Honolulu Personal Injury Lawyer - Spinal Cord Injuries

A Plaintiffs Attorney Reflects on Injury, Hardship, Disappointment and Loss - Law As Poetry

Wayne Parsons — Tue, 05 May 2009 05:01:49 GMT

They are all injured - my clients. Their lives have been visited by misfortune. Sometimes their house is falling down or some variation of that theme. Sometimes an insurance adjuster working for a huge insurer like Allstate or AIG is holding back on paying their medical bills or refusing to pay their lost wages - and the fear of being thrown on the streets is in their hearts. Sometimes they have been cheated or discriminated against. Sometimes they can't move or see or they hide their scars from public view. Sometimes they have lost a child or a parent or their partner. An attorney's life is full of passion and poetry. Real life. Real passion. You have to look hard to see the poetry but it is there. The people who pass through the door of an attorney's office walk in with hardship, disappointment and loss in their minds and heavy in their hearts. I want to share this little poem by Rumi as my reflection on life in general and the pain and fear that often comes to us - and particularly to my injured clients:

The Guest House

This being human is a guest-house.

Every morning a new arrival.

A joy, a depression, a meanness,

some momentary awareness comes

as an unexpected visitor.

Welcome and entertain them all!

Even if they’re a crowd of sorrows,

who violently sweep your house

empty of its furniture.

Still, treat each guest honorably.

He may be clearing you out

for some new delight.

The dark thought, the shame, the malice,

meet them at the door laughing,

and invite them in.

Be grateful for whoever comes,

because each has been sent

as a guide from beyond.

- by Rumi

That's all. Nothing more tonight.

Originally posted at InjuryBoard by Wayne Parsons

Spinal Surgery Outcomes Improved by New Imaging Technology

Wayne Parsons — Thu, 25 Dec 2008 12:51:56 GMT

ScienceDaily reports on Dec. 23, 2008 that spine surgeons at the Mayo Clinic in Florida are using a three-dimensional (3D) image-guided system to help place screws in the spines of patients. They claim that the imaging system allows more accurate surgery with a decrease in the number of misplaced screws, and subsequent injuries, seen in more traditional operations, say neurosurgeons at Mayo Clinic in Florida.

In the Dec. 9 on-line edition of the Journal of Neurosurgery: Spine, Mayo physicians published the largest study yet using 3D image-guided technology to place screws in the spine for spinal fusion procedures. The screws are used to stabilize the spine in patients who suffer from collapsed discs or compressed nerves.

Surgeons analyzed the placement of 1,084 "pedicle" screws in 220 patients and calculated a nerve injury rate of less than 1 percent. Additionally, less than 1 percent of the screws were significantly misplaced. Stanford surgery techniques average an injury rate of up to 8 percent and a misplacement rate of up to 55 percent. Re-operation for removal of a misplaced screw has been reported in other surgical literature to be as high as 6.5 percent but occurred in less than half of one percent of all patients in the Mayo study, according to the researchers.

"Using 3D image-guided technology to help us place these screws results in a much better outcome for our patients," says Mayo Clinic neurosurgeon Eric Nottmeier, M.D., the study's lead investigator. "In addition to the decreased incidence of nerve root injury, this technology allows us to place larger screws into the spine, which can also increase the success rate of the operation."

Mayo Clinic uses a special camera using infrared light mounted on a computer to track a surgical instrument in three dimensions. The surgeon places the instrument on the patient's spine and navigates the spine using the computer. The surgical instrument is used to determine the best entry point and trajectory for each screw. An image-guided screwdriver is used to place a screw.

Conventional surgery involves placing pedicle screws by hand and eye or by using X-rays to show a 2-dimensional image on a television screen as the screw is inserted. The old technique results in less accurate screw placement and exposes both patients and the operating room staff to radiation resulting in them having to wear lead clothing for protection.

"Every person's spine is a little bit unique," Dr. Nottmeier says, "and unexpected variations in bone shape and density can make screw placement in the spine more challenging, especially in patients who have had previous spine surgery." Almost half of the patients in the Mayo study had a previous spine surgery.

"This technique allows us to have the best view possible of the vertebrae as we operate," Dr. Nottmeier says.

The new system is now used in all spinal screw operations at Mayo Clinic in Florida.

Two different image guided systems were used in this study: the "Stealth Treon," manufactured by Medtronic of Littleton, Mass., and the "BrainLAB Vector Vision," from BrainLAB in Westchester, Ill. Nottmeier is a paid consultant for BrainLAB, however, this study was done independently and did not involve any company funding.

Co-authors of the study include Phillip M. Young, M.D., Department of Radiology, Mayo Clinic in Florida, and Will Seemer, B.A., Department of Chemistry, from the University of North Florida in Jacksonville.

Originally posted at InjuryBoard by Wayne Parsons

Recovery From Spinal Cord Injury Improves With Sole Use Of Impaired Limb

Wayne Parsons — Sun, 21 Sep 2008 14:52:07 GMT

There is important new hope for brain injury and spinal cord injury patients reported in Science Daily Health!

An important new study of rats with minor spinal cord injuries showed full recovery in rats that had to use the impaired limb. The explanation for this phenomenon is that by using the impaired limb the growth of healthy nerve fibers is increased as is the formation of new nerve cell clusters. The study was published in the Journal of Neuroscience. Society for Neuroscience (2008, September 20), Sole Use Of Impaired Limb Improves Recovery In Spinal Cord Injury.

The findings show the promise that physical therapy holds for spinal cord injuries and point the physical therapists and doctors treating spinal cord injuries towards therapies that use the impaired limbs in patients with spinal cord or brain injuries.

Dr. Stephen Strittmatter, MD, PhD, of Yale University School of Medicine points out that although physical therapy has long been the standard of care therapy for spinal cord and brain injuries resulting in impairment of the use a limb, that the mechanisms of why it is beneficial has not been understood. Dr. Strittmatter was not affiliated with the current study which was conducted at the University of Zurich and the Swiss Federal Institute of Technology by Irin Maier and Martin Schwab.

Rats with an impaired limb were divided into groups. In one group the limb was restricted so the rat could not use it and in the other group the good limb was restricted so the rat had to use the impaired limb. After there weeks the restrictive braces were removed and in a ladder test the rats who had been forced to use the impaired limb showed complete functional recovery. In contrast the other rats had significant difficulty with the horizontal rungs of the ladder.

In all rats there was growth of healthy nerve fibers (axons) but the rats that were forced to use the impaired limbs showed more extensive nerve growth. The medical researchers hypothesize that use promotes healthy nerve cells to form new connections (synapses) with the cells affected by the injury thus rerouting and rewiring damages circuits in the spinal cord circuits associated with movement.

This research also used gene chip technology that measured how limb use turned on and/or off certain genes involved in never fiber growth and synapse formation. These discoveries could lead to new drugs for treatment of spinal cord injuries. For those with spinal cord injury this study points towards an increase in physical therapy over that already given. The work was supported by the Christopher and Dana Reeve Foundation as well as the Swiss National Science Foundation.

Originally posted at InjuryBoard by Wayne Parsons