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Cervical collar

Asuka Desroches, Yuichiro Morishita, Itaru Yugue, Takeshi Maeda, Charles-Henri Flouzat-Lachaniette, Philippe Hernigou, Keiichiro Shiba
STUDY DESIGN: A retrospective evaluation of sagittal angular motion from cervical spinal flexion to extension. OBJECTIVE: To evaluate the kinematic effects of cervical laminoplasty for cervical spondylotic myelopathy (CSM) on the occipitoatlantoaxial junction. SUMMARY OF BACKGROUND DATA: The kinematic effects of cervical laminoplasty for CSM on the occipitoatlantoaxial junction remain controversial. METHODS: A total of 65 CSM patients who were treated with cervical laminoplasty ranging from the C3 to C7 vertebrae were included in the study...
October 6, 2016: Clinical Spine Surgery
Alan Cowley, Ashley Hague, Neal Durge
Techniques for extricating vehicle occupants after road-traffic collisions have evolved largely through fear of worsening a cervical spine injury, rather than being evidence-based. Recent research has looked at the safety of allowing the alert patient to self-extricate, rather than being assisted with equipment such as long spinal boards and semirigid cervical collars. This review aims to elucidate whether it is safe to allow an alert, ambulant patient to self-extricate from a vehicle with minimal or no cervical spine immobilization...
September 29, 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
M Kleine-Brueggeney, R Greif, N Urwyler, B Wirthmüller, L Theiler
We compared the Bonfils(™) and SensaScope(™) rigid fibreoptic scopes in 200 patients with a simulated difficult airway randomised to one of the two devices. A cervical collar inhibited neck movement and reduced mouth opening to a mean (SD) of 23 (3) mm. The primary outcome parameter was overall success of tracheal intubation; secondary outcomes included first-attempt success, intubation times, difficulty of intubation, fibreoptic view and side-effects. The mean (95% CI) overall success rate was 88 (80-94)% for the Bonfils and 89 (81-94)% for the SensaScope (p = 0...
September 27, 2016: Anaesthesia
Audrey E Ertel, Bryce Rh Robinson, Mark H Eckman
BACKGROUND: Recent guidelines from EAST conditionally recommend cervical collar removal after a negative cervical CT in obtunded adult blunt trauma patients. Though the rates of missed injury are extremely low, the impact of chronic care costs and litigation upon decision-making remains unclear. We hypothesize that the cost-effectiveness of strategies that include additional imaging may contradict current guidelines. METHODS: A cost-effectiveness analysis was performed for a base-case 40 year-old, obtunded, male with a negative CT...
September 16, 2016: Journal of Trauma and Acute Care Surgery
E O Uche, O E Nwankwo, E Okorie, A Muobike
BACKGROUND: Treatment of cervical spine injury is the most challenging of all the injuries of the spine, and there is yet no agreement on the best method of care. OBJECTIVE: We studied the complications and outcome of two skull traction devices used to treat cases of cervical spine injury in three centers in Enugu, South East Nigeria. PATIENTS AND METHODS: A retrospective analysis of patients with cervical spine injury managed with skull traction as the definitive treatment using either Crutchfield or Gardner-Wells tongs over a 5-year period (April 2008-March 2013)...
September 2016: Nigerian Journal of Clinical Practice
Vikram V Holla, Sanjeev Kumar, Rakesh Shukla
Hirayama disease (HD) is a rare disease commonly seen in India and Japan typically presenting in adolescent age group with male predominance and asymmetrical distal pure motor, lower-motor neuron-type weakness. We report a patient of HD who had significant involvement of proximal periscapular muscles along with typical distal involvement. The patient also had scapular winging, which is rare in HD. He was treated conservatively with physiotherapy and hard cervical collar and is presently under follow-up during the static phase of disease...
March 2016: Annals of Neurosciences
Jason J Bischof, Ashish R Panchal, Geoffrey I Finnegan, Thomas E Terndrup
UNLABELLED: Introduction Endotracheal intubation (ETI) is a complex clinical skill complicated by the inherent challenge of providing care in the prehospital setting. Literature reports a low success rate of prehospital ETI attempts, partly due to the care environment and partly to the lack of consistent standardized training opportunities of prehospital providers in ETI. Hypothesis/Problem The availability of a mobile simulation laboratory (MSL) to study clinically critical interventions is needed in the prehospital setting to enhance instruction and maintain proficiency...
October 2016: Prehospital and Disaster Medicine
B Hylton, S Lidder, A Armitage, S James
UNLABELLED: PURPOSE OF THE STUDY The aim of this pilot study was to develop The Eastbourne Miami-J Protocol for care of cervical injuries within the community. Led by orthopaedic senior practitioners, a multidisciplinary approach was developed to provide education and collar care for patients on a weekly basis. MATERIALS AND METHODS A total of 51 patients (17 male and 33 female), mean age 74 years (21 to 95) with CT confirmed cervical injuries during November 2010 and May 2014 followed the Eastbourne Miami-J Protocol...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
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
Lovro Suhodolčan, Marko Mihelak, Janez Brecelj, Rok Vengust
We describe a case of a 19-year-old young man with oligoarthritis type of juvenile idiopathic arthritis, who presented with several month duration of lower neck pain and progressive muscular weakness of all four limbs. X-rays of the cervical spine demonstrated spontaneous apophyseal joint fusion from the occipital condyle to C6 and from C7 to Th2 with marked instability between C6 and C7. Surgical intervention began with anterolateral approach to the cervical spine performing decompression, insertion of cage and anterior vertebral plate and screws, followed by posterior approach and fixation...
July 18, 2016: World Journal of Orthopedics
Şaban Akkuş, Şeref Kerem Çorbacıoğlu, Yunsur Çevik, Emine Akıncı, Hüseyin Uzunosmanoğlu
PURPOSE: The purpose of the study is to investigate whether spinal immobilization with a long backboard (LBB) and semirigid cervical collar (CC) at 20° instead of 0° conserve pulmonary functions, including forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio. METHODOLOGY: The study included 56 adult healthy volunteers. Volunteers were randomly divided into 2 groups, and those in the first group (group 1) had LBBs and CCs applied at 0° (n=30), whereas volunteers in the second group (group 2) had LBBs and CCs applied at 20° (n=26)...
July 1, 2016: American Journal of Emergency Medicine
H Janssen, G Buchholz, M Killer, L Ertl, H Brückmann, J Lutz
PURPOSE: While today mechanical thrombectomy is an established treatment option for main branch occlusions in anterior circulation stroke, there is still an ongoing debate on the kind of anesthesia to be preferred. Introducing a simple method for head stabilization, we analyzed safety and duration of endovascular recanalization procedures under general anesthesia (GA) and conscious sedation (CS). METHODS: We retrospectively identified 84 consecutive patients who underwent mechanical thrombectomy owing to acute anterior circulation stroke...
September 2016: Cardiovascular and Interventional Radiology
Abidemi Oseni, Georg Kakavas, Martin Scholz, Athanasios Petridis
In patients with C2 rheumatoid pannus with spinal cord compression the treatment of choice is extensive surgery either through a transoral resection of the dens axis or a dorsal stabilisation, or both. We present a case of an 11-mm rheumatoid pannus with significant compression of the spinal cord, which failed surgical treatment with respect to dorsal stabilisation. Therefore, rigid cervical collar for 8 weeks followed by soft collar for another 4 weeks was chosen as a treatment option. During the follow-up period of 1 year, the pannus reduced significantly and the spinal cord decompressed...
July 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Mohammad Davood Sharifi, Hamid Zamani Moghadam Doloo, Amir Masoud Hashemian, Javad Tootian Tourghabe, Behrang Rezvani Kakhki, Sasan Johari Teimoori, Niaz Mohammad Jafari Chokan, Hamid Reza Noroozi
BACKGROUND: Cervical spine trauma occurs mostly among young males due to falls and car accidents. The CT scan technology is replacing radiography in many medical clinics as it is very capable in detecting subtle cervical spine injuries. However, the use of CT scan for routine screening in patients with cervical spine trauma remains controversial due to its radiation risks and relatively high cost. OBJECTIVE: The focus of this research was on using morphine in patients with cervical spine trauma...
May 2016: Electronic Physician
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
M Kreinest, S Goller, G Rauch, B Gliwitzky, C Frank, S Matschke, C G Wölfl, M Münzberg
BACKGROUND: The application of cervical collars is a standard procedure in emergency care of trauma patients. It is often observed that the application of cervical collars is performed incorrectly, which may lead to reduced immobilization of the cervical spine. OBJECTIVES: The objective of this study was to analyze the practical skills of professional emergency care providers concerning the application of cervical collars. MATERIALS AND METHODS: Emergency care professionals (n = 104) were asked to apply a cervical collar to a training doll...
June 29, 2016: Der Unfallchirurg
Gurpal S Pannu, Mitesh P Shah, Marty J Herman
BACKGROUND: Cervical spine clearance in the pediatric trauma patient represents a particularly challenging task. Unfortunately, standardized clearance protocols for pediatric cervical clearance are poorly reported in the literature and imaging recommendations demonstrate considerable variability. With the use of a web-based survey, this study aims to define the methods utilized by pediatric trauma centers throughout North America. Specific attention was given to the identification of personnel responsible for cervical spine care, diagnostic imaging modalities used, and the presence or absence of a written pediatric cervical spine clearance protocol...
June 18, 2016: Journal of Pediatric Orthopedics
Jennifer A Reynolds, Joel D MacDonald
BACKGROUND: Acute complex C2 vertebral body fracture specifically does not involve the odontoid process or C2 pars interarticularis. External stabilization can be effective but may prolong healing and increase morbidity. Many traditional surgical techniques can achieve internal stabilization at the expense of normal cervical motion. We describe direct surgical C2 pedicle screw fixation as an option for managing acute complex C2 vertebral body fracture. CASE DESCRIPTION: Three patients were treated with direct pedicle screw fixation of acute traumatic complex C2 vertebral body fractures...
September 2016: World Neurosurgery
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
Lisa Bush, Robert Brookshire, Breanna Roche, Amelia Johnson, Frederic Cole, Riyad Karmy-Jones, William Long, Matthew J Martin
IMPORTANCE: Current trauma guidelines dictate that the cervical spine should not be cleared in intoxicated patients, resulting in prolonged immobilization or additional imaging. Modern computed tomography (CT) technology may obviate this and allow for immediate clearance. OBJECTIVE: To analyze cervical spine clearance practices and the utility of CT scans of the cervical spine in intoxicated patients with blunt trauma. DESIGN, SETTING, AND PARTICIPANTS: We performed a prospective observational study of 1668 patients with blunt trauma aged 18 years and older who underwent cervical spine CT scans from March 2014 to March 2015 at an American College of Surgeons-verified Level I trauma center...
September 1, 2016: JAMA Surgery
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