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Spinal column injury

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https://www.readbyqxmd.com/read/28103119/iatrogenic-spinal-cord-injury-in-a-trauma-patient-with-ankylosing-spondylitis
#1
Ahmad Maarouf, Colleen M McQuown, Jennifer A Frey, Rami A Ahmed, Lisa Derrick
BACKGROUND: The recommended practice for over 30 years has been to routinely immobilize patients with unstable cervical spinal injuries using cervical spinal collars. It is shown that patients with Ankylosing spondylitis (AS) are four times more likely to suffer a spinal fracture compared to the general population and have an eleven-fold greater risk of spinal cord injury. Current protocols of spinal immobilization were responsible for secondary neurologic deterioration in some of these patients...
January 19, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28090452/classifying-thoracolumbar-fractures-role-of-quantitative-imaging
#2
REVIEW
Fernando Ruiz Santiago, Pablo Tomás Muñoz, Elena Moya Sánchez, Marta Revelles Paniza, Alberto Martínez Martínez, Antonio Luis Pérez Abela
This article describes different types of vertebral fractures that affect the thoracolumbar spine and the most relevant contributions of the different classification systems to vertebral fracture management. The vertebral fractures types are based on the three columns model of Denis that includes compression, burst, flexion-distraction and fracture-dislocation types. The most recent classifications systems of these types of fractures are reviewed, including the Thoracolumbar Injury Classification and Severity score (TLICS) and the Arbeitsgemeinschaft für Osteosynthesefragen Spine Thoracolumbar Injury Classification and Severity score (AOSpine-TLICS)...
December 2016: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28072502/wallerian-degeneration-beyond-the-corticospinal-tracts-conventional-and-advanced-mri-findings
#3
REVIEW
Yin Jie Chen, Seyed Ali Nabavizadeh, Arastoo Vossough, Sunil Kumar, Laurie A Loevner, Suyash Mohan
Wallerian degeneration (WD) is defined as progressive anterograde disintegration of axons and accompanying demyelination after an injury to the proximal axon or cell body. Since the 1980s and 1990s, conventional magnetic resonance imaging (MRI) sequences have been shown to be sensitive to changes of WD in the subacute to chronic phases. More recently, advanced MRI techniques, such as diffusion-weighted imaging (DWI) and diffusion tensor imaging (DTI), have demonstrated some of earliest changes attributed to acute WD, typically on the order of days...
November 7, 2016: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/28035466/a-rare-postoperative-complication-of-anterior-lower-thoracic-instrumentation-diaphragmatic-laceration-with-hemothorax
#4
Yat Wa Wong, Jason Pui Yin Cheung, Keith Dip Kei Luk, Kenneth Man Chee Cheung
PURPOSE: To highlight the importance of preventing visceral injury due to prominent anterior implants at the spinal column. METHODS: A 52-year-old man with cord compression was treated with a T9/10 discectomy and instrumented fusion via a right thoracotomy and trans-pleural approach. Postoperatively, he had improved lower limb numbness. However, after a bout of coughing, there was sudden increase in chest drain output, hemodynamic instability and massive fluid collection in the right chest cavity...
December 29, 2016: European Spine Journal
https://www.readbyqxmd.com/read/28028650/occult-subaxial-cervical-disco-ligamentous-injuries-in-computer-tomography-negative-trauma-patients
#5
Jiun-Lih Lin, Sumant Samuel, Randolph Gray, Stephen Ruff, Con Vasili, Andrew Cree, Nathan Hartin
PURPOSE: Due to lack of cervical clearance consensus in literature and the devastating consequences of missed cervical injuries, Magnetic resonance imaging (MRI) of the neurologically intact symptomatic patient with negative CT scan is frequently done to rule out disco-ligamentous injuries. This study retrospectively evaluates occult disco-ligamentous injuries detected by MRI in patients with no abnormalities detected by modern multi-detector CT scanning and postulates a new theory of ligamentous stability of cervical spine...
December 27, 2016: European Spine Journal
https://www.readbyqxmd.com/read/28009224/mesenteric-ischemia-following-the-correction-of-adult-spinal-deformity-case-report
#6
Krishn Khanna, Sigurd H Berven
Vascular complications are an important adverse event that can be associated with spinal reconstructive surgery. Direct injury of vessels, or indirect traction or compression of vessels, can cause both arterial and venous injury. Indirect compression of the mesenteric vessels is a well-recognized complication of bracing and surgical care of children with spinal deformity (superior mesenteric artery syndrome), but the complication is not common or well recognized in the adult population with spinal deformity...
December 23, 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28005617/lateral-extracavitary-approach-versus-posterior-extensive-circumferential-decompression-in-the-treatment-of-complicated-thoracic-and-lumbar-tuberculous-spondylitis
#7
Khaled Omran, Ahmed S Abdel-Fattah, Ahmed M A Othman, Ahmed O Youssef, Amr Solimen, Mohamed A ElRefai, Ahmed N Saleh, Mohammed Ali
OBJECTIVES AND STUDY DESIGN: The aim of this study was to retrospectively evaluate 45 patients operated upon either by posterior extensive circumferential decompression (PECD) or by the lateral extracavitary (LEC) technique and compare the clinical, radiologic, laboratory, and functional outcomes. SUMMARY OF BACKGROUND: The debate continues on the best decompression-fusion technique for treating complicated spinal tuberculosis. In recent times, the advantages of combined surgery have been successfully achieved using the 1-stage salvage technique, with enough accessibility to all 3 spinal columns...
December 21, 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27988344/combined-chondroitinase-and-klf7-expression-reduce-net-retraction-of-sensory-and-cst-axons-from-sites-of-spinal-injury
#8
Zimei Wang, Kristen Winsor, Christopher Nienhaus, Evan Hess, Murray G Blackmore
Axon regeneration in the central nervous system is limited both by inhibitory extracellular cues and by an intrinsically low capacity for axon growth in some CNS populations. Chondroitin sulfate proteoglycans (CSPGs) are well-studied inhibitors of axon growth in the CNS, and degradation of CSPGs by chondroitinase has been shown to improve the extension of injured axons. Alternatively, axon growth can be improved by targeting the neuron-intrinsic growth capacity through forced expression of regeneration-associated transcription factors...
December 14, 2016: Neurobiology of Disease
https://www.readbyqxmd.com/read/27917533/human-spinal-ejaculation-generator
#9
Clément Chéhensse, Patricia Facchinetti, Stéphane Bahrami, Philippe Andrey, Jean-Marc Soler, Fabrice Chrétien, Jacques Bernabé, Pierre Clément, Pierre Denys, François Giuliano
OBJECTIVE: A spinal ejaculation generator (SEG) has been identified in the rat with lumbar galaninergic interneurons playing a pivotal role (Science 2002;297:1566-1569). The aim was to evidence a SEG in humans. METHODS: Spatial distribution of galaninergic neurons was studied in postmortem spinal cord segments of 6 men and compared with that of 6 women for evidencing sexual dimorphism. Based on the identified segmental distribution of galaninergic neurons, the ability for penile vibratory stimulation (PVS) to elicit ejaculation when the concerned spinal segments were injured was studied in 384 patients with clinically complete spinal cord injury (SCI) and consequent anejaculation...
December 5, 2016: Annals of Neurology
https://www.readbyqxmd.com/read/27915066/the-impact-of-hospital-teaching-status-on-timing-of-intervention-inpatient-morbidity-and-mortality-after-surgery-for-vertebral-column-fractures-with-spinal-cord-injury
#10
Rafael De la Garza Ramos, Jonathan Nakhla, Rani Nasser, Ajit Jada, Daniel M Sciubba, Merritt D Kinon, Reza Yassari
OBJECTIVE: To investigate the impact of hospital teaching status on the timing of intervention and inpatient morbidity and mortality after surgery for acute spinal cord injury (SCI). METHODS: Data from the Nationwide Inpatient Sample (2002 - 2011) were reviewed. Patients were included if they had a diagnosis of closed vertebral column fracture with SCI, underwent spine surgery, and were admitted urgently or emergently. Early intervention (the day of or the day after admission), inpatient morbidity and mortality rates were compared between patients admitted to teaching versus nonteaching hospitals...
November 30, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27913838/isolated-transverse-process-fractures-insignificant-injury-or-marker-of-complex-injury-pattern
#11
G Lombardo, P Petrone, K Prabhakaran, C P Marini
INTRODUCTION: This study investigates the incidence of isolated transverse process fractures (ITPFx) amongst vertebral fractures in trauma patients, and specific-associated injury patterns present in patients with ITPFx. MATERIALS AND METHODS: A retrospective, 4-year review of our Level 1 Trauma Center registry was performed. Patients with blunt spinal column fractures were identified. Data collected included patient demographics, Injury Severity Score (ISS), type of imaging obtained, and concomitant injuries, including rib and pelvic fractures, liver, spleen, and kidney injury (SOI)...
December 2, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27906739/posterior-vertebral-column-resection-with-intraoperative-manual-retraction-for-the-treatment-of-posttubercular-kyphosis-in-upper-thoracic-spine-or-cervicothoracic-junction
#12
Yuqiao Chen, Guohua Lü, Bing Wang, Lei Li, Lei Kuang
STUDY DESIGN: This is a case-series. OBJECTIVE: To evaluate the clinical and radiologic outcomes of posterior vertebral column resection (PVCR) for treatment of posttubercular kyphosis in upper thoracic spine and cervicothoracic junction (CTJ). SUMMARY OF BACKGROUND DATA: Surgical management of severe posttubercular kyphosis in upper thoracic spine or CTJ is challenging. A new technique that combines PVCR and intraoperative manual traction in a single procedure, was developed to maximize the correction rate and minimize the risk of dural buckling and spinal cord injury...
November 30, 2016: Clinical Spine Surgery
https://www.readbyqxmd.com/read/27871718/aza%C3%A3-%C3%A3-n-s-disease-a-19th-century-epidemic-of-neurolathyrism-in-spain
#13
REVIEW
S Giménez-Roldán, P S Spencer
The cultivation and consumption of grasspea (Lathyrus sativus) in Spain probably dates back centuries, especially during times of famine when the neurotoxic potential of this legume was expressed in the form of a spastic paraparesis known as neurolathyrism. Little known outside the country, the epidemic of neurolathyrism in the years following the Spanish Civil War (1936-1939) came to affect more than a thousand people. In late 1872, during the Six Years Revolutionary Term, young Alejandro San Martín Satrústegui (1847-1908), then editor of the popular weekly El Siglo Médico, travelled to Azañón, a remote village in the province of Guadalajara, to clarify a so-far unknown disease...
December 2016: Revue Neurologique
https://www.readbyqxmd.com/read/27867025/comparison-of-short-segment-pedicle-fixation-with-versus-without-inclusion-of-the-fracture-level-in-the-treatment-of-mild-thoracolumbar-burst-fractures
#14
Chao Sun, Guoping Guan, Xinhui Liu, Hailong Zhang, Bin Wang
BACKGROUND: A review of the literature showed that posterior short-segment fixation including the fractured vertebra (PSFFV) has better outcomes in the treatment of thoracolumbar burst fractures(TBFs) than patients with short-segment pedicle screw fixation(SSPF) alone. However, its efficacy in mild TBFs with load-sharing scores of 3 and 4 points has not been specifically analyzed. The aim of this study was to compare the clinical, functional and radiologic results of PSFFV with SSPF for mild TBFs and to determine whether the screws in the fractured vetebra were necessary for these patients...
December 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27834648/epidural-stimulation-of-rat-spinal-cord-at-lumbosacral-segment-using-a-surface-electrode-a-computer-simulation-study
#15
Qi Xu, Li Kong, Hui Zhou, Jiping He
Clinical research indicates that the epidural spinal cord stimulation (ESCS) at lumbosacral segment has shown potential for promoting locomotor recovery in patients with incomplete spinal cord injury. However, the underlying neural mechanism needs to be determined by animal experiments. In order to refine experimental protocols, we used a finite element simulation to investigate the activation of nerve fibers in a rat spinal cord model. Our model is composed of a volume conductor model from L1 to S2 spinal segments and the McIntyre-Richard-Grill axon model, which is used to investigate the threshold of selected spinal fibers with different diameters at varied locations and predict the neural responses of any target fibers with bipolar electrode configuration...
November 4, 2016: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/27816708/minimally-invasive-pedicle-screw-fixation-combined-with-percutaneous-vertebroplasty-for-the-treatment-of-thoracolumbar-burst-fracture
#16
Chunbo Li, Jianfeng Pan, Yutong Gu, Jian Dong
INTRODUCTION: To evaluate the feasibility, efficacy and safety of minimally invasive pedicle screw fixation (MIPS) combined with percutaneous vertebroplasty (PVP) using calcium phosphate for the treatment of thoracolumbar burst fracture without neurologic deficits. METHODS: Between September 2011 and April 2013, a total of thirty-seven patients with a mean age of 50.73 years (range 40-63 years), who suffered from thoracic or lumbar burst fracture without neurologic deficits underwent the procedure of MIPS combined with PVP using calcium phosphate...
December 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27788683/analysis-of-the-independent-risk-factors-of-neurologic-deficit-after-thoracolumbar-burst-fracture
#17
Peifu Tang, Anhua Long, Tao Shi, Licheng Zhang, Lihai Zhang
BACKGROUND: The objective of this study is to identify the independent risk factors of neurologic deficit after thoracolumbar burst fracture. Traumatic fractures of the thoracolumbar spine are the most common type of spinal column fractures. Many studies have attempted to determine whether neurologic deficit in such fractures is related to spinal canal stenosis or other parameters observed on axial computed tomography. However, this relationship remains controversial. METHODS: A review of the clinical data and axial computed tomography (CT) for 105 patients was performed...
October 24, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27774835/the-contributions-to-the-human-dorsal-column-tracts-from-the-spinal-cord-laminae
#18
Özlem Kirazlı, Bilgehan Solmaz, Safiye Çavdar
The dorsal column tracts (fasciculus gracilis and fasciculus cuneatus) are concerned with discriminative qualities of sensation. There are controversial descriptions related to the relations of dorsal column tracts with the dorsal horn laminae in text-books. The present study aims to define the laminae of the dorsal horn of the spinal cord that contribute fibers to the dorsal column tracts in the cervical, thoracic and lumbar spinal level. Series paraffin spinal cords sections of six formalin-embalmed adult human cadavers were evaluated...
September 2016: Journal of Integrative Neuroscience
https://www.readbyqxmd.com/read/27766191/vertebral-column-resection-for-kyphoscoliosis-in-a-patient-with-ehlers-danlos-syndrome-an-intraoperative-neurophysiological-monitoring-alert
#19
Faisal R Jahangiri, Sami Al Eissa, Samir Sayegh, Fahad Al Helal, Shomoukh A Al-Sharif, Monerah M Annaim, Sheryar Muhammad, Tanweer Aziz
A 16-year-old male patient with Ehler-Danlos syndrome (EDS) and a back deformity since birth presented with severe kyphoscoliosis. The patient was neurologically intact but had respiratory and cardiac insufficiencies. A two-stage vertebral column resection (VCR) at T9-T10 with multiple level fusion with multimodality intraoperative neurophysiological monitoring (IONM) was planned.  During the first stage, pedicle screws were placed at multiple spinal levels above and below the VCR level. Upper and lower somatosensory evoked potentials (SSEP), transcranial electrical motor evoked potentials (TCeMEP), and electromyography were monitored continuously and showed no significant changes...
August 31, 2016: Curēus
https://www.readbyqxmd.com/read/27713008/ct-based-morphological-analysis-of-spinal-fractures-in-patients-with-diffuse-idiopathic-skeletal-hyperostosis
#20
Eijiro Okada, Takashi Tsuji, Kentaro Shimizu, Masanori Kato, Kentaro Fukuda, Shinjiro Kaneko, Jun Ogawa, Kota Watanabe, Ken Ishii, Masaya Nakamura, Morio Matsumoto
PURPOSE: To clarify correlations between spinal fracture and delayed paralysis in patients with diffuse idiopathic skeletal hyperostosis (DISH) using computed tomography (CT) with multiplanar reformatting (CT-MPR). DISH increases susceptibility to unstable spinal fractures, leading to neurological deterioration. The pathomechanism of the neurological injury is unclear. METHODS: This multicenter retrospective study included 42 DISH patients (32 male; 10 female) treated for 45 spinal fractures during a 5-year period...
October 3, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
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