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Trauma spine

Michael J Mulcahy, Jonathon R Ball
The Morel-Lavallée lesion (MLL) is a closed degloving injury caused by traumatic separation of the subcutaneous tissue from the underlying fascia, without a break in the overlying skin. We present two cases that demonstrate a previously unrecognised association of the MLL with thoracolumbar spine fractures. The lesion is frequently missed, or its significance is overlooked, on initial evaluation. Awareness of this injury should allow tailored strategies to decrease the high risk of wound complications.
September 2018: Journal of Spine Surgery (Hong Kong)
(no author information available yet)
OBJECTIVESince 2007, a continuous neurosurgery emergency service has been available in the International Security Assistance Force (ISAF) field hospital in Mazar-e-Sharif (MeS), Afghanistan. The object of this study was to assess the number and range of surgical procedures performed on the spine in the period from 2007 to 2014.METHODSThis is a retrospective analysis of the annual neurosurgical caseload statistics from July 2007 to October 2014 (92 months). The distribution of surgical urgency (emergency, delayed urgency, or elective), patient origin (ISAF, Afghan National Army, or civilian population), and underlying causes of diseases and injuries (penetrating injury, blunt injury/fracture, or degenerative disease) was analyzed...
December 1, 2018: Neurosurgical Focus
Patrick Strube, Michael Putzier, Jan Siewe, Sven Oliver Eicker, Marc Dreimann, Timo Zippelius
INTRODUCTION: Surgical treatment methods for degenerative spondylolisthesis (decompression versus decompression and fusion) have been critically debated. The medical care situation is almost unknown for either treatment. Therefore, the aim of the present study was to provide information regarding the use of parameters for decision-making and the employment of surgical techniques. MATERIALS AND METHODS: A web-based survey was performed among members of the German-Spine-Society (DWG)...
December 12, 2018: Archives of Orthopaedic and Trauma Surgery
Alexandre Jaccard, César Macedo, Gabriel Castro, Alfredo Guiroy
Background: The Gorham-Stout syndrome (GSS), also known as phantom bone disease, is a rare bone condition of unknown etiology. Involvement of the spine is described in <50 cases in the literature. Here, we report a case of thoracic spine fracture dislocation in a young female who was known to have GSS. Case Description: A 23-year-old female developed a left spontaneous hemothorax 10 years previously along with left ribs lytic lessions. Pleural and rib biopsies diagnosed angiomatosis and the clinical diagnosis of GSS was established...
2018: Surgical Neurology International
Bamini Gopinath, Jagnoor Jagnoor, Annette Kifley, Michael Nicholas, Fiona Blyth, Justin Kenardy, Ashley Craig, Ian D Cameron
There is paucity of prospective studies that have examined rates and prognostic indicators of pain severity following a road-traffic crash injury. This cohort study involved 1854 participants aged ≥17 years with a non-catastrophic injury. Primary analyses of pain severity involved 1604 individuals who reported any pain since the injury at baseline, of these, 1188 and 972 participants were re-examined at 6- and 12-month follow-up, respectively. Mean pain severity (primary study outcome) was assessed using a numeric rating scale (NRS), and a range of possible pain predictors were assessed...
December 7, 2018: Journal of Pain: Official Journal of the American Pain Society
Robert Tisherman, Nicholas Vaudreuil, Rahul Ramanathan, Robert Hartman, Joon Lee, Kevin Bell
Fractures of the odontoid present frequently in spinal trauma, and Type II odontoid fractures, occurring at the junction of the odontoid process and C2 vertebrae, represent the bulk of all traumatic odontoid fractures. It is currently unclear what soft-tissue stabilizers contribute to upper cervical motion in the setting of a Type II odontoid fracture, and evaluation of how concomitant injury contributes to cervical stability may inform surgical decision-making as well as allow for the creation of future, accurate, biomechanical models of the upper cervical spine...
November 22, 2018: Journal of Biomechanics
Katie Suzanne Traylor, Stephen F Kralik, Rupa Radhakrishnan
Acute onset of neurological signs and symptoms referable to the spine including difficulty walking, bowel and bladder dysfunction, and paresthesias in the extremities may be manifestations of pediatric spine emergency. Trauma is the most common etiology for a pediatric spinal emergency. Because a history of trauma is often available, the role of imaging involves detection of spinal injuries. Other pathologies such as infection, inflammation, vascular, and neoplasms may lead to pediatric spinal emergencies that also require imaging for assistance in determining the etiology and appropriate management...
December 2018: Seminars in Ultrasound, CT, and MR
Alexandria S Jo, Zachary Wilseck, Matthew S Manganaro, Mohannad Ibrahim
Traumatic injuries of the spine portend long-term morbidity and mortality. Timely diagnosis and appropriate management of mechanical instability of the spine is of utmost importance in preventing further neurologic deterioration. We present a comprehensive review of the indications for spinal imaging in the trauma setting, describe each imaging modality including plain radiographs, multidetector computed tomography and magnetic resonance imaging, basic anatomy and common fracture patterns, and discuss the traditional spinal injury classification systems and the new Subaxial Cervical Spine Injury Classification and Thoracolumbar Injury Classification and Severity score...
December 2018: Seminars in Ultrasound, CT, and MR
Matthew Bernard, Raymond Wright, Hannah Anderson, Andrew Bernard
BACKGROUND: Wilderness travel and rock climbing are increasingly popular. Urban falls from height have been reported from trauma centers; however, there have been no trauma center reports of rock climbing or wilderness falls (WFs) in the United States. We sought to describe the injury pattern of WF and to determine whether rock climbers represent a distinct pattern of injury. MATERIALS AND METHODS: The trauma database from our level 1 trauma center was queried from 1/1/06 to 12/31/16 for the diagnosis of "fall from cliff" (ICD9: e884...
February 2019: Journal of Surgical Research
Khaled Omran, Ahmed S Abdel-Fattah
BACKGROUND DATA: Complexity in ventral surgical exposure, presence of scapula and large para-scapular musculature during posterior surgery are the main obstacles in operative treatment of Upper Thoracic Spine Compressive Lesions (UTSCL) like trauma, tuberculosis and neoplasm. Recently, the advantages of combined ventro-dorsal surgery could be successfully gained using 1-stage posterior salvage technique with enough accessibility to all three spinal columns. PURPOSE: Retrospective evaluation of 35 patients with UTSCL treated by Posterior Extensive Circumferential Decompressive Reconstructive (PECDR) procedure...
December 3, 2018: World Neurosurgery
Gianluca Scalia, Francesco Certo, Massimiliano Maione, Giuseppe Mv Barbagallo
BACKGROUND: Arachnoiditis ossificans (AO) is a rare condition often associated with previous spine surgery. Here we describe a unique case of a patient affected by ankylosing spondylitis (AS), presenting with progressive neurological deterioration due to AO. We also review the literature on evaluation and management of patients suffering from AO. CASE DESCRIPTION: The 65-year-old patient had a history of previous spinal trauma and related thoraco-lumbar surgery...
December 3, 2018: World Neurosurgery
Joana Raquel Santos Veiga, Kay Mitchell
BACKGROUND: A missed cervical spinal injury could have devastating consequences. Patients with a suspected cervical spinal injury are kept in rigid collars for cervical immobilisation. Prolonged collar use has important clinical implications. A well-defined guideline related to the removal of cervical collars from adult obtunded blunt trauma patients has not been developed. AIM: We sought to determine if Magnetic Resonance Imaging offered a definitive benefit over Computer Tomography with respect to patient management...
November 30, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
Venkat Kavuri, Gurpal Pannu, Matthew Moront, Peter Pizzutillo, Martin Herman
BACKGROUND: Safe and effective clearance of the pediatric cervical spine presents a challenging problem due to a myriad of reasons, which has often led to further imaging studies such as computed tomographic (CT) scans being performed, exposing the pediatric patient to significant radiation with a potential increased cancer risk. The goal of this study is to develop an effective algorithm for cervical spine clearance that minimizes radiation exposure. METHODS: A cervical spine clearance protocol had been utilized in our institution from 2002 to 2011...
November 30, 2018: Journal of Pediatric Orthopedics
Joe W Brewer, Charles S Cox, Stephen A Fletcher, Manish N Shah, Michelle Sandberg, David I Sandberg
BACKGROUND: This study sought to determine the role of social factors in pediatric gunshot wounds (GSW). METHODS: We identified medical records of victims aged 0-15 years who presented to our Level 1 pediatric trauma center from 2001 to 2016. RESULTS: Three hundred fifty-eight children were treated between 2001 and 2016. Patients ranged from 2.5 months to 15 years old (mean = 10.8 years). Two hundred ninety-two patients (81.6%) were male, and 66 (18...
November 7, 2018: Journal of Pediatric Surgery
Kateřina Kalová, Kateřina Boberová, Renáta Přichystalová, Jan Nováček, Ivana Jarošová, Tomáš Zikmund, Jozef Kaiser, Klaudia Kyselicová, Lukáš Šebest, Marián Baldovič, Adam Frtús, Martin Sikora, Morten E Allentoft
The skeletal remains of the young female (20-24 years) from Grave JP/106, discovered in the Southern Suburb of the Břeclav - Pohansko Stronghold (Early Middle Ages, 9th century-beginning of the 10th century, present day Czech Republic) display several noteworthy pathologies. The first is deformation of the mandible, which was most probably caused by a fracture of the ramus in combination with a subcondylar fracture. The spine of this young woman also exhibits a probable traumatic injury of the cervical spine in combination with a slowly growing structure situated inside the spinal canal, which caused deformation centered upon C7...
November 26, 2018: International Journal of Paleopathology
M Mangané, A Almeimoune, Th M Diop, A S Dembélé, B Diallo, A Napo, Y Sogoba, Y Bomou, M Doumbia, S Koita, S I Tambassi, M D Diango
INTRODUCTION: Traditional gold washing traumatism during traditional gold panningfalls within the scope of occupational accidents, which are common pathologies in developing countries such as Mali. Our work aimed to study traumatism during traditional gold panning. MATERIAL AND METHOD: A 1-year prospective study from November 2014 to November 2015 on the cases of traumatism during traditional gold washing (TOT) admitted to the emergency room(ER) of the University Hospital Gabriel Touré during the study period...
2018: Le Mali Médical
Greg Ungerer
Classification of athletes for para sport is a complex process, and provides the necessary structure for competition. Classification systems aim to ensure that para athletes achieve sporting excellence. By minimizing the effect of the impairment on sports performance, classification systems ensure para sport is not dominated by those athletes with the least impairment, but rather athletic excellence is the key determinant of success. For athletes with cervical spinal cord injuries, assessment of manual muscle power is most commonly used as the starting point for athlete evaluation...
2018: Handbook of Clinical Neurology
Erik E Swartz
Participation in any sport activity carries risk of cervical spine trauma, but certain activities have a higher risk than others, and hence, demand concerted efforts in developing prevention strategies. Prevention often includes efforts surrounding education of stakeholders, creating or modifying rules, and specific policies adopted for decreasing such risk. Stakeholders include sport clinicians, participants, coaches, parents, league administrators, officials, and the public. Thus, both athlete-specific and setting-specific factors must be considered and controlled to the extent possible for a multipronged approach for decreasing cervical spine injury risk...
2018: Handbook of Clinical Neurology
Joseph Dadabo, Prakash Jayabalan
Traumatic cervical spine injuries represent a significant cause of morbidity and mortality in sports. Appropriate management of such injuries is critical to minimizing harm and facilitating optimal long-term recovery and outcome. Management strategies begin with emergency preparedness amongst sideline providers and extends to paramedic services and medical teams in the acute care setting. This chapter outlines the principles of treatment across the care continuum, with a primary focus on hospital-based care...
2018: Handbook of Clinical Neurology
Daniel Blatz, Brendon Ross, Joseph Dadabo
Cervical spine trauma is a relatively rare but catastrophic event in sports. These critical situations depend on sports medicine personnel understanding every aspect of sideline care to ensure a safe and successful evaluation. This involves thorough preparation, vigilant observation of the sporting event to detect the possible mechanism of injury, and initiation of the appropriate action plan when a potentially catastrophic injury is suspected. Sideline management of cervical spine trauma requires the appropriate primary survey, with spine stabilization if necessary, secondary survey for concomitant injury, and, potentially, initiation of full spine stabilization with a spine board...
2018: Handbook of Clinical Neurology
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