Emeritus Consultant Surgeon in Spinal Injuries Robert Jones & Agnes Hunt Orthopaedic Hospital – Oswestry. He served as the Chairman of BASCIS, as the President of International Spinal Cord Society (ISCoS). He is a Trustee of the Institute of Orthopaedic R J A H Hospital, Oswestry. Also, he is the Founder Member and Chairman of Trustees SPIRIT Educational Charity in Spinal Injuries.
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