Spinal column injury

BACKGROUND: Cervical spondyloptosis is defined as the dislocation of the spinal column most often caused by trauma. Due to compression or transection of the spinal cord, severe neurological deficits are common. Here, we review the literature and report a case of traumatic C5-6 spondyloptosis that was successfully treated using an anterior-only surgical approach. METHODS: The patient presented with quadriplegia and absent sensation distal to the C5 dermatome following a rollover motor vehicle accident...

STUDY DESIGN: Anatomical Study. OBJECTIVE: Determine if shoulder depression (e.g., taping the shoulders) might result in C5 nerve traction and subsequent injury. SUMMARY OF BACKGROUND DATA: Postoperative C5 nerve palsy is a recognized entity that is still often enigmatic. Inferior shoulder depression is usually employed to assist with surgical visualization during cervical spine procedures. METHODS: In the supine position, ten adult fresh frozen human cadavers underwent dissection of the spinal cord and its adjacent dorsal, ventral roots and spinal nerves from C4 to T1...

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No abstract text is available yet for this article.

PURPOSE: In principle, MR methods that exploit magnetization transfer (MT) may be used to quantify changes in the molecular composition of tissues after injury. The ability to track such changes in injured spinal cord may allow more precise assessment of the state of neural tissues. METHODS: Z-Spectra were obtained from the cervical spinal cord before and after a unilateral dorsal column lesion in monkeys at 9.4T. The amplitudes of chemical exchange saturation transfer (CEST) and nuclear Overhauser enhancement (NOE) effects from multiple proton pools, along with nonspecific semisolid MT effects from immobile macromolecules, were quantified using a five-peak Lorenzian fitting of each Z-spectrum...

OBJECT: To assess the clinical and radiographic outcomes of posterior vertebral column resection (PVCR) without anterior support in treatment of Yang's A type severe rigid thoracic kyphoscoliosis. METHODS: The records of 27 Yang's A type severe thoracic kyphoscoliosis patients treated with PVCR without anterior support from January 2010 to September 2013 were retrospectively analyzed. Intraoperative multimodal neurophysiological monitoring (IONM) (6 modes: Somatosensory evoked potential (SSEP), Motor evoked potential (MEP), Descending neurogenic evoked potential (DNEP), Spinal cord evoked potential (SCEP), and Electromyography, both triggered and free run EMG) was conducted in all patients...

OBJECTIVE: The aim of this study was to evaluate the complications, efficacy and safety of posterior vertebral column resection (PVCR) in severe angular kyphosis (SAK) greater than 100°. METHODS: The medical records of 17 patients (mean age 17.9 (range, 9-27) years) with SAK who underwent PVCR, were reviewed. Mean follow-up period was 32.2 (range, 24-64) months. Diagnosis of the patients included congenital kyphosis in 11 patients, post-tuberculosis kyphosis in 3 patients and neurofibromatosis in 3 patients...

Gunshot wounds to the spine cause severe neurological and/or internal organs damages. Although most of publications in the literature are realized on military injuries, increased civilian arming which raises civilian gunshot injuries is a new social danger causing serious health problems. In gunshot injuries to the spine; vertebral column, spinal cord and nerve roots are damaged with direct, indirect and transient cavitation related mechanisms. In this case report, we present 24 years old male patient who had severe pain and monoparesis in left upper extremity followed by gunshot injury to the spine with clinical, radiological and postoperative follow-up findings...

OBJECTIVE The authors conducted a study to compare neurological deficit rates associated with complex adult spinal deformity (ASD) surgery when recorded in retrospective and prospective studies. Retrospective studies may underreport neurological deficits due to selection, detection, and recall biases. Prospective studies are expensive and more difficult to perform, but they likely provide more accurate estimates of new neurological deficit rates. METHODS New neurological deficits were recorded in a prospective study of complex ASD surgeries (pSR1) with a defined outcomes measure (decrement in American Spinal Injury Association lower-extremity motor score) for neurological deficits...

OBJECTIVES: To report a single-institution experience with isolated transverse process fractures (ITPFs) and provide increasing support for the development of evidence-based guidelines. Additionally, the authors evaluate the presence of concerning symptoms or red flags that may indicate additional, underlying injuries in the setting of ITPFs. METHODS: The Ronald Reagan UCLA Medical Center patient database was queried (years 2005 to 2016) using International Classification of Diseases, Ninth Revision code 805: fracture of the vertebral column without mention of spinal cord injury...

Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by calcifications and ossification of ligaments and tendon insertions. The patients with DISH are susceptible to spinal column injury with trivial trauma due to immobilization of vertebrae and this easily leads to spinal cord injury. However, only few reports on hyperextension injuries of the thoracolumbar spine with DISH exist. Here we report three cases of those who developed delayed leg paraplegia after hyperextension injuries of the thoracolumbar spine with DISH...

STUDY DESIGN: A retrospective epidemiological study. OBJECTIVE: To reveal incidence and epidemiological features of traumatic spinal injuries (TSI) in Northern Finland. SUMMARY OF BACKGROUND DATA: In Finland the annual incidence of traumatic spine fractures requiring inpatient care has been found to be 27/100 000, while international incidences have varied across the range of 16-64/100 000. More specific epidemiological data from Finland is not available...

Impaired breathing is a devastating result of high cervical spinal cord injuries (SCI) due to partial or full denervation of phrenic motoneurons, which innervate the diaphragm - a primary muscle of respiration. Consequently, people with cervical level injuries often become dependent on assisted ventilation and are susceptible to secondary complications. However, there is mounting evidence for limited spontaneous recovery of respiratory function following injury, demonstrating the neuroplastic potential of respiratory networks...

INTRODUCTION: The objective of this study was to assess the feasibility of the use of functional magnetic resonance imaging (fMRI) to evaluate the spinal activation during sexual response of the thoracic, lumbar and sacral spinal cord. MATERIALS AND METHODS: This is a laboratory-based pilot study in human females at a University-based medical center in the United States. In three healthy spinal cord injury (SCI) females, spinal cord activations during sexual audiovisual stimulation (alone), genital self-stimulation (alone) and simultaneous audiovisual and genital self-stimulation (combined) were assessed and then compared with each subjects' remaining sensory and motor function...

PURPOSE: The risk of neurological injury during vertebral column resection is high. In this study, we investigated the incidence and risk factors for neurological complications when treating spinal deformities by thoracic posterior vertebral column resection (PVCR). METHODS: Between 2008 and 2013, there were 62 consecutive patients (34 female patients and 28 male; the mean age: 16.3 years, range 6-46 years) treated with thoracic PVCR. We retrospectively reviewed the clinical records to obtain demographic and radiographic data, operative time, estimated blood loss (EBL, the ratio between circulating and lost blood), bleeding volume (the lost blood), number of vertebrae fused, number of vertebrae resected, usage of titanium mesh cage, and intraoperative neuromonitoring data...

OBJECTIVE Tethered cord syndrome is the clinical manifestation of an abnormal stretch on the spinal cord, presumably causing mechanical injury, a compromised blood supply, and altered spinal cord metabolism. Tethered cord release is the standard treatment for tethered cord syndrome. However, direct untethering of the spinal cord carries potential risks, such as new neurological deficits from spinal cord injury, a CSF leak from opening the dura, and retethering of the spinal cord from normal scar formation after surgery...

A major concern associated with ZIKV infection is the increased incidence of microcephaly with frequent calcifications in infants born from infected mothers. To date, postmortem analysis of the central nervous system (CNS) in congenital infection is limited to individual reports or small series. We report a comprehensive neuropathological study in ten newborn babies infected with ZIKV during pregnancy, including the spinal cords and dorsal root ganglia (DRG), and also muscle, pituitaries, eye, systemic organs, and placentas...

STUDY DESIGN: Retrospective clinical and radiographic study. OBJECTIVE: To examine the efficacy and safety of vertebrectomy and expandable cage placement by a single-stage posterior approach for unstable mid and lower lumbar burst fractures (below the L3). SUMMARY OF BACKGROUND DATA: Patients with unstable mid and lower lumbar burst fractures require surgical treatment to relieve pain, address paralysis, and stabilize the spine to prevent further segmental deformity...

PURPOSE: To report on the multi-phase process used in developing the AOSpine Patient Reported Outcome Spine Trauma (AOSpine PROST), as well as the results of its application in a pilot study. METHODS: The International Classification of Functioning, Disability and Health (ICF) methodology was used as the basis for the development of this tool. Four preparatory studies and a consensus conference were performed, and resulted in the selection of 25 core ICF categories as well as the scale for use...

To generate voluntary forearm movements, the information that is encoded in the activity of the cortical neurons has to travel through the spinal cord and activate the skeletal muscles. The axons carrying these signals are tightly bundled together in the descending tracts that control the spinal circuitry innervating the forearm muscles. In this paper, we show that corticospinal tract (CST) signals can be used to predict forearm electromyographic (EMG) activities that are recorded during an isometric-pull task...