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Spine And Trauma

Christina W Cheng, Amy M Cizik, Armagan H C Dagal, Larissa Lewis, John Lynch, Carlo Bellabarba, Richard J Bransford, Haitao Zhou
BACKGROUND: Surgical site infection (SSI) following spine surgery is associated with increased morbidity, reoperation rates, hospital readmissions and cost. The incidence of SSI following posterior cervical spine surgery is higher than anterior cervical spine surgery, with rates from 4.5-18%. It is well documented that higher body mass index (BMI) is associated with increased risk of SSI after spine surgery. There are only a few studies that examine the correlation of BMI and SSI after posterior cervical instrumented fusion (PCIF) using national databases, however, none that compare trauma and non-traumatic patients...
October 10, 2018: Spine Journal: Official Journal of the North American Spine Society
Juan M Vinas-Rios, Fatima Medina-Govea, Viktor von Beeg-Moreno, Frerk Meyer
BACKGROUND: Risk factors for incidental durotomies are good documented claimed from some authors the degree of invasiveness as a direct risk factor on this serious complication. We compared the rate of incidental durotomies and its dependence from the degree of invasiveness. METHODS: The German Spine Registry could document 6016 surgeries for lumbar spinal canal stenosis, n= 2539 microsurgical decompression and n= 2371 open decompression with stabilization. RESULTS: Both groups were identical concerning age and sex of patients: mean age 77,1 ± 1,60, female 58%, male 32%...
October 10, 2018: Journal of Neurosurgical Sciences
Juan Iaconis Campbell, Federico Coppola, Emilio Volpe, Eduardo Salas Lopez
Spinal Cord Injury Without Radiologic Abnormality (SCIWORA) accounts for up to 19% of spinal cord related lesions in pediatric population, mostly comprising the cervical spine. A 2-year-old patient is presented, who suffered a motor-vehicle accident. After being admitted, neither X-Ray nor spinal TC scan showed any structural abnormalities. Neurological examination showed complete sensory and motor loss under T7 as well as bladder and bowel dysfunction. Magnetic resonance imaging (MRI) showed spinal cord lesion extending from T7 to T10...
October 2018: Journal of Surgical Case Reports
Chidozie H Ewurum, Yingying Guo, Seang Pagnha, Zhao Feng, Xiongbiao Luo
Orthopedic surgery is a widely performed clinical procedure that deals with problems in relation to the bones, joints, and ligaments of the human body, such as musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors, and congenital disorders. Surgical navigation is generally recognized as the next generation technology of orthopedic surgery. The development of orthopedic navigation systems aims to analyze pre-, intra- and/or postoperative data in multiple modalities and provide an augmented reality 3-D visualization environment to improve clinical outcomes of surgical orthopedic procedures...
2018: Advances in Experimental Medicine and Biology
Ingrid Arevalo-Rodriguez, Edgar Muñoz, Diana Buitrago-Garcia, Solange Nuñez-González, Nadia Montero-Oleas, Vanessa Garzón, Hector Pardo-Hernandez, Xavier Bonfill
Few Orthopaedics and Traumatology journals from Latin America and Spain are indexed in major databases; controlled clinical trials published in these journals cannot be exhaustively retrieved using electronic literature searches. We aimed to identify, describe and assess the quality of controlled clinical trials published in Orthopaedics and Traumatology journals from Latin America and Spain through handsearching and evidence mapping methods. We identified controlled clinical trials published in eligible Orthopaedics/Traumatology journals in Spanish until July 2017 by handsearching...
2018: SAGE Open Medicine
John H Chi, Kurt M Eichholz, Paul A Anderson, Paul M Arnold, Andrew T Dailey, Sanjay S Dhall, James S Harrop, Daniel J Hoh, Sheeraz Qureshi, Craig H Rabb, P B Raksin, Michael G Kaiser, John E O'Toole
BACKGROUND: Treatment of thoracolumbar burst fractures has traditionally involved spinal instrumentation with fusion performed with standard open surgical techniques. Novel surgical strategies, including instrumentation without fusion and percutaneous instrumentation alone, have been considered less invasive and more efficient treatments. OBJECTIVE: To review the current literature and determine the role of fusion in instrumented fixation, as well as the role of percutaneous instrumentation, in the treatment of patients with thoracolumbar burst fractures...
October 8, 2018: Neurosurgery
Alexander Grant, Matthew Stuttard, Thomas Mitchell
BACKGROUND: The Accident and Emergency Department (A&E) is a busy environment that requires time- and resource-efficient teaching. Managing cervical spine (c-spine) trauma is often an unfamiliar skill for new doctors starting work in A&E. This study investigated the efficacy of brief teaching interventions in changing clinician behaviour within A&E. The Accident and Emergency Department is a busy environment that requires time- and resource-efficient teaching METHODS: Data for 482 patients receiving c-spine computed tomography (CT) imaging in two Gloucestershire A&Es before and after multimodal departmental teaching were compared...
October 9, 2018: Clinical Teacher
Jian-Cai Wang, Yu-Qian Li, Da-Yun Feng, Xin Zhou, Feng-Qi Yan, Yang Li, Li Gao, Li-Hong Li
Morphine administration is a medical problem characterized by compulsive opioid use that causes terrible negative consequences. The exact mechanisms of morphine-induced dependence and morphine withdrawal symptoms remain unclear. Recent studies have revealed that the upregulation of Wnt/β-catenin signaling plays important roles in morphine exposure and morphine withdrawal. Secreted frizzled-related protein 2 (Sfrp2) can prevent the activation of Wnt/β-catenin signaling by competing with the Frizzled receptor for Wnt ligands...
October 3, 2018: Behavioural Brain Research
Amitesh Dubey, Sachin Tomar, Ashok Gupta, Dinesh Khandelwal
Noncompressive myelopathy of lower dorsal spine secondary to trauma is a rare event. We report a case of delayed paraplegia in a patient with a history of road traffic accident. The X-ray of dorsolumbar spine did not show any abnormality. Magnetic resonance imaging of dorsolumbar spine was performed which showed the presence of central T2-weighted hyperintensities from D10-D11 to D12-L1 level. No associated bony injury was documented, and the integrity of the spinal canal was maintained. The patient was managed conservatively with bed rest, and steroids were given...
July 2018: Asian Journal of Neurosurgery
Dinesh P Thawrani, Steven S Agabegi, Ferhan Asghar
The sacroiliac joint (SIJ) is a diarthrodial joint that has been implicated as a pain generator in approximately 10% to 25% of patients with mechanical low back or leg symptoms. Unique anatomic and physiologic characteristics of SIJ make it susceptible to mechanical stress and also create challenges in the diagnosis of SIJ pain. A variety of inciting causes for SIJ pain may exist, ranging from repetitive low-impact activities such as jogging to increased stress after multilevel spine fusion surgery to high-energy trauma such as in motor vehicle accidents...
October 1, 2018: Journal of the American Academy of Orthopaedic Surgeons
David N Kugelman, Abdullah M Qatu, Eric J Strauss, Sanjit R Konda, Kenneth A Egol
OBJECTIVES: What patient characteristics and injury factors predict decreased knee range of motion (ROM) following operative management of tibial plateau fractures? DESIGN: Prospective cohort study. SETTING: Academic medical center. PATIENTS: Over 11 years, tibial plateau fractures at a single academic institution were prospectively followed. A total of 266 patients were included in this study. INTERVENTION: Surgical repair of tibial plateau fractures and secondary interventions due to arthrofibrosis...
September 10, 2018: Journal of Orthopaedic Trauma
Catherine W Cahill, Kristen E Radcliff, Charles A Reitman
Background: Very little normative computed tomography (CT) scan data exist defining expected relationships of vertebral structures in the intact cervical spine. Better understanding of normal relationships should improve sensitivity of injury detection, particularly for facet subluxation. The purpose of this paper was to describe the normal anatomical relationships and most sensitive measurements to detect abnormal alignment in the subaxial cervical spine. Methods: A group of 30 CT scans with no documented cervical spine injury were utilized from an established database in a trauma population...
August 2018: International Journal of Spine Surgery
Mohamad Soud, Abdulah Alrifai, Amjad Kabach, Zaher Fanari, M Chadi Alraies
Background: Electrical disturbances following blunt cardiac injuries are rare but can be caused by electrical or structural damage to the heart. We present the case of a patient who had conduction abnormalities following blunt traumatic injury that were incidentally detected on telemetry. Case Report: A 64-year-old female with no history of cardiac disease was brought to the emergency department after a motor vehicle collision that resulted in chest wall bruising...
2018: Ochsner Journal
Leanne M Ward, Stasia Hadjiyannakis, Hugh J McMillan, Garey Noritz, David R Weber
Duchenne muscular dystrophy is associated with an increased risk of bone fragility due to the adverse effects of prolonged glucocorticoid therapy and progressive muscle weakness on bone strength. Osteoporosis manifests clinically as low-trauma long-bone and vertebral fractures (VFs), with VFs frequent, particularly in those treated with glucocorticoid therapy. It is increasingly recognized that bone pain, medical complications of osteoporosis (such as fat embolism syndrome), and the potential for permanent, fracture-induced loss of ambulation can be mitigated with timely bone health surveillance and management...
October 2018: Pediatrics
Sui Kwong Li, William B Messer
Gram-negative vertebral osteomyelitis infections are increasing due to rising intravenous drug use but overall remain uncommon. Here, we present a case of Burkholderia cepacia complex cervical osteomyelitis in an intravenous drug user. Burkholderia cepaciacomplex vertebral osteomyelitis has been infrequently described in the literature thus far with varied antibiotic treatment regimens. A 68-year-old male presented to the emergency department with neck pain after minor trauma. He endorsed active intravenous heroin and methamphetamine use...
2018: Case Reports in Infectious Diseases
Hyeun Sung Kim, Nitin Adsul, Jung Soo Bang, Ravindra Singh, Chang Hwan Park, Il-Tae Jang
BACKGROUND: Kummell's disease is defined as avascular necrosis of vertebra, occurs after the delayed posttraumatic osteoporotic vertebral collapse and mainly occurs in adults > 50 years of age. We report the first case of refracture of Kummell's disease and epidural hematoma followed by paraparesis. CASE REPORT: A 67-year-old woman known case of osteoporotic T12 fracture (3 months back) visited our outpatient clinic complaining of persistent back pain and paraparesis after jerk while getting up from the bed...
September 25, 2018: World Neurosurgery
Maged D Fam, Royce W Woodroffe, Logan Helland, Jennifer Noeller, Nader S Dahdaleh, Arnold H Menezes, Patrick W Hitchon
OBJECTIVE: Adult spinal arachnoid cysts (SACs) are rare entities of indistinct etiology that present with pain or myelopathy. Diagnosis is made on imaging studies with varying degrees of specificity. In symptomatic cases, the standard treatment involves surgical exploration and relief of neural tissue compression. The aim of this study was to illustrate features of SACs in adults, surgical management, and outcomes. METHODS: The authors searched medical records for all SACs in adults in the 10-year period ending in December 2016...
September 28, 2018: Journal of Neurosurgery. Spine
Ziya Asan
OBJECTIVE: This study aims to evaluate the long-term clinical and radiological findings of cases diagnosed with spinal concussion and to describe the spinal cord injuries that are detected in the later course. METHODS: Data obtained from 91 cases who had been diagnosed with spinal concussion were retrospectively evaluated. Cases were evaluated under two groups based on the type of trauma as those subjected to axial forces and those subjected to vertical forces. Late spinal MRI scans of the cases taken more than 6 months post-trauma were inspected...
September 24, 2018: World Neurosurgery
Joshua Scott Will, David C Bury, John A Miller
Low back pain is usually nonspecific or mechanical. Mechanical low back pain arises intrinsically from the spine, intervertebral disks, or surrounding soft tissues. Clinical clues, or red flags, may help identify cases of nonmechanical low back pain and prompt further evaluation or imaging. Red flags include progressive motor or sensory loss, new urinary retention or overflow incontinence, history of cancer, recent invasive spinal procedure, and significant trauma relative to age. Imaging on initial presentation should be reserved for when there is suspicion for cauda equina syndrome, malignancy, fracture, or infection...
October 1, 2018: American Family Physician
João Pedro Ferraz Montenegro Lobo, Vitorino Veludo Moutinho, António Francisco Martingo Serdoura, Carolina Fernandes Oliveira, André Rodrigues Pinho
Objective: To evaluate the clinical and radiological outcomes of the surgical treatment in patients diagnosed with odontoid fracture who underwent open reduction and internal fixation (ORIF) with screws. Methods: This was a retrospective study with nine patients. Pain (visual analog scale [VAS]) and neurological status (Frankel scale) were assessed. The neck disability index (NDI) and the post-operative cervical range of motion were calculated. The cervical spine was radiologically evaluated (X-ray and CT) pre- and postoperatively...
September 2018: Revista Brasileira de Ortopedia
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