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https://www.readbyqxmd.com/read/28647656/delayed-retroclival-and-cervical-spinal-subdural-hematoma-complicated-by-pre-existing-chiari-malformation-in-an-adult-trauma-patient
#1
Ha Nguyen, Hoon Choi, Shekar Kurpad, Hesham Soliman
INTRODUCTION: Traumatic spinal subdural hematoma involving the retroclival region and upper cervical spine is a rare pathology. To our knowledge, there have only been two prior cases in an adult trauma patient. We describe a patient with pre-existing Chiari 1 malformation, who recently sustained a unilateral Type 1 OCF (occipital condyle fracture) with associated disruption of the tectorial membrane and transverse ligament, that returned with a retroclival subdural hematoma extending down to C7, causing spinal cord compression and symptomatic obstructive hydrocephalus...
June 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28647095/increased-detection-of-blunt-carotid-and-vertebral-artery-injury-after-implementation-of-diagnostic-imaging-pathway-in-level-1-trauma-centre-in-western-australia
#2
Manimaran Sinnathamby, Sudhakar V Rao, Dieter G Weber
BACKGROUND: The incidence of Blunt Carotid Artery and Vertebral Artery Injury (BCVI) is relatively low in modern trauma practice. However, these injuries may be associated with severe neurological consequences. Following the introduction of a Diagnostic Imaging Pathway in Department of Health of Western Australia, we hypothesized that this injury would be less likely to be missed, and accordingly diagnosed more frequently. METHOD: A review of all major trauma (Injury Severity Scale>15) admissions at the State Major Trauma Centre in Royal Perth Hospital was undertaken from 1995 until 2013...
June 13, 2017: Injury
https://www.readbyqxmd.com/read/28645672/percutaneous-pedicle-screw-placement-under-single-dimensional-fluoroscopy-with-a-designed-pedicle-finder-a-technical-note-and-case-series
#3
Fon-Yih Tsuang, Chia-Hsien Chen, Yi-Jie Kuo, Wei-Lung Tseng, Yuan-Shen Chen, Chin-Jung Lin, Chun-Jen Liao, Feng-Huei Lin, Chang-Jung Chiang
BACKGROUND CONTEXT: Minimally invasive spine surgery has become increasingly popular in clinical practice, and it offers patients the potential benefits of reduced blood loss, wound pain, and infection risk and also diminishes the loss of working time and length of hospital stay. However, surgeons require more intraoperative fluoroscopy and ionizing radiation exposure during minimally invasive spine surgery for localization, especially for guidance in instrumentation placement. In addition, computer navigation is not accessible in some facility-limited institutions...
June 20, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28642835/differential-carbonyl-stress-expression-in-the-intervertebral-disc-between-singular-and-persistent-mechanical-injuries
#4
Itaru Hibino, Simon Tang
Low back pain is a significant public health problem worldwide. Intervertebral disc degeneration is most significant known risk factor for low back pain. Yet the mechanisms of degeneration remain relatively unknown. Carbonyl stress and oxidation have been implicated in cartilage and fibrocartilage degeneration. Here we investigate the role of oxidative stress and carbonyl production in the intervertebral disc after mechanical injury using an in vitro organ model of the mouse functional spine unit. We use a single-stab insult to model mild injury, and the three-stab insult to model severe trauma...
2017: Nagoya Gakuin Daigaku Ronshu Igaku Kenko Kagaku Supotsu Kagakuhen
https://www.readbyqxmd.com/read/28642012/evaluation-of-a-device-combining-an-inferior-vena-cava-filter-and-a-central-venous-catheter-for-preventing-pulmonary-embolism-among-critically-ill-trauma-patients
#5
Victor F Tapson, Joshua P Hazelton, John Myers, Claudia Robertson, Ramyar Gilani, Julie A Dunn, Marko Bukur, Martin A Croce, Ann Peick, Sonlee West, Lawrence Lottenberg, Jay Doucet, Preston R Miller, Bruce Crookes, Rajesh R Gandhi, Chasen A Croft, Anthony Manasia, Brian A Hoey, Howard Lieberman, Oscar D Guillamondegui, Victor Novack, Gregory Piazza, Samuel Z Goldhaber
PURPOSE: To evaluate efficacy and safety of a novel device that combines an inferior vena cava (IVC) filter and central venous catheter (CVC) for prevention of pulmonary embolism (PE) in critically ill patients. MATERIALS AND METHODS: In a multicenter, prospective, single-arm clinical trial, the device was inserted at the bedside without fluoroscopy and subsequently retrieved before transfer from the intensive care unit (ICU). The primary efficacy endpoint was freedom from clinically significant PE or fatal PE 72 hours after device removal or discharge, whichever occurred first...
June 20, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28640778/a-cohort-study-of-blunt-cerebrovascular-injury-screening-in-children-are-they-just-little-adults
#6
Mackenzie R Cook, Cordelie E Witt, Robert H Bonow, Eileen M Bulger, Ken F Linnau, Saman Arbabi, Bryce R H Robinson, Joseph Cuschieri
BACKGROUND: Blunt cerebrovascular injuries (BCVI) are rare with nonspecific predictors, making optimal screening critical. Radiation concerns magnify these issues in children. The Eastern Association for the Surgery of Trauma (EAST) criteria, the Utah score (US) and the Denver criteria (DC) have been advocated for pediatric BCVI screening, though direct comparison is lacking. We hypothesized that current screening guidelines inaccurately identify pediatric BCVI. METHODS: This was a retrospective cohort study of pediatric trauma patients treated from 2005-2015 with radiographically confirmed BCVI...
June 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28632646/the-utility-of-adding-magnetic-resonance-imaging-to-computed-tomography-alone-in-the-evaluation-of-cervical-spine-injury-a-propensity-matched-analysis
#7
Andrew J Schoenfeld, Daniel G Tobert, Hai V Le, Dana A Leonard, Allan L Yau, Prashant Rajan, Charles H Cho, James D Kang, Christopher M Bono, Mitchel B Harris
STUDY DESIGN: Adult patients who received CT alone or CT-MRI for the evaluation of cervical OBJECTIVE.: To evaluate the utility of CT-MRI in the diagnosis of cervical spine injury using propensity matched techniques. SUMMARY OF BACKGROUND DATA: The optimal evaluation (computed tomography [CT] alone vs CT and magnetic resonance imaging [MRI]) for patients with suspected cervical spine injury in the setting of blunt trauma remains controversial. METHODS: The primary outcome was the identification of a cervical spine injury, with decision for surgery and change in management considered secondarily...
June 19, 2017: Spine
https://www.readbyqxmd.com/read/28632547/a-less-invasive-retroperitoneal-lumbar-approach-animal-feasibility-study-and-primary-clinical-study
#8
Yu Qian, Zhen Lin, Cong Jin, Xing Zhao, Minghao Zheng
STUDY DESIGN: Surgical approach development in an animal model, and a prospective study comparing clinical outcomes between novel and conventional approaches in thoracolumbar burst fracture fixation. OBJECTIVE: To investigate the feasibility of a less-invasive retroperitoneal approach to the lumbar spine in a sheep model and to compare the clinical outcomes of anterior reconstruction in the treatment of thoracolumbar burst fractures using novel and conventional approaches...
July 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28628414/paraspinal-fat-pad-changes-as-a-valuable-indicator-of-posterior-ligamentous-complex-injury-in-upper-cervical-spine-trauma
#9
Miso Kim, Seunghun Lee, Yoonah Song
No abstract text is available yet for this article.
July 2017: Radiology
https://www.readbyqxmd.com/read/28621192/-reconstruction-of-the-inguinal-ligament-with-fascia-lata-sling-first-reported-case-in-hungary
#10
Gábor Bognár, Loránd Barabás, Enikő Tóth, Andrea Schöller, Gábor István
INTRODUCTION: A technique of reconstructing the inguinal ligament using pedicled fascia lata flap is described. PRESENTATION OF CASE: A 66-year-old woman was referred with massive incarcerated left inguinal hernia, following acute surgery on a femoral vein leasion and numerous attempts at repair and subsequent recurrences. There was complete absence of the left inguinal ligament. The inguinal ligament was reconstructed using a strip of fascia lata, pedicled on the anterior superior iliac spine...
June 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28610768/intracranial-subarachnoid-fat-and-hemorrhage-secondary-to-sacral-fracture-with-spondylopelvic-dissociation
#11
J Carreres Polo, M V Álvarez Martínez, D Sánchez Mateos
We describe a case of fat droplets and blood in the cerebral subarachnoid space secondary in a patient with a complex sacral fracture without associated cranial trauma, a few days after admission. To our knowledge, there is only one published case with similar findings and without any other underlying lesion as cause. We explain the differences in the mechanism of production between this direct fat embolism and brain fat embolism syndrome, which is an intravascular embolism with different radiological appearance...
June 10, 2017: Radiología
https://www.readbyqxmd.com/read/28607823/traumatic-spondyloptosis-of-the-cervical-spine-a-case-report-and-discussion-of-worldwide-treatment-trends
#12
Kelly E Wong, Peter S Chang, Mark S Monasky, Rodney M Samuelson
BACKGROUND: Cervical spondyloptosis is defined as the dislocation of the spinal column most often caused by trauma. Due to compression or transection of the spinal cord, severe neurological deficits are common. Here, we review the literature and report a case of traumatic C5-6 spondyloptosis that was successfully treated using an anterior-only surgical approach. METHODS: The patient presented with quadriplegia and absent sensation distal to the C5 dermatome following a rollover motor vehicle accident...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28603566/current-concepts-in-pediatric-cervical-spine-trauma
#13
Kunal Shah, Agnivesh Tikoo, Manish K Kothari, Abhay Nene
BACKGROUND: Pediatric spinal trauma is rare and challenging entity. Although cervical spine is commonly affected, it is often missed on routine imaging investigations. Therefore better understanding of growing spine and its patho-physiology is crucial. METHODS: Articles related to pediatric cervical trauma were searched on Pubmed and other online research data banks. We have summarized unique anatomy of pediatric spine, investigations followed by common injury patterns, their diagnostic challenges and management...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28601333/variability-in-ct-imaging-of-blunt-trauma-among-ed-physicians-surgical-residents-and-trauma-surgeons
#14
Melissa K James, Shi-Wen Lee, Jennifer A Minneman, Maureen D Moore, Taylor R Klein, R Jonathan Robitsek, Phillip S Barie, Sebastian D Schubl
BACKGROUND: Trauma triage decisions can be influenced by both knowledge and experience. Consequently, there may be substantial variability in computed tomography (CT) scans desired by emergency medicine physicians, surgical chief residents, and attending trauma surgeons. We quantified this difference and studied the effects of each group's decisions on missed injuries, cost, and radiation exposure. METHODS: All blunt trauma activations at an urban level 1 trauma center were studied over a 6-mo period...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28595648/investigation-and-management-of-osteoporosis-in-aged-trauma-patients-a-treatment-algorithm-adapted-to-the-german-guidelines-for-osteoporosis
#15
Carl Neuerburg, Lena Mittlmeier, Ralf Schmidmaier, Christian Kammerlander, Wolfgang Böcker, Wolf Mutschler, Ulla Stumpf
BACKGROUND: Osteoporosis-associated fractures are of increasing importance in trauma surgery. Systematic diagnostics and treatment of osteoporosis during a hospital stay, however, remain inadequate. Therefore, a specific algorithm for diagnosing and treating osteoporosis in trauma surgery patients was developed based on the DVO (German Osteology Society) guideline for osteoporosis from 2014. METHODS: In a first step, the individuals' age and risk profile for osteoporosis is identified considering specific fractures indicating osteoporosis and risk factors assessed by a specific questionnaire...
June 8, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28594515/cervical-spine-injuries-in-the-athlete
#16
Gregory D Schroeder, Alexander R Vaccaro
Cervical spine injuries are common and range from relatively minor injuries, such as cervical muscle strains, to severe, life-threatening cervical fractures with spinal cord injuries. Although cervical spine injuries are most common in athletes who participate in contact and collision sports, such as rugby and American football, they also have been reported in athletes who participate in noncontact sports, such as baseball, gymnastics, and diving. Cervical spine injuries in athletes are not necessarily the result of substantial spine trauma; some athletes have chronic conditions, such as congenital stenosis, that increase their risk for a serious cervical spine injury after even minor trauma...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28591075/comparison-of-the-vacuum-mattress-versus-the-spine-board-alone-for-immobilization-of-the-cervical-spine-injured-patient-a-biomechanical-cadaveric-study
#17
Mark L Prasarn, Per Kristian Hyldmo, Laura A Zdziarski, Evan Loewy, Dewayne Dubose, MaryBeth Horodyski, Glenn R Rechtine
STUDY DESIGN: Biomechanical cadaveric study. SUMMARY OF BACKGROUND DATA: Trauma patients in the United States are immobilized on a rigid spine board, whereas in many other places vacuum mattresses are used with the proposed advantages of improved comfort and better immobilization of the spine. OBJECTIVE: We sought to determine the amount of motion generated in an unstable cervical spine fracture with use of the vacuum mattress versus the spine board alone...
June 6, 2017: Spine
https://www.readbyqxmd.com/read/28589067/intraoperative-dexmedetomidine-induced-polyuric-syndrome
#18
Shannon Granger, David Ninan
A 23-year-old male trauma patient with a cervical spine fracture underwent an anterior and posterior discectomy and spinal fusion surgery. The patient presented to the operating room with a stabilizing halo fixation device in place, and a fiberoptic intubation was performed with dexmedetomidine for sedation. During the surgical procedure, general anesthesia was maintained with a propofol and remifentanil infusion as the patient was monitored using somatosensory and motor evoked potentials. The patient's urine output increased gradually during the nine-hour surgical procedure from 150 mL/hour to over 700 mL/hour in the eighth hour of the procedure, where it remained until the end of the procedure...
May 3, 2017: Curēus
https://www.readbyqxmd.com/read/28580386/hospitalizations-for-osteoporosis-related-fractures-economic-costs-and-clinical-outcomes
#19
Derek Weycker, Xiaoyan Li, Rich Barron, Rebecca Bornheimer, David Chandler
BACKGROUND: Osteoporotic fractures frequently require inpatient care, and are associated with elevated risks of morbidity, mortality, and re-hospitalization. A comprehensive evaluation of healthcare costs, resource utilization, and outcomes associated with osteoporosis (OP)-related fractures treated in US hospitals was undertaken. METHODS: A retrospective analysis using the Premier Perspective Database (2010 - 2013) was conducted. Study population comprised patients aged ≥ 50 years hospitalized with a principal diagnosis of a closed or pathologic fracture commonly associated with OP; the first qualifying hospitalization was designated the "index admission"...
December 2016: Bone Reports
https://www.readbyqxmd.com/read/28573824/bone-cement-cardiac-and-pulmonary-embolism
#20
Tomás F Cianciulli, Diego E Mc Loughlin, Luis A Morita, María C Saccheri, Jorge A Lax
This case describes a complication of bone cement use. A 65-year-old male patient with back spine trauma caused by a fall, underwent a percutaneous vertebroplasty. Five years later, he consulted for palpitations, and the electrocardiogram showed supraventricular arrhythmia. A transthoracic two-dimensional echocardiography showed a hyperechogenic linear structure of 7 cm length, running from the lateral wall of the right ventricle to the right atrium through the tricuspid valve. This foreign body, which was suspicious for bone cement embolism, appeared rigid and was attached at the lateral wall of the right ventricle, with its proximal end free in the right atrium...
June 1, 2017: Echocardiography
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