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https://www.readbyqxmd.com/read/30103595/-advanced-progress-on-the-treatment-of-anterior-approach-to-the-thoracolumbar-vertebral-fractures
#1
REVIEW
Lei Han, Ren-Fu Quan, Yun-Gen Hu, Wei-Li Fang, Bo Jin, Shi-Chao Xu
Thoracolumbar fractures are common and severe traumas. Anterior approaches can achieve adirect spinal cord decompression and reconstruct anterior column height what load bearing the major load distribution of the spine. Therefore, anterior approach is an important method in the treatment of thoracolumbar fractures. With the application of pedicle screw, most of the patients were treated with posterior approaches.Because of the unique advantages of anterior approach, the posterior approach can not be replaced it...
July 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/30083632/blunt-traumatic-cervical-vascular-injury-without-any-modified-denver-criteria
#2
Jed T Ritter, Chadd K Kraus
Blunt traumatic cervical vascular injury (BCVI) is challenging to recognize, but it is a potentially devastating entity that warrants attention from emergency physicians. Injury to the vertebral or carotid artery can result in a delayed manifestation of neurologic injury that may be preventable if promptly recognized and treated. The modified Denver Criteria are frequently used to guide imaging decisions for BCVI; however, injuries can still be missed. We present a case of BCVI in a trauma patient whose initial presentation evaded standard screening criteria, illustrating the need for a high index of suspicion for BCVI in blunt trauma...
August 2018: Clinical practice and cases in emergency medicine
https://www.readbyqxmd.com/read/30081170/seat-belt-abdominal-aortic-injury-treatment-modalities
#3
Ivan Tomic, Marko Dragas, Dragan Vasin, Zlatibor Loncar, Nikola Fatic, Lazar Davidovic
Blunt abdominal aortic injuries are extremely rare, diagnosed in less than 0.05% of all trauma admissions. Aortic injury caused by a seat belt during a car accident is often referred as "seat-belt aorta". We present a case of an 18-year old woman, restrained back passenger involved in a vehicular collision, sustaining vertebral column and multiple rib fractures, mesenterium and colonic injury and infra-renal aortic contusion with localized dissection and partial thrombosis.
August 3, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/30080783/independent-predictors-of-survival-after-traumatic-atlanto-occipital-dissociation
#4
Morgan Schellenberg, Kenji Inaba, Vincent Cheng, James M Bardes, Patrick Heindel, Kazuhide Matsushima, Elizabeth Benjamin, Demetrios Demetriades
BACKGROUND: Atlanto-occipital dissociation (AOD) occurs when the skull base is forcibly separated from the vertebral column. Existing literature on AOD is sparse and risk factors for mortality are unknown. This study determined independent predictors of survival after AOD. METHODS: Patients who sustained AOD were identified from the National Trauma Data Bank (2007-2014). Those arriving without signs of life or with missing mortality data were excluded. Study groups were defined as patients who survived to hospital discharge versus patients who died in hospital...
August 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/30077025/outcomes-following-single-stage-posterior-vertebral-column-resection-for-severe-thoracic-kyphosis
#5
Cecilia L Dalle Ore, Christopher P Ames, Vedat Deviren, Darryl Lau
INTRODUCTION: Thoracic kyphosis can result in neurologic deficits, pain, and cardiopulmonary dysfunction. Vertebral column resection (VCR) is a powerful technique that can be employed for large curves and fixed deformities. This study reports the outcomes of posterior VCR for adult spinal deformity (ASD) with severe thoracic kyphosis. METHODS: Retrospective review of all ASD patients who underwent posterior VCR for severe thoracic kyphosis (defined as segmental kyphosis greater than 80 degrees) was performed...
August 1, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/30074441/blunt-vertebral-artery-injury-in-occipital-condyle-fractures
#6
Joshua D Burks, Andrew K Conner, Robert G Briggs, Phillip A Bonney, Adam D Smitherman, Cordell M Baker, Chad A Glenn, Cameron A Ghafil, Dillon P Pryor, Kyle P O'Connor, Bradley N Bohnstedt
OBJECTIVE A shifting emphasis on efficient utilization of hospital resources has been seen in recent years. However, reduced screening for blunt vertebral artery injury (BVAI) may result in missed diagnoses if risk factors are not fully understood. The authors examined the records of blunt trauma patients with fractures near the craniocervical junction who underwent CTA at a single institution to better understand the risk of BVAI imposed by occipital condyle fractures (OCFs). METHODS The authors began with a query of their prospectively collected trauma registry to identify patients who had been screened for BVAI using ICD-9-CM diagnostic codes...
August 3, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/30060372/spinal-gunshot-wounds-pattern-and-associated-lesions-in-civilians
#7
Jorge Arturo Cabrera Escamilla, Jorge Álvaro González Ross, José Manuel Pérez Atanasio, Gustavo Casas Martínez, Arelhi González Cisneros, Jose Jimenez Avila
STUDY DESIGN: Retrospective, descriptive case series study. PURPOSE: To investigate the frequency, bone pattern, and associated lesions to the spine of gunshot wounds. OVERVIEW OF LITERATURE: Gunshot wounds are penetrating in nature and are caused by a bullet or projectile. These are becoming more common and are associated with significant sequelae, requiring long and costly multidisciplinary treatment. Associated spinal cord injuries (SCIs) in the civilian population represent 13%-17% of all spinal traumas...
August 2018: Asian Spine Journal
https://www.readbyqxmd.com/read/30053545/limited-clinical-relevance-of-vertebral-artery-injury-in-blunt-trauma
#8
Mark E Lytle, James West, Jason N Burkes, Besem Beteck, Tammy Fisher, Yahya Daoud, Dennis R Gable, William P Shutze
BACKGROUND: Blunt cerebrovascular injury (BCVI), although rare, is more common than previously thought and carries a substantial stroke and mortality risk. The purpose of our study was to evaluate the differences between blunt carotid artery (CA) and vertebral artery (VA) injuries, assess the stroke and death rates related to these injuries, and identify the relationship of Injury Severity Score (ISS) with stroke and mortality in BCVI. MATERIAL AND METHODS: Using a retrospective review of the Trauma Registry at a Level I Trauma Center, we identified patients with BCVI...
July 24, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/30008109/comparison-of-combined-posterior-and-anterior-spondylodesis-versus-hybrid-stabilization-in-unstable-burst-fractures-at-the-thoracolumbar-spine-in-patients-between-60-and-70-years-of-age
#9
Ulrich J Spiegl, Brian M Devitt, Ihor Kasivskiy, Jan-Sven Jarvers, Christoph Josten, Christoph-Eckhard Heyde, Hannes M Fakler
INTRODUCTION: Surgical treatment of unstable burst fractures of the thoracolumbar spine in the elderly population is highly variable with combined posterior and anterior stabilization (CPAS) and posterior augmented stabilization with cementation of the vertebral body (hybrid) being two commonly used techniques. The aim of this study was to compare the clinical and radiographic outcomes of CPAS versus hybrid stabilization for the treatment of unstable burst fractures of the thoracolumbar spine in patients aged between 60 and 70 years...
July 14, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/30007758/blunt-craniocervical-trauma-does-the-patient-have-a-cerebral-vascular-injury
#10
REVIEW
Aaron Winn, Anthony M Durso, Catalina Restrepo Lopera, Felipe Munera
Blunt cerebrovascular injury involves injury to the carotid and/or vertebral arteries sustained via generalized multitrauma or directed blunt craniocervical trauma. Stroke remains the most consequential outcome. Timely diagnosis and initiation of treatment before the development of neurologic complications has a well-established role in decreasing morbidity and mortality. This article presents evidence and controversies surrounding the optimization of diagnostic imaging for suspected blunt cerebrovascular injury...
August 2018: Neuroimaging Clinics of North America
https://www.readbyqxmd.com/read/29995797/magnetic-resonance-imaging-evaluation-of-intervertebral-disc-injuries-can-predict-kyphotic-deformity-after-posterior-fixation-of-unstable-thoracolumbar-spine-injuries
#11
Shozo Kanezaki, Masashi Miyazaki, Toshinobu Ishihara, Naoki Notani, Hiroshi Tsumura
The aim of the present study is to identify factors correlated with kyphotic deformity after thoracolumbar spine injuries. We performed a retrospective case-control study with data from thoracolumbar spine fracture patients who were treated with posterior spinal fixation. Patients with a follow-up period shorter than 6 months and who experienced low-energy trauma were excluded. Intervertebral disc injuries (IDIs) were graded from 0 to 3 upon admission in accordance with Sander's classification of traumatic intervertebral disc lesions...
July 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29985893/posterior-scapula-approaches-extensile-and-modified-judet
#12
Peter A Cole, Anthony J Dugarte
The Extensile Judet has been widely used in the management of scapula fractures. An enhanced understanding of these injuries, however, has allowed for the strategic development of alternative methods in which soft tissues may be better spared. The purpose of this video is to highlight the indications and techniques for 2 posterior approaches to the scapula: The Extensile Judet and the Modified Judet. Case 1 demonstrates the Modified Judet approach. The "boomerang" incision follows the curve of the scapula spine and vertebral border, and fixation occurs through an intermuscular window...
August 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29984323/airway-management-in-a-displaced-comminuted-fracture-of-the-mandible-and-atlas-with-a-vertebral-artery-injury-a-case-report
#13
Rathna Paramaswamy
Complex cervical spine fractures are a serious complications of maxillofacial trauma and associated with high mortality and neurological morbidity. Strict vigilance in preventing further insult to the cervical spine is a crucial step in managing patients who are at risk for neurologic compromise. We report a rare case of a right transverse process of atlas fracture with right-sided vertebral artery injury that was associated with a comminuted fracture of the body and angle of the mandible, which restricted mouth opening...
June 2018: Journal of Dental Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29975956/endovascular-management-of-a-rare-case-of-pediatric-vertebral-artery-mycotic-aneurysm-a-case-report
#14
Jeyaseelan Nadarajah, Leve Joseph Devarajan Sebastian, Nishchint Jain, S B Gaikwad, Prashant Jauhari, Ashish Saini
Pediatric posterior-circulation aneurysms are uncommon, difficult-to-treat lesions associated with significant morbidity and mortality. Infections and trauma are important risk factors in children. Here, we present a 10-year-old boy with a lower respiratory tract infection, rapidly progressive right-neck swelling, and weakness of the right upper limb. Imaging revealed a partially thrombosed right vertebral-artery pseudoaneurysm with multiple cavitory lung lesions. Subsequent laboratory work-up showed underlying primary immunodeficiency disorder (chronic granulomatous disease)...
July 4, 2018: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29967897/stroke-secondary-to-traumatic-carotid-artery-injury-a-case-report
#15
Zoltán Bajkó, Smaranda Maier, Anca Moţăţăianu, Rodica Bălaşa, Smaranda Vasiu, Adina Stoian, Sebastian Andone
Introduction: Lesions of the carotid and vertebral arteries secondary to direct trauma, called blunt cerebrovascular injuries (BCVI) are relatively rare and are markedly different from spontaneous dissections. Ischaemic stroke is a significant complication, with high morbidity and mortality rates. The basis of a diagnosis relies on appropriate, high sensitivity imaging screening. Case report: We present the case of a 31 years old male patient with polytraumatism secondary to a motor vehicle accident, who was admitted to an orthopaedic clinic for multiple lower extremity fractures...
January 2018: Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29961910/traumatic-posterior-atlantoaxial-dislocation-with-associated-c1-jefferson-fracture-and-bilateral-vertebral-artery-occlusion-without-odontoid-process-fracture-or-neurological-deficit
#16
Mark Nowell, Richard Nelson
PURPOSE: Traumatic atlantoaxial dislocation (AAD) is usually associated with fatal high-velocity road traffic accidents (Xu et al. in Medicine (Baltimore) 94:e1768, 2015). There are few reports of survival following posterior AAD without odontoid fracture (Xu et al. 2015; Zhen et al. in Arch Orthop Trauma Surg 131:681-685, 2011; de Carvalho and Swash in Handb Clin Neurol 119:435-448, 2014). METHOD: We present a previously undescribed case of posterior AAD associated with a C1 Jefferson fracture but no odontoid fracture and bilateral vertebral artery occlusion without neurological deficit...
July 2, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29958832/what-are-the-expected-findings-on-follow-up-computed-tomography-angiogram-in-post-traumatic-patients-with-blunt-cerebrovascular-injury
#17
Khaled Y Elbanna, Mohammed F Mohammed, Jung-In Choi, J Philip Dawe, Emilie Joos, Saleh Baawain, Ismail Tawakol Ali, Savvas Nicolaou
PURPOSE: Blunt cerebrovascular injury (BCVI) is a rare but potentially devastating diagnosis. Our study establishes the temporal changes and findings on follow-up imaging. METHODS: For this retrospective, institutional review board-approved study, the hospital trauma registry was queried for all severely injured polytrauma patients who underwent computed tomography angiogram (CTA) scans in the emergency department between January 1, 2010, and December 31, 2016, with injury severity score ≥16, yielding 3747 patients...
August 2018: Canadian Association of Radiologists Journal, Journal L'Association Canadienne des Radiologistes
https://www.readbyqxmd.com/read/29946734/screening-to-prevent-osteoporotic-fractures-updated-evidence-report-and-systematic-review-for-the-us-preventive-services-task-force
#18
REVIEW
Meera Viswanathan, Shivani Reddy, Nancy Berkman, Katie Cullen, Jennifer Cook Middleton, Wanda K Nicholson, Leila C Kahwati
Importance: Osteoporotic fractures cause significant morbidity and mortality. Objective: To update the evidence on screening and treatment to prevent osteoporotic fractures for the US Preventive Services Task Force. Data Sources: PubMed, the Cochrane Library, EMBASE, and trial registries (November 1, 2009, through October 1, 2016) and surveillance of the literature (through March 23, 2018); bibliographies from articles. Study Selection: Adults 40 years and older; screening cohorts without prevalent low-trauma fractures or treatment cohorts with increased fracture risk; studies assessing screening, bone measurement tests or clinical risk assessments, pharmacologic treatment...
June 26, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29938605/tubular-surgery-with-the-assistance-of-endoscopic-surgery-via-a-paramedian-or-midline-approach-for-lumbar-spinal-canal-stenosis-at-the-l4-5-level
#19
Jun Komatsu, Tomoya Muta, Nana Nagura, Masumi Iwabuchi, Hironari Fukuda, Kazuo Kaneko, Osamu Shirado
BACKGROUND: Lumbar spinal canal stenosis surgery has recently improved with the use of minimally invasive techniques. Less invasive procedures have emerged, and microendoscopic decompression through smaller incisions is frequently performed. Tubular surgery with the assistance of endoscopic surgery procedures has led to particularly remarkable changes in surgery, with reduced tissue trauma and morbidity. PURPOSE: The purpose of this study was to compare the clinical outcomes of two different minimally invasive decompressive surgical techniques (microendoscopic bilateral decompression surgery using the unilateral approach [microendoscopic laminectomy (MEL)] and microendoscopy-assisted muscle-preserving interlaminar decompression (MILD; ME-MILD)) using spinal endoscopy for lumbar spinal canal stenosis measured using a visual analog scale (VAS), the Japanese Orthopedic Association (JOA) score, and the JOA Back Pain Evaluation Questionnaire (JOABPEQ), which is based on a patient-oriented scoring system...
May 2018: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/29926436/delayed-rupture-of-a-vertebral-artery-laceration-a-case-report-and-challenges-for-the-forensic-pathologist
#20
Daniel S Smyk, Jayantha C Herath
Vertebral artery laceration/dissection (VALD) resulting in fatal subarachnoid hemorrhage (SAH) is a rare, but well-known phenomenon encountered in the forensic setting. Delayed ruptures are exceptionally rare, and pose several challenges to the forensic pathologist. In this paper we present a case of a 47-year-old male who collapsed suddenly following recent complaints of a headache and a reported seizure. He had a reported history of potential head trauma that occurred several days prior. Attempts at resuscitation were unsuccessful, and an autopsy examination was ordered...
June 20, 2018: Forensic Science, Medicine, and Pathology
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