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  • I did not get more functional recovery 3 or more years after injury.

    68 46.90%
  • I had a "complete" spinal cord injury at 24 hours and had no voluntary movement or sensation more than 2 segments below the injury site but recovered additional motor and/or sensory function 3 or more years after injury

    19 13.10%
  • I was an ASIA A at 24 hours and recovered additional function 3 or more years after injury

    29 20.00%
  • I was ASIA B at 24 hours and recovered additional function 3 or more years after injury

    22 15.17%
  • I was ASIA C at 24 hours and recovered additional function 3 or more years after injury

    7 4.83%
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Thread: Do people who were ASIA A, B, C at 24 hours after injury recover function 3 or more years after injury?

  1. #31
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    dr. young-
    how 'bout this. No movement or anal sensation for 4 weeks until vascular conus injury was obliterated. Then toes wiggling, pockets of sensation, and some motor return in upper legs; but due to vascular injury site, sacral sensation nil, however now there is much tone.
    What does this make me? This topic is depressing! I had no control over what ASIA level I am or was. mine is one of those stories without the happy ending! I have been in a wheelchair as a T12 paraplegic for 4 years, so any recovery isn't even worth mentioning, since I am still wheelchairbound. I can forsee Patients with complete injuries getting left behind if some sort of therapy miracle ever happens.

    sherman brayton

  2. #32
    Sherman, I am not sure what you mean. There is no talk or intention to leave those with "complete" injury behind. We need to press on all fronts.

    Those people with lower spinal cord injury that may have damaged gray matter (and hence the neurons that innervate the muscles), axonal regeneration may not be sufficient. That is one of the reasons why we need to push for continued stem cell research because these represent a source of cells for neuronal replacement.

    I am getting concerned by all the places, particularly overseas, that are claiming miraculous therapies based on little or no evidence. A lot of people are thinking of partaking in such therapies with the attitude of "What do I have to lose". I think that it is essential that well documented evidence of recovery is available before people spend a lot of time, money, and effort on a therapy.

    Wise.

  3. #33
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    Dr. Young, Please describe in a little detail what kind of therapy is required to restore AsiaC more Locomotor recovery.We've tried a number of things but after awhile of not seeing enough we give up.We have 2 EMS machines we used for awhile but It does take a lot of time nd whenever 1 of us would get sick, the excercise regimend would lapse and we would be back to square 1.Any thoughts?

  4. #34
    Joseph, we need therapies. Exercise and functional electrical stimulation can do only do so much. Beyond that, we need regeneration, remyelination, and other approaches. I wish that I had something to recommend. That is what the clinical trials are all about. I believe that there will be therapies. Wise.

  5. #35
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    Thanks Dr. Young.I guess we'll just have to be patient.I think after a few years of trying so many different possible ways of producing some healing it all comes down to restorative therapies that will bring re-connection.I see all these folks so desparate(including us) that they wiil travel around the world for the smallest possibility of help but nothing really substantial yet.Still a few years off it seems.Maybe it really is 10 years away.I originnaly thought when I joined these boards over 4 years ago that it was only 3 to 5 years away but this whole procees are finding restorative therapies is alot more complex then most of us originally thought.Thanks for the Methalprodasone,Justin recieved that the 1st day after the accident and thanks for your undying devotion to bring us to that wonderful time of breakthru Therapies.

  6. #36
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    I meant the Methylprednisolone.I think thats the biggest reason Justin went from Asia A to Asia C.

  7. #37
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    Dr. Young,

    According to the descriptions I found in your article, even brainstem/cortico-spinal tract injuries cound be classified under the ASIA system.
    It would seem ASIA A doesn't usually happen since generally there is no loss of sensation, but complete loss of motor function as in ASIA B, for locked-in syndrome.
    If there is some return of motor function these people would move to ASIA C, as has happened with Jason.
    Some people could conceivably reach ASIA D.
    I have even seen someone with the same size lesion in the pons as Jason recover almost full motor function although this is exceedingly rare, and she did show signs of recovery early on within the first few months.
    I know that a treadmill training program that was considering Jason wanted to know his ASIA status.
    So do you feel it is just as appropriate to use this impairment scale in brainstem/cortico-spinal tract injuries?

  8. #38
    Faye,

    I think that a different classification system should be used for brainstem and midbrain injuries. The reason is that brainstem injuries involve multiple systems that are usually not part of spinal cord injury. The level of injury should include cranial nerve and other brainstem function. The manifestations of interrupting connections between the cortex and the brainstem are likely to differ from interrupting the connections between the brainstem and the spinal cord.

    An ASIA A classification would be very rare for brainstem or midbrain injuries because survival from a "complete" loss of all connections between the cortex and the brainstem would be very rare or perhaps impossible. An ASIA B (senory present but motor absent) can occur in spinal cord injury that because sensory and motor tracts are partly segregated anatomically in the spinal cord. In the brainstem, motor and sensory pathways are intermingled. However, a "locked-in" syndrome involving the thalamus can produce a sensory loss with some preservation of motor.

    In my opinion, applying the ASIA classification system to the brainstem can be done but will not provide any meaningful classification or prognostic information. The ASIA classification should be to people who have spinal cord injury only. A different system should be devised for people who have supraspinal injuries and for people who have combined supraspinal and spinal cord injury.

    Wise.

  9. #39
    bump for more votes

  10. #40
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    dr. young-
    I was talking with a cousin of mine who works at a E.R. trauma center in Boston. He and others have been trained to ask an acute SCI patient, just arrived, if he or she can feel them putting a finger in their rectum, if the patient cannot, the overall consensus is that this patient is not going to recover successfully. The actual terminology they used was they are f***ed.
    man what a bad brake! I enter ER with avm induced paraplegia and am already considered unsalvagable with no sacral sensation. If I had such a low avm ( on conus ), why would I be considered a complete injury if my rectal area was one of the nerves most affected? this whole thing blows!

    sherman brayton

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