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https://www.readbyqxmd.com/read/29657134/early-mortality-and-morbidity-following-a-type-ii-odontoid-fracture-in-the-elderly
#1
Hassaan Q Sheikh, Michael Athanassacopoulos, Arpan B Doshi, Lee Breakwell, Ashley Cole, Antony Louis Rex Michael, Neil Chiverton
BACKGROUND: We aimed to analyse the rates of early and causes of death in patients aged over 65 years with a type II odontoid fracture. METHODS: A consecutive series of 93 patients with a type II fracture of the odontoid process was retrospectively identified. Data collected included patient demographics, co-morbidities, associated injuries, neurological injury, date of death and cause of death. Mean patient age was 81. Five patients (5%) were treated operatively while the rest were treated in a hard cervical collar...
April 12, 2018: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/29656152/occipital-condyle-fractures-and-concomitant-cervical-spine-fractures-implications-for-management
#2
James L West, Atilio E Palma, Lukas Vilella, Kyle M Fargen, Charles L Branch, Stacey Q Wolfe
INTRODUCTION: Occipital condyle fractures (OCFs) have previously been described based upon anatomic characteristics; however, recent literature has proposed management based on biomechanical stability and neural element compression. The treatment of biomechanically stable fractures varies between observation and cervical immobilization. Prior to determining best management, understanding of concomitant cervical spine fractures in the presence of OCFs is prudent. The primary aim of this pilot study was to determine the rate of occurrence of biomechanically significant cervical spine fractures with OCFs...
April 12, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29651626/current-topics-in-the-management-of-acute-traumatic-spinal-cord-injury
#3
Christopher D Shank, Beverly C Walters, Mark N Hadley
Acute traumatic spinal cord injury (SCI) affects more than 250,000 people in the USA, with approximately 17,000 new cases each year. It continues to be one of the most significant causes of trauma-related morbidity and mortality. Despite the introduction of primary injury prevention education and vehicle safety devices, such as airbags and passive restraint systems, traumatic SCI continues to have a substantial impact on the healthcare system. Over the last three decades, there have been considerable advancements in the management of patients with traumatic SCI...
April 12, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29649609/surgical-treatment-improves-survival-of-elderly-with-axis-fracture-a-national-population-based-multi-registry-cohort-study
#4
Anna-Lena Robinson, Claes Olerud, Yohan Robinson
Background Context Fractures of the axis (C2) are the most common cervical spinal injuries in the elderly population. Several authors have reported improved survival among elderly patients with C2 fractures when treated surgically. Purpose To analyze whether surgery improves survival of elderly with C2 fractures. Study Design/ Setting Observational population-based longitudinal multi-registry study Patient Sample Swedish Patient Registry 1997 to 2014, and Swedish Cause of Death Registry 1997 to 2014 Outcome measures Survival after C2 fracture according to non-surgical and surgical treatment...
April 9, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29649032/airway-management-practice-in-adults-with-an-unstable-cervical-spine-the-harborview-medical-center-experience
#5
Michael G Holmes, Armagan Dagal, Bryan A Feinstein, Aaron M Joffe
BACKGROUND: Airway management in the presence of acute cervical spine injury (CSI) is challenging. Because it limits cervical spine motion during tracheal intubation and allows for neurological examination after the procedure, awake fiberoptic bronchoscopy (FOB) has traditionally been recommended. However, with the widespread availability of video laryngoscopy (VL), its use has declined dramatically. Our aim was to describe the frequency of airway management techniques used in patients with CSI at our level I trauma center and report the incidence of neurological injury attributable to airway management...
April 11, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29624623/motion-and-dural-sac-compression-in-the-upper-cervical-spine-during-the-application-of-a-cervical-collar-in-case-of-unstable-craniocervical-junction-a-study-in-two-new-cadaveric-trauma-models
#6
Shiyao Liao, Niko R E Schneider, Petra Hüttlin, Paul A Grützner, Frank Weilbacher, Stefan Matschke, Erik Popp, Michael Kreinest
BACKGROUND: Unstable conditions of the craniocervical junction such as atlanto-occipital dislocation (AOD) or atlanto-axial instability (AAI) are severe injuries with a high risk of tetraplegia or death. Immobilization by a cervical collar to protect the patient from secondary damage is a standard procedure in trauma patients. If the application of a cervical collar to a patient with an unstable craniocervical condition may cause segmental motion and secondary injury to the spinal cord is unknown...
2018: PloS One
https://www.readbyqxmd.com/read/29618189/cervical-collar-makes-difficult-airway-a-simulation-study-using-the-lemon-criteria
#7
Moonsu Yuk, Woonhyung Yeo, Kangeui Lee, Jungin Ko, Taejin Park
OBJECTIVE: Endotracheal intubation is extremely difficult to perform in patients wearing a cervical collar for a head and neck injury. Therefore, we analyzed actual measurements using the look externally, evaluate 3-3-2, Mallampati score, obstruction, and neck mobility (LEMON) criteria before and after cervical collar application to investigate the causes of a difficult airway. METHODS: This simulation study was performed in 76 healthy volunteers. We measured the mouth opening, modified Mallampati classification, and neck extension before and after cervical collar application...
March 2018: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29608449/conservative-treatment-of-hangman-variant-fractures
#8
Thomas E Niemeier, Sakthevil R Manoharan, Amrita Mukherjee, Steven M Theiss
STUDY DESIGN: This is retrospective cohort study. OBJECTIVE: Investigate the stability of patients with hangman variant fractures and outcomes of treatment with external immobilization. SUMMARY OF BACKGROUND DATA: Traumatic spondylolisthesis of the axis (C2) with the fracture extending into the vertebral body has been incompletely characterized. Small case series have showed high rates of neurological injury and cite difficulty treating closed due to greater instability secondary to extensive ligamentous injury...
March 31, 2018: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29588621/investigating-the-effects-of-cervical-collar-design-and-fit-on-the-biomechanical-and-biomarker-reaction-at-the-skin
#9
Peter R Worsley, Nathan D Stanger, Aran K Horrell, Dan L Bader
Background: Research has shown that up to 33% of pressure ulcers (PUs) acquired in hospitals result from the application of a medical device. Cervical collars (C-collars) have been implicated in causing PUs, due to the mechanical force they apply to the skin. In order to improve our understanding of collar-related PUs, the present study aimed to assess the biomechanical, biochemical, and microclimate effects of C-collar design and fitting tension. Methods: A cohort of 15 healthy volunteers was fit with two different C-collars according to the manufacturer guidelines...
2018: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/29541850/hirayama-disease
#10
David C Kieser, P J Cox, S C J Kieser
PURPOSE: Hirayama disease is an initially progressive disease caused by cervical neck flexion compressing the anterior horns of the lower cervical spinal cord. It is primarily seen in young males of Indian or Asian descent. With increasing dispersion of these populations this condition is increasingly being encountered internationally. This grand round reviews this rare but increasingly recognized condition. MATERIALS AND METHODS: We present a classic case of a young Indian male with progressive hand and forearm weakness...
March 14, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29541768/the-devil-is-in-the-details-when-removing-cervical-collars-after-blunt-trauma
#11
Mayur B Patel, John J Como, Elliott R Haut
No abstract text is available yet for this article.
March 14, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29541757/cost-effectiveness-of-magnetic-resonance-imaging-in-cervical-clearance-of-obtunded-blunt-trauma-after-a-normal-computed-tomographic-finding
#12
Xiao Wu, Ajay Malhotra, Bertie Geng, Vivek B Kalra, Khalid Abbed, Howard P Forman, Pina Sanelli
Importance: Magnetic resonance imaging (MRI) continues to be performed for cervical clearance of obtunded blunt trauma, despite poor evidence regarding its utility after a normal computed tomographic (CT) finding. Objective: To evaluate the utility and cost-effectiveness of MRI vs no follow-up after a normal cervical CT finding in patients with obtunded blunt trauma. Design, Setting and Participants: This cost-effectiveness analysis evaluated an average patient aged 40 years with blunt trauma from an institutional practice...
March 14, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29528997/lack-of-consensus-in-physician-recommendations-regarding-return-to-driving-after-cervical-spine-surgery
#13
Michael J Moses, Jared C Tishelman, Saqib Hasan, Peter L Zhou, Ioanna Zevgaras, Justin S Smith, Aaron J Buckland, Yong Kim, Afshin Razi, Themistocles S Protopsaltis
STUDY DESIGN: Cross-Sectional Study. OBJECTIVE: The goal of this study is to investigate how surgeons differ in collar and narcotic use, as well as return to driving recommendations following cervical spine surgeries and the associated medico-legal ramifications of these conditions. SUMMARY OF BACKGROUND DATA: Restoration of quality of life is one of the main goals of cervical spine surgery. Patients frequently inquire when they may safely resume driving after cervical spine surgery...
March 9, 2018: Spine
https://www.readbyqxmd.com/read/29460009/the-global-spine-care-initiative-applying-evidence-based-guidelines-on-the-non-invasive-management-of-back-and-neck-pain-to-low-and-middle-income-communities
#14
REVIEW
Roger Chou, Pierre Côté, Kristi Randhawa, Paola Torres, Hainan Yu, Margareta Nordin, Eric L Hurwitz, Scott Haldeman, Christine Cedraschi
PURPOSE: The purpose of this review was to develop recommendations for the management of spinal disorders in low-income communities, with a focus on non-invasive pharmacological and non-pharmacological therapies for non-specific low back and neck pain. METHODS: We synthesized two evidence-based clinical practice guidelines for the management of low back and neck pain. Our recommendations considered benefits, harms, quality of evidence, and costs, with attention to feasibility in medically underserved areas and low- and middle-income countries...
February 19, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29456914/is-cervical-bracing-necessary-after-one-and-two-level-instrumented-anterior-cervical-discectomy-and-fusion-a-prospective-randomized-study
#15
Samuel C Overley, Robert K Merrill, Evan O Baird, Joshua J Meaike, Samuel K Cho, Andrew C Hecht, Sheeraz A Qureshi
Study Design: Prospective randomized control trial. Objective: To investigate the role of cervical collars in postoperative care following 1- and 2-level instrumented anterior cervical discectomy and fusion (ACDF). Methods: The Cervical Spine Research Society Resident Fellow Grant funded this project. Fifty consecutive patients undergoing 1- or 2-level ACDF surgery were randomized into groups receiving either no brace or a cervical brace for 6 weeks postoperatively...
February 2018: Global Spine Journal
https://www.readbyqxmd.com/read/29405797/new-immobilization-guidelines-change-ems-critical-thinking-in-older-adults-with-spine-trauma
#16
Linda Underbrink, Alice Twink Dalton, Jan Leonard, Pamela W Bourg, Abigail Blackmore, Holly Valverde, Thomas Candlin, Lisa M Caputo, Christopher Duran, Sherrie Peckham, Jeff Beckman, Brandon Daruna, Krista Furie, Debra Hopgood
OBJECTIVE: The impact of immobilization techniques on older adult trauma patients with spinal injury has rarely been studied. Our advisory group implemented a change in the immobilization protocol used by emergency medical services (EMS) professionals across a region encompassing 9 trauma centers and 24 EMS agencies in a Rocky Mountain state using a decentralized process on July 1, 2014. We sought to determine whether implementing the protocol would alter immobilization methods and affect patient outcomes among adults ≥60 years with a cervical spine injury...
February 6, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29362286/-bilateral-internal-carotid-artery-dissection-caused-by-elongated-styloid-processes-a-case-report
#17
Toru Takino, Satoshi Shibuma, Yu Kanemaru, Koji Okamura, Aki Oshima, Manami Tazawa, Takeo Nashimoto, Naoto Tsuchiya, Junichi Yoshimura, Kiminori Netsu, Takafumi Saito
We report a case of bilateral internal carotid artery(ICA)dissection associated with bilateral elongated styloid processes(ESPs). A 46-year-old man presented with transient aphasia and left visual disturbance at a business meeting. He complained of a foreign body sensation in his throat during swallowing for two years. Magnetic resonance imaging(MRI)demonstrated fresh small infarcts in the left corona radiata. Magnetic resonance angiography(MRA)revealed string signs bilaterally in the cervical ICAs. The patient was diagnosed with bilateral idiopathic ICA dissection and was treated with ozagrel and clopidogrel...
January 2018: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/29321048/danish-first-aid-books-compliance-with-the-new-evidence-based-non-resuscitative-first-aid-guidelines
#18
Theo Walther Jensen, Thea Palsgaard Møller, Søren Viereck, Jens Roland, Thomas Egesborg Pedersen, Freddy K Lippert
BACKGROUND: The European Resuscitation Council (ERC) released new guidelines on resuscitation in 2015. For the first time, the guidelines included a separate chapter on first aid for laypersons. We analysed the current major Danish national first aid books to identify potential inconsistencies between the current books and the new evidence-based first aid guidelines. METHODS: We identified first aid books from all the first aid courses offered by major Danish suppliers...
January 10, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29242653/awake-orotracheal-fibre-optic-intubation-comparison-of-two-different-doses-of-dexmedetomidine-on-intubation-conditions-in-patients-undergoing-cervical-spine-surgery
#19
Jaya Sharma, Shobha Purohit, Sonali Bhatia, Poonam Kalra, Mamta Sharma, Reema Meena
Background and Aims: Awake fibre-optic intubation (AFOI) is an integral part of anaesthetic management of difficult airways. Conscious sedation is essential to assist AFOI. This study compared two different doses of dexmedetomidine in combination with topical spray and airway blocks for awake orotracheal fibre-optic intubation in patients undergoing elective cervical spine surgery with rigid cervical collar in situ . Methods: A randomized, prospective, comparative study design was conducted in sixty patients divided into two groups: Group (L) ( n = 30) patients received low dose of dexmedetomidine (0...
October 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29228289/clinical-practice-guideline-for-physical-therapy-assessment-and-treatment-in-patients-with-nonspecific-neck-pain
#20
Jasper D Bier, Wendy G M Scholten-Peeters, J Bart Staal, Jan Pool, Maurits W van Tulder, Emmylou Beekman, Jesper Knoop, Guus Meerhoff, Arianne P Verhagen
The Royal Dutch Society for Physical Therapy (KNGF) issued a clinical practice guideline for physical therapists that addresses the assessment and treatment of patients with nonspecific neck pain, including cervical radiculopathy, in Dutch primary care. Recommendations were based on a review of published systematic reviews.During the intake, the patient is screened for serious pathologies and corresponding patterns. Patients with cervical radiculopathy can be included or excluded through corresponding signs and symptoms and possibly diagnostic tests (Spurling test, traction/distraction test, and Upper Limb Tension Test)...
March 1, 2018: Physical Therapy
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