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Spine And Trauma

Bart N Green, Claire D Johnson, Scott Haldeman, Edward J Kane, Michael B Clay, Erin A Griffith, Juan M Castellote, Matthew Smuck, Shanmuganathan Rajasekaran, Eric L Hurwitz, Margareta Nordin, Kristi Randhawa, Hainan Yu
PURPOSE: The purpose of this study was to develop recommendations for prevention interventions for spinal disorders that could be delivered globally, but especially in underserved areas and in low- and middle-income countries. METHODS: We extracted risk factors, associations, and comorbidities of common spinal disorders (e.g., back and neck pain, spinal trauma, infection, developmental disorders) from a scoping review of meta-analyses and systematic reviews of clinical trials, cohort studies, case control studies, and cross-sectional studies...
August 11, 2018: European Spine Journal
Benjamin Khechen, Brittany E Haws, Mundeep S Bawa, Dil V Patel, Kaitlyn L Cardinal, Jordan A Guntin, Simon P Lalehzarian, Kern Singh
STUDY DESIGN: Retrospective Cohort OBJECTIVE.: To determine if comorbidity as determined by Charlson Comorbidity Index (CCI) is associated with inpatient complication rate, length of stay (LOS), or direct hospital costs after minimally-invasive transforaminal lumbar interbody fusion (MIS-TLIF). SUMMARY OF BACKGROUND DATA: In the spine literature, comorbidity burden has been associated with an increased risk for complications, prolonged LOS, and greater hospital costs...
August 7, 2018: Spine
Antonia F Chen, Andrew Fleischman, Matthew S Austin
Intrawound antibiotics have been used in orthopaedic surgery procedures to prevent the development of surgical site infections. Local delivery of antibiotic powder has demonstrated a notable reduction in surgical site infection in rabbit and rodent in vivo models, as well as in other surgical fields, including vascular, colorectal, cardiothoracic, and dermatologic surgery. Intrawound antibiotic powder has been used in many orthopaedic applications, including spine surgery, total joint arthroplasty, trauma, foot and ankle reconstruction, and elbow surgery...
August 8, 2018: Journal of the American Academy of Orthopaedic Surgeons
Sean T Campbell, John P Kleimeyer, Jeffrey L Young, Michael J Gardner, Kirkham B Wood, Julius A Bishop
OBJECTIVE: We asked the following questions: 1. Does the use of an structured review instrument (SRI) at journal club increase presentation quality, as measured objectively by a standardized evaluation rubric? 2. Does SRI use increase the time required to prepare for journal club? 3. Does SRI use positively impact presenter perceptions about confidence while presenting, satisfaction, and journal club effectiveness, as measured by postparticipation surveys? DESIGN: A prospective study was designed in which a grading rubric was developed to evaluate journal club presentations...
August 7, 2018: Journal of Surgical Education
Vijayanth Kanagaraju, P K Karthik Yelamarthy, Harvinder Singh Chhabra, Ajoy Prasad Shetty, Ankur Nanda, Gururaj M Sangondimath, Kali Dutta Das, Murari Lal Bansal, Bibhudendu Mohapatra, Nishit Patel, Rainer Abel, Sagun Tuli, Tarsissio Barros, Vikas Tandon
STUDY DESIGN: A psychometrics study. OBJECTIVES: To determine intra and inter-observer reliability of Allen Ferguson system (AF) and sub-axial injury classification and severity scale (SLIC), two sub axial cervical spine injury (SACI) classification systems. SETTING: Online multi-national study METHODS: Clinico-radiological data of 34 random patients with traumatic SACI were distributed as power point presentations to 13 spine surgeons of the Spine Trauma Study Group of ISCoS from seven different institutions...
August 8, 2018: Spinal Cord
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
Woo-Keun Kwon, Woong-Bae Park, Gun-Young Lee, Joo Han Kim, Youn-Kwan Park, Hong Joo Moon
OBJECTIVE: We introduce our technique and results of retro-pleural/peritoneal "lateral pediculectomy" for the decompression of thoracolumbar fractures and reconstruction using expandable titanium cage, and circumferential fixation at a single stage. METHODS: 18 patients who had single unstable, burst thoracolumbar fracture were treated by this technique between January 2014 and December 2016 (T12: 9 cases, L1: 7 cases, L2: 2 cases). They were reviewed retrospectively in terms of radiologic (CT scan and X-ray), clinical outcomes and complications...
July 28, 2018: World Neurosurgery
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
Claudia Patricia Lozano Guzman, Kevin A Chen, Joshua A Marks, Jay S Jenoff, Murray J Cohen, Michael S Weinstein
BACKGROUND: Cervical spine injuries (CSI) can have major effects on the respiratory system and carry a high incidence of pulmonary complications. Respiratory failure can be due to spinal cord injuries, concomitant facial fractures or chest injury, airway obstruction, or cognitive impairments. Early tracheostomy (ET) is often indicated in patients with CSI. However, in patients with anterior cervical fusion (ACF), concerns about cross-contamination often delay tracheostomy placement. This study aims to demonstrate the safety of ET within four days of ACF METHODS: Retrospective chart review was performed for all trauma patients admitted to our institution between 2001-2015 with diagnosis of CSI who required both ACF and tracheostomy, +/- posterior cervical fusion (PCF), during the same hospitalization...
August 7, 2018: Journal of Trauma and Acute Care Surgery
Alaa Mohamed Khidr, Mohamed R El Tahan, D John Doyle, Yasser Maher Aljehani
We describe the novel combined use of a fiberoptic bronchoscope and a Fuji Uniblocker placed outside the endotracheal tube (ETT) for removal of a retained BioGlue polymerized tissue fragment (2.8 × 0.8 cm) from the right main bronchus (RMB). The patient was a trauma victim who presented with a diffuse axonal injury, cervical spine and maxillofacial injuries, and a flail chest, and the procedure we describe took place following the surgical repair of a disrupted left main bronchus. Endoscopic retrieval using different sizes of grasping forceps and a Dormia basket failed to remove the foreign body (FB)...
July 30, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
WanLi Zhou, Vinod Chandran, Richard Cook, Dafna D Gladman, Lihi Eder
OBJECTIVE: To assess the association between occupational-related mechanical factors and the severity of radiographic peripheral and axial joint damage in patients with longstanding Psoriatic Arthritis (PsA). METHODS: Patients with longstanding PsA (disease duration≥10 years) were identified from a prospective longitudinal cohort. Using an occupation history questionnaire, patients were asked to report all paid employments since the age of 18. The key predictor variables included various occupational-related mechanical exposures...
June 19, 2018: Seminars in Arthritis and Rheumatism
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
Laura Musazzi, Paolo Tornese, Nathalie Sala, Maurizio Popoli
Posttraumatic stress disorder (PTSD), the fifth most prevalent mental disorder in the United States, is a chronic, debilitating mental illness with as yet limited options for treatment. Hallmark symptoms of PTSD include intrusive memory of trauma, avoidance of reminders of the event, hyperarousal and hypervigilance, emotional numbing, and anhedonia. PTSD is often triggered by exposure to a single traumatic experience, such as a traffic accident, a natural catastrophe, or an episode of violence. This suggests that stressful events have a primary role in the pathogenesis of the disorder, although genetic background and previous life events are likely involved...
2018: Frontiers in Pharmacology
C Mourouzis, O Schoinohoriti, C Krasadakis, G Rallis
BACKGROUND: Maxillofacial fractures have been recognized as high risk trauma for concomitant cervical spine or spinal cord injury. OBJECTIVE: To investigate the incidence of concomitant cervical spine fractures (CSF) in patients with maxillofacial trauma and elucidate their relationship, guiding diagnosis and pointing their implications in maxillofacial trauma repair. MATERIAL AND METHODS: An analysis of 432 patients with maxillofacial fractures, treated at the Department of Oral and Maxillofacial Surgery of the "KAT" General Hospital of Attica during a three-year-long period, was conducted to investigate concomitant CSF...
July 11, 2018: Journal of Cranio-maxillo-facial Surgery
Kathleen M O'Connell, D Alex Quistberg, Robert Tessler, Bryce R H Robinson, Joseph Cuschieri, Ronald V Maier, Frederick P Rivara, Monica S Vavilala, Paul I Bhalla, Saman Arbabi
OBJECTIVE: The aim of this study was to examine the risk of delirium in geriatric trauma patients with rib fractures treated with systemic opioids compared with those treated with regional analgesia (RA). SUMMARY OF BACKGROUND DATA: Delirium is a modifiable complication associated with increased morbidity and mortality. RA may reduce the need for opioid medications, which are associated with delirium in older adults. METHODS: Cohort study of patients ≥65 years admitted to a regional trauma center from 2011 to 2016...
September 2018: Annals of Surgery
Sebastian Ruetten, Patrick Hahn, Semih Oezdemir, Xenophon Baraliakos, Georgios Godolias, Martin Komp
BACKGROUND: Surgery for thoracic disc herniation and stenosis is comparatively rare and often demanding. The goal is to achieve sufficient decompression without manipulating the spinal cord and to minimize surgical trauma and its consequences. Individual planning and various surgical techniques and approaches are required. The key factors for selecting the technique are anatomical location, consistency of the pathology, general condition of the patient, and the surgeon's experience. OBJECTIVES: The objective of the study was the evaluation of the technical implementation and outcomes of a full-endoscopic uniportal technique via the extraforaminal approach in patients with symptomatic soft or calcified disc herniation of the thoracic spine, taking specific advantages and disadvantages and literature into consideration...
July 2018: Pain Physician
Michael J Ellis, Patrick J McDonald, Ashley Olson, James Koenig, Kelly Russell
OBJECTIVE: To examine the prevalence of cervical spine injuries among children and adolescents referred with suspected and diagnosed sports-related concussion (SRC); and evaluate the effect of cervical spine dysfunction (CSD) on physician-documented clinical recovery following SRC. SETTING: A multidisciplinary pediatric concussion program. PARTICIPANTS: A total of 266 patients (6-19 years) referred with suspected SRC. DESIGN: A retrospective cohort study...
July 24, 2018: Journal of Head Trauma Rehabilitation
S Krinner, A Langenbach, F F Hennig, A Ekkernkamp, S Schulz-Drost
BACKGROUND: Fractures of the anterior chest wall are rare among the total number of fractures. They include sternal fractures (SF) and the adjacent cartilaginous structures of the ribs. The accident mechanism can allow conclusions to be drawn about which further accompanying injuries may be present, e.g. rib and spinal fractures. OBJECTIVE: The present work is intended to give an overview of injuries of the anterior chest wall. It includes clinical aspects as well as imaging and popular literature...
August 2018: Der Unfallchirurg
Yung Yuan Chen, Yong Ju Jang
Saddle nose correction remains a challenging procedure for rhinoplasty surgeons due to both aesthetic and functional issues. The most common causes of saddle nose are nasal trauma and prior septal surgery, and a defective relationship between the caudal septum and the anterior septal spine is the principal postoperative pathology. The authors propose their own classification system for saddle nose with one new category and several approaches to deal with this condition in accordance with the level of severity...
August 2018: Facial Plastic Surgery: FPS
Marieke Geerdes, Simone P Smook, Tim A von Schükkmann
A 42-year-old woman presented with neck pain without previous trauma. On suspicion of spondylodiscitis, an MRI of the cervical spine was made. This MRI and an additional CT showed calcific tendinitis of the longus colli muscle, a self-limiting disorder.
May 22, 2018: Nederlands Tijdschrift Voor Geneeskunde
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