S137 S290
Poster 85:
Prevalence of Endocrinopathy on Admission to Acute
Inpatient Rehabilitation after Hypoxic Ischemic Brain
Injury
Benjamin Ingraham, DO (McGaw MC of NW Univ NW Med Schl/RIC),
Mithra B. Maneyapanda, MD, Taegh S. Sokhey, Student,
David L. Ripley, MD, MS, FAAPMR
Disclosures:
Benjamin Ingraham: I Have No Relevant Financial Re-
lationships To Disclose
Objective:
To assess the prevalence of neuroendocrine abnormalities
in patients with hypoxic-ischemic encephalopathy (HIE) and describe
which neuroendocrine abnormalities most commonly occur.
Design:
Retrospective cohort study.
Setting:
Brain injury unit in an academic inpatient rehabilitation
hospital in the United States.
Participants:
46 patients admitted for inpatient rehabilitation after
hypoxic ischemic encephalopathy since 2013.
Interventions:
N/A.
Main Outcome Measures:
Free T4, TSH, prolactin, testosterone,
DHEA sulfate, FSH, LH, estrogen, progesterone, ACTH, cortisol, so-
matomedin C, serum sodium level.
Results:
Of the 46 subjects, 26 (56.5%) had a neuroendocrine abnor-
mality. The most common neuroendocrine abnormality was a prolactin
abnormality, which was present in 13 (39.4%) subjects. Hypogonadism
was the second most common, seen in 5 (25.0%) subjects. Cortisol
abnormality was seen in 7 (18.9%) subjects.
Conclusions:
Neuroendocrine abnormalities are common after trau-
matic brain injury (TBI), however the prevalence of hypothalamic-pi-
tuitary dysfunction in patients with HIE is unknown. On admission to
acute inpatient rehabilitation the prevalence of endocrinopathy in our
cohort was 56.5% with the most common abnormalities being high
prolactin levels followed by hypogonadism. This is a similar pattern to
that seen in moderate-to-severe TBI populations.
Level of Evidence:
Level IV
Poster 91:
Bladder Trabeculation and Urodynamic Study in
Spinal Cord Injury Patients
Jeong-Hwan Seo, MD, PhD (Chonbul Nat Univ Hosp)
Disclosures:
Jeong-Hwan Seo: I Have No Relevant Financial Relation-
ships To Disclose
Objective:
Neurogenic bladder combined with morphologic change of
bladder is common complication of spinal cord injury. We aimed to
investigate the relationship between bladder trabeculation and uri-
nary function, and compare clinical parameters according to the
bladder trabeculation.
Design:
Retrospective, medical record review.
Setting:
University hospital setting.
Participants:
Total 162 patients.
Interventions:
Not applicable.
Main Outcome Measures:
Clinical parameters and parameters of
urodynamic study and voiding cystourethrogram.
Results:
The urodynamic study parameters showed correlations with
trabeculation. As the grading of bladder trabeculation increases,
voiding volume, bladder capacity, and compliance were decrease, but
bladder tone, detrusor pressure and frequency of vesicoureteral reflux
were increased.
Conclusions:
To our knowledge, our study has 1st apply to identify
relationship between bladder trabeculation and clinical parameters in
spinal cord injury only. We can make prediction about bladder char-
acteristic by grading of bladder trabeculation and this grading system
help the proper management in complication of neurogenic bladder
like about vesicoureteral reflux.
Level of Evidence:
Level III
Friday, October 13, 2017
8:00 AM
e
9:15 AM
Room 705, Meeting Room Level
LEADING IN RESEARCH: PAIN AND SPINE MEDICINE PODIUM
SESSION
Poster 100:
Intervertebral Kinematics in the Cervical Spine
Before, During and After High Velocity Low
Amplitude Manipulation
Marissa K. Pfoff (University of Pittsburgh School of Medicine),
William Anderst, PhD
Disclosures:
Marissa Pfoff: I Have No Relevant Financial Relationships
To Disclose
Objective:
To characterize the three-dimensional intervertebral ki-
nematics of the cervical spine in individuals with neck pain before,
during and after high velocity low amplitude (HVLA) spinal
manipulation.
Design:
Quantitative descriptive/observational study.
Setting:
Research lab containing a biplane radiography system and
radiolucent examination table.
Participants:
10 subjects (age 18 to 70) with mechanical neck pain of
less than 6 weeks duration, reproducible by neck movement/provo-
cation tests.
Interventions:
Biplane radiography was collected at 30 images/sec-
ond during cervical spine range of motion including upright, flexion/
extension, rotation and lateral bending positions, prior to and imme-
diately after HVLA manipulation. Radiography was collected at 160
images/second during HVLA manipulation. Axial CT scans of the cer-
vical spine were used to generate subject-specific bone models of each
vertebra. An automated, validated volumetric tracking process
matched the bone models to the stereoradiographic images to track 3-
dimensional bone movement with sub-millimeter accuracy.
Main Outcome Measures:
Intervertebral range of motion at each
motion segment of the cervical spine during upright, flexion/exten-
sion, rotation and lateral bending positions before and after manipu-
lation, and facet joint gapping during HVLA manipulation.
Results:
Intervertebral range of motion during flexion/extension,
rotation and lateral bending was stable or increased by up to 4.5 de-
grees after manipulation. The targeted facet joint gap temporarily
increased from 1.4 mm to 2.7 mm over 140 milliseconds during HVLA
manipulation. This increased gap occurred on the side contralateral to
the manual contact point for the manipulation.
Conclusions:
For the first time in live humans, this study has
demonstrated that facet joint gapping occurs during cervical manip-
ulation. The functional improvement following manipulation is re-
flected in increased intervertebral range of motion throughout the
cervical spine, not exclusively at the targeted motion segment.
Level of Evidence:
Level IV
Poster 101:
Effect of Depression on Outcomes Following Cervical
Epidural Steroid Injection for Degenerative Spine
Disease
Byron J. Schneider, MD, FAAPMR (Vanderbilt University, Nashville, TN,
United States), Elliott Kim, MD, Silky Chotai, MD
Disclosures:
Byron Schneider: I Have No Relevant Financial Relation-
ships To Disclose
Objective:
To assess the effect depression has on outcomes after
cervical epidural steroid injections (CESI).
Design:
Retrospective analysis of prospectively collected data from a
single institution’s spine registry database.
Setting:
Academic outpatient medical center.
S137
Abstracts / PM R 9 (2017) S131-S290