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Spinal immobilisation

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https://www.readbyqxmd.com/read/27747560/the-epidemiology-of-pre-hospital-potential-spinal-cord-injuries-in-victoria-australia-a-six-year-retrospective-cohort-study
#1
Ala'a O Oteir, Karen Smith, Johannes U Stoelwinder, Shelley Cox, James W Middleton, Paul A Jennings
BACKGROUND: Traumatic Spinal Cord Injury (TSCI) is relatively uncommon, yet a devastating and costly condition. Despite the human and social impacts, studies describing patients with potential TSCI in the pre-hospital setting are scarce. This paper aims to describe the epidemiology of patients potentially at risk of or suspected to have a TSCI by paramedics, with a view to providing a better understanding of factors associated with potential TSCI. METHODS: This is a retrospective cohort study of all adult patients managed and transported by Ambulance Victoria (AV) between 01 January 2007 and 31 December 2012 who, based on meeting pre-hospital triage protocols and criteria for spinal clearance, paramedic suspicion or spinal immobilisation, were classified to be at risk of or suspected to have a TSCI...
December 2016: Injury Epidemiology
https://www.readbyqxmd.com/read/27566300/cervical-spondylodiscitis-following-an-invasive-procedure-on-the-neopharynx-after-circumferential-pharyngolaryngectomy-a-retrospective-case-series
#2
Florent Espitalier, Anne de Keating-Hart, Sylvain Morinière, Jean-Michel Badet, Nathalie Asseray, Christophe Ferron, Olivier Malard
PURPOSE: To highlight cervical spondylodiscitis as an infrequent complication following an invasive procedure on the neopharynx in patients previously treated with circumferential pharyngolaryngectomy with pectoralis major myocutaneous flap reconstruction. METHODS: Patients diagnosed with cervical spondylodiscitis after circumferential pharyngolaryngectomy between 2001 and 2013 were retrospectively studied using a questionnaire sent to the French head and neck tumour study group...
August 26, 2016: European Spine Journal
https://www.readbyqxmd.com/read/27474412/heterogeneity-in-cervical-spine-assessment-in-paediatric-trauma-a-survey-of-physicians-knowledge-and-application-at-a-paediatric-major-trauma-centre
#3
Aaron J Buckland, Silvia Bressan, Helen Jowett, Michael B Johnson, Warwick J Teague
OBJECTIVE: Evidence-based decision-making tools are widely used to guide cervical spine assessment in adult trauma patients. Similar tools validated for use in injured children are lacking. A paediatric-specific approach is appropriate given important differences in cervical spine anatomy, mechanism of spinal injury and concerns over ionising radiation in children. The present study aims to survey physicians' knowledge and application of cervical spine assessment in injured children. METHODS: A cross-sectional survey of physicians actively engaged in trauma care within a paediatric trauma centre was undertaken...
October 2016: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/27364894/pushing-the-limits-of-the-leksell-stereotactic-frame-for-spinal-lesions-up-to-c3-fixation-at-the-maxilla
#4
Manjul Tripathi, Narendra Kumar, Kanchan Kumar Mukherjee
BACKGROUND: Spinal radiosurgery is not considered in the domain of traditional Gamma Knife radiosurgery (GKRS) setup. The major obstacles in GKRS for upper cervical spine lesions remain in difficulty of frame fixation, avoiding collision and maintaining the integrity of the relative position of the lesion from image acquisition to treatment. METHODOLOGY: The supraorbital margin remains the standard lowest fixation point for Leksell stereotactic frame. We describe fixation at the maxilla to target and treat upper cervical spine lesions (up to C3 vertebra) with measures to ensure cervical immobilisation and precision of the GKRS treatment...
September 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27349605/diurnal-blood-pressure-and-urine-production-in-acute-spinal-cord-injury-compared-with-controls
#5
M Y Goh, M S Millard, E C K Wong, D J Brown, A G Frauman, C J O'Callaghan
STUDY DESIGN: This is a prospective observational study. OBJECTIVES: The objective of this study was to determine time-dependent changes in diurnal blood pressure (BP) and urine production in acute spinal cord injury (SCI). SETTING: This study was conducted in a specialist, state-based spinal cord service in Victoria, Australia. METHODS: Consenting patients admitted consecutively with acute SCI were compared with patients confined to bed rest while awaiting surgery and with mobilising able-bodied controls...
June 28, 2016: Spinal Cord
https://www.readbyqxmd.com/read/27325345/-spinaltrauma-clinical-diagnosis-and-initial-care
#6
M Kettner
DIAGNOSTIC WORK-UP: The rescue, treatment and transport of patients with an injured spine require a systematic scheme with the subsequent rating of the findings and suspected diagnoses. In addition to the assessment of temporal urgency, the available resources and personnel, the duration and complexity of any possible technical measures that might be anticipated, the rational selection of immobilisation tools also plays a significant role. The most important medical rescue aids are the scoop stretcher and the spine board; the spine board, vacuum mattress and cervical collar are used to immobilise the patient...
August 2016: Der Radiologe
https://www.readbyqxmd.com/read/27277072/the-characteristics-and-pre-hospital-management-of-blunt-trauma-patients-with-suspected-spinal-column-injuries-a-retrospective-observational-study
#7
J T Oosterwold, D C Sagel, P M van Grunsven, M Holla, J de Man-van Ginkel, S Berben
BACKGROUND: Pre-hospital spinal immobilisation by emergency medical services (EMS) staff is currently the standard of care in cases of suspected spinal column injuries. There is, however, a lack of data on the characteristics of patients who received spinal immobilisation during the pre-hospital phase and on the adverse effects of immobilisation. The objectives of this study were threefold. First, we determined the pre-hospital characteristics of blunt trauma patients with suspected spinal column injuries who were immobilised by EMS staff...
June 8, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27233026/does-spinal-immobilisation-hinder-diagnosis
#8
(no author information available yet)
Assessment of trauma victims could be hampered by symptoms generated by immobilisation treatments. In a recent study, 21 healthy volunteers were spinally immobilised in the standard manner with a rigid cervical collar, taped and supported by sandbags on a long spinal board. The volunteers were immobilised for 30 minutes and then released.
May 1, 1994: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/27091739/effect-of-spineboard-and-headblocks-on-the-image-quality-of-head-ct-scans
#9
Baukje Hemmes, Cécile R L P N Jeukens, Aliaa Al-Haidari, Paul A M Hofman, Ed S Vd Linden, Peter R G Brink, Martijn Poeze
Trauma patients at risk for, or suspected of, spinal injury are frequently transported to hospital using full spinal immobilisation. At the emergency department, immobilisation is often maintained until radiological work-up is completed. In this study, we examined how these devices for spinal stabilization influence visual image quality. Image quality was judged for both patient CT scans and phantom CT scans. CT scans of 217 patients were assessed retrospectively by two radiologists for visual scoring of image quality, scoring both quantity and impact of artifacts caused by the immobilization devices...
June 2016: Emergency Radiology
https://www.readbyqxmd.com/read/26896762/a-novel-approach-for-biomechanical-spine-analysis-mechanical-response-of-vertebral-bone-augmentation-by-kyphoplasty-to-stabilise-thoracolumbar-burst-fractures
#10
A Germaneau, T Vendeuvre, M Saget, P Doumalin, J C Dupré, F Brémand, F Hesser, M Couvertier, C Brèque, P Maxy, M Roulaud, O Monlezun, P Rigoard
Kyphoplasty has been shown as a well-established technique for spinal injuries. This technique allows a vertebral bone augmentation with a reduction of morbidity and does not involve any adjacent segment immobilisation. There is a lack of biomechanical information resulting in major gaps of knowledge such as: the evaluation of the "quality" of stabilisation provided by kyphoplasty as a standalone procedure in case of unstable fracture. Our objective is to analyse biomechanical response of spine segments stabilised by Kyphoplasty and PMMA cement after experiencing burst fractures...
June 2016: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/26813044/inter-and-intra-fraction-motion-in-stereotactic-body-radiotherapy-for-spinal-and-paraspinal-tumours-using-cone-beam-ct-and-positional-correction-in-six-degrees-of-freedom
#11
Renee Finnigan, Brock Lamprecht, Tamara Barry, Kimberley Jones, Joshua Boyd, Andrew Pullar, Bryan Burmeister, Matthew Foote
INTRODUCTION: Stereotactic body radiotherapy (SBRT) for spinal tumours delivers high doses per fraction to targets in close proximity to neural tissue. With steep dose gradients, small changes in position can confer significant dosimetric impact on adjacent structures. We analysed positioning error in consecutively treated patients on a strict image-guidance protocol with online correction in 6 degrees of freedom (6-DOF). METHODS: Set-up error, residual error post-correction and intra-fraction motion for 30 courses of spinal SBRT in 27 patients were assessed using cone-beam CT...
February 2016: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/26754428/effect-of-spinal-immobilisation-devices-on-radiation-exposure-in-conventional-radiography-and-computed-tomography
#12
Baukje Hemmes, Cécile R L P N Jeukens, Gerrit J Kemerink, Peter R G Brink, Martijn Poeze
Trauma patients at risk for, or suspected of, spinal injury are frequently transported to hospital using full spinal immobilisation. At the emergency department, immobilisation is often maintained until radiological work-up is completed. In this study, we examined how these devices influence radiation exposure and noise, as a proxy for objective image quality. Conventional radiographs (CR) and computer tomography (CT) scans were made using a phantom immobilised on two types of spineboard and a vacuum mattress and using two types of headblocks...
April 2016: Emergency Radiology
https://www.readbyqxmd.com/read/26362582/confirmation-of-suboptimal-protocols-in-spinal-immobilisation
#13
Mark Dixon, Joseph O'Halloran, Ailish Hannigan, Scott Keenan, Niamh M Cummins
BACKGROUND: Spinal immobilisation during extrication of patients in road traffic collisions is routinely used despite the lack of evidence for this practice. In a previous proof of concept study (n=1), we recorded up to four times more cervical spine movement during extrication using conventional techniques than self-controlled extrication. OBJECTIVE: The objective of this study was to establish, using biomechanical analysis which technique provides the minimal deviation of the cervical spine from the neutral in-line position during extrication from a vehicle in a larger sample of variable age, height and mass...
December 2015: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/26312112/resuscitation-of-polytrauma-patients-the-management-of-massive-skeletal-bleeding
#14
Enrique Guerado, Maria Luisa Bertrand, Luis Valdes, Encarnacion Cruz, Juan Ramon Cano
The term 'severely injured patient' is often synonymous of polytrauma patient, multiply-injured patient or, in some settings, polyfractured patient. Together with brain trauma, copious bleeding is the most severe complication of polytrauma. Consequently hypotension develop. Then, the perfusion of organs may be compromised, with the risk of organ failure. Treatment of chest bleeding after trauma is essential and is mainly addressed via surgical manoeuvres. As in the case of lesions to the pelvis, abdomen or extremities, this approach demonstrates the application of damage control (DC)...
2015: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/26051883/spinal-immobilisaton-in-pre-hospital-and-emergency-care-a-systematic-review-of-the-literature
#15
REVIEW
Natalie Hood, Julie Considine
BACKGROUND: Spinal immobilisation has been a mainstay of trauma care for decades and is based on the premise that immobilisation will prevent further neurological compromise in patients with a spinal column injury. The aim of this systematic review was to examine the evidence related to spinal immobilisation in pre-hospital and emergency care settings. METHODS: In February 2015, we performed a systematic literature review of English language publications from 1966 to January 2015 indexed in MEDLINE and Cochrane library using the following search terms: 'spinal injuries' OR 'spinal cord injuries' AND 'emergency treatment' OR 'emergency care' OR 'first aid' AND immobilisation...
August 2015: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/25820893/secondary-neurological-deterioration-in-traumatic-spinal-injury-data-from-medicolegal-cases
#16
N V Todd, D Skinner, J Wilson-MacDonald
We assessed the frequency and causes of neurological deterioration in 59 patients with spinal cord injury on whom reports were prepared for clinical negligence litigation. In those who deteriorated neurologically we assessed the causes of the change in neurology and whether that neurological deterioration was potentially preventable. In all 27 patients (46%) changed neurologically, 20 patients (74% of those who deteriorated) had no primary neurological deficit. Of those who deteriorated, 13 (48%) became Frankel A...
April 2015: Bone & Joint Journal
https://www.readbyqxmd.com/read/25784068/-a-new-protocol-is-the-spine-still-safe
#17
Marike C Kokke, Wietske Ham, Loek P H Leenen
The latest version of the Dutch National Protocol Ambulance Care (Landelijk Protocol Ambulancezorg LPA8), introduced on 1 January 2015, contains too few guarantees of the safety of trauma patients in whom spinal immobilisation has to be performed. A number of strict indications have been removed and too much freedom is also permitted with respect to implementation. Although the previous standard method using a spinal board, collar and blocks did have disadvantages, the new operating method has been insufficiently substantiated and, in addition, is not well matched to the protocols of Accident and Emergency departments...
2015: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/25687944/-management-of-difficult-airway-with-inhalation-induction-in-a-patient-with-lennox-gastaut-syndrome-and-neck-injury
#18
J Rey, C M Encabo, N E Pizarro, J L San Martín, F López-Timoneda
Lennox-Gastaut syndrome is a childhood epileptic encephalopathy, and is characterized by frequent and difficult to treat seizures associated with mental retardation. The case is presented of a 21 year-old male with Lennox-Gastaut syndrome, with bilateral cervical facet joint dislocation fracture at C6-C7 and spinal canal compression as a result of a fall during a seizure. In this case the management of the difficult airway expected in an awake and uncooperative patient, with cervical spinal cord injury is described...
November 2015: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/25687175/stereotactic-body-radiotherapy-for-spinal-and-bone-metastases
#19
REVIEW
I S Bhattacharya, P J Hoskin
Stereotactic body radiotherapy (SBRT) can deliver high radiation doses to small volumes with very tight margins, which has significant advantages when treating tumours close to the spinal cord or at sites of retreatment. When treating spinal tumours, meticulous quality control is essential with effective immobilisation, as dose gradients at the edge of the spinal cord will be steep and excessive movements can be catastrophic. A range of dose-fractionation schedules have been used from single doses of 15-24 Gy to fractionated schedules delivering 15-35 Gy in three to five fractions...
May 2015: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/25687133/comparison-of-fusion-rates-between-rod-based-laminar-claw-hook-and-posterior-cervical-screw-constructs-in-type-ii-odontoid-fractures
#20
COMPARATIVE STUDY
Andrzej Maciejczak, Andzelina Wolan-Nieroda, Katarzyna Jabłońska-Sudoł
BACKGROUND: This study was aimed (i) to compare the fusion rates of rod-based laminar claw hook constructs to that of posterior C1/C2 screw constructs in odontoid fractures, and (ii) to evaluate any complications associated with claw hook/rod constructs. To our knowledge, no study in contemporary literature has presented the effects of using modern rod-based laminar claw hooks for treating odontoid fractures. Unlike laminar clamps from the 1980s, contemporary laminar hook-rod instrumentation systems provide better immobilisation of the cervical spine and allows for building reliable frame-like constructs similar to cervical screw-rod systems...
July 2015: Injury
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