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Spinal cord trauma

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https://www.readbyqxmd.com/read/27909638/four-rod-instrumentation-for-treatment-of-charcot-spinal-arthropathy-causing-autonomic-dysreflexia-case-report-and-literature-review
#1
Stephanie Zyck, Gentian Toshkezi, John Pizzuti, Satya Marawar
Late complications of spinal cord injury can include Charcot arthropathy, in which spinal instability occurs as a result of repetitive trauma in the insensate spine. In rare cases, this can present as autonomic dysreflexia. We present the case of a 60-year-old man with longstanding C6 quadriplegia who presented with six months of hypertension, diaphoresis and dizziness. After an extensive workup, the patient's symptoms were attributed to autonomic dysreflexia in the setting of spinal instability from Charcot spinal arthropathy...
October 27, 2016: Curēus
https://www.readbyqxmd.com/read/27904758/penetrating-thoracic-spinal-cord-injury-with-ice-pick-extending-into-the-aorta-a-technical-note-and-review-of-the-literature
#2
Rani Nasser, Jonathan Nakhla, Saadat Sharif, Merritt Kinon, Reza Yassari
BACKGROUND: Penetrating spinal cord injuries pose a great challenge to both patients and the treating physicians. Although the overall incidence of penetrating spinal cord injury is the highest in the military, the ubiquity of guns in our society continues to make penetrating spinal cord injury prevalent in the civilian population. These types of injuries are particularly complicated because, beyond the trauma to the neural elements and supporting structures, other organs can be affected and a team approach is required for successful treatment...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27904755/paraplegia-caused-by-cerebral-contusions-in-the-bilateral-precentral-gyri
#3
Hideaki Matsumura, Hiroyuki Fujimori, Naoaki Sato, Akira Matsumura
BACKGROUND: Paraplegia is mainly caused by spinal cord disease and rarely occurs due to head trauma. In this report, we describe a case of paraplegia caused by cerebral contusions in the bilateral precentral gyri. CASE DESCRIPTION: A 72-year-old man was admitted to our hospital with mildly impaired consciousness and severe pure motor paralysis in both legs. He was healthy until the morning of the day, but his wife found him injured in front of his house upon returning home...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/27898477/costs-and-length-of-stay-for-the-acute-care-of-patients-with-motor-complete-spinal-cord-injury-following-cervical-trauma-the-impact-of-early-transfer-to-specialized-acute-sci-center
#4
Andréane Richard-Denis, Debbie Ehrmann Feldman, Cynthia Thompson, Étienne Bourassa-Moreau, Jean-Marc Mac-Thiong
OBJECTIVE: Acute spinal cord injury (SCI) centers aim to optimize outcome following SCI. However, there is no timeframe to transfer patients from regional to SCI centers in order to promote cost-efficiency of acute care. Our objective was to compare costs and length of stay (LOS) following early and late transfer to the SCI center. DESIGN: A retrospective cohort study involving 116 individuals was conducted. Group 1 (n = 87) was managed in an SCI center promptly after the trauma, whereas group 2 (n = 29) was transferred to the SCI center only after surgery...
November 24, 2016: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/27893643/early-percutaneous-dilational-tracheostomy-does-not-lead-to-an-increased-risk-of-surgical-site-infection-following-anterior-spinal-surgery
#5
Chris Kaczmarek, Mirko Aach, Martin F Hoffmann, Emre Yilmaz, Christian Waydhas, Thomas A Schildhauer, Uwe Hamsen
BACKGROUND: Most patients suffering cervical spinal cord injuries require tracheostomy. The optimal timing is still a matter of debate. Previous studies showed that patients receiving early tracheostomy had fewer ventilator days, decreased rates of pneumonia, and were mobilized earlier. Due to the proximity of the anterior approach to the tracheostoma, there is concern about an increased risk of surgical site infection related to tracheostomy. METHODS: Retrospective analysis at a Level 1 trauma center of patient records from 2008-2014, identifying all patients with spinal cord injury who received anterior cervical spinal surgery and had early percutaneous dilational tracheostomy...
November 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27886876/complications-in-the-management-of-patients-with-spine-trauma
#6
REVIEW
Geoffrey Stricsek, George Ghobrial, Jefferson Wilson, Thana Theofanis, James S Harrop
More than 50% of patients diagnosed with acute, traumatic spinal cord injury will experience at least 1 complication during their hospitalization. Age, severity of neurological injury, concurrent traumatic brain injury, comorbid illness, and mechanism of injury are all associated with increasing risk of complication. More than 75% of complications will occur within 2 weeks of injury. The complications associated with SCI carry a significant risk of morbidity and mortality; their early identification and management is critical in the care of the SCI patient...
January 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/27886871/update-on-new-imaging-techniques-for-trauma
#7
REVIEW
Lubdha M Shah, Adam E Flanders
Computed tomography (CT) and MRI are complementary imaging modalities for the evaluation of the traumatic spine. Osseous delineation is best assessed with CT, whereas MRI gives superb soft tissue description. Awareness of the strengths and pitfalls of each modality is critical in the accurate interpretation of images. Advances in MR imaging of the spine, particularly of the spinal cord, provide glimpses into to the pathobiological mechanism of spinal cord injury. Innovative techniques relay microstructural information about the integrity of the axons and myelin sheaths...
January 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/27884333/c-spine-injury-and-mandibular-fractures-lifesaver-broken-in-two-spots
#8
Michael W Chu, Tahereh Soleimani, Tyler A Evans, Sarah I Fernandez, Leigh Spera, Carrie Klene, Ben L Zarzaur, Sunil S Tholpady
BACKGROUND: Trauma is a leading cause of injury and mortality and may involve mandibular fractures and cervical spine injuries. Manipulation of the spine during trauma protocols and operative treatment has the potential to cause serious spinal cord injuries. The purpose of this study was to identify risk factors associated with cervical spine injury (CSI) in patients with mandibular fractures. METHODS: The National Trauma Databank (2007-2010) was used to identify patients with mandibular fractures...
December 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27864669/subaxial-cervical-spine-trauma
#9
REVIEW
Eric Feuchtbaum, Jacob Buchowski, Lukas Zebala
Subaxial cervical spine trauma is common and an often missed diagnosis. Accurate and efficient diagnosis and management is necessary to avoid devastating complications such as spinal cord injury. Several classification schemes have been devised to help categorize fractures of the subaxial spine and define treatment algorithms. The Subaxial Cervical Spine Injury Classification System (SLIC) is widely used and evaluates not only fracture morphology but also considers ligamentous injury and neurological status in surgical decision making...
December 2016: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/27857994/triple-trouble-a-case-of-traumatic-cervical-spinal-cord-injury-in-a-patient-with-ossification-of-posterior-longitudinal-ligament-and-disc-prolapse
#10
Kosar Hussain, Sally Khalid Ahmed Abu-Khumra, Firas Jaafar Kareem Alnajjar, Motea Mohamad Abdo
We describe the case of a trauma patient who presented to our emergency department with signs and symptoms suggestive of cervical cord injury. The patient had an underlying ossification of the posterior longitudinal ligament with multiple cervical disc prolapses from C3 to C7. The presence of these two factors increased the impact of the traumatic cervical cord injury. The patient underwent spinal decompression via laminectomy. Unfortunately, his neurological status did not show any significant improvement after the surgery...
September 2016: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27853664/return-to-play-after-cervical-spine-injuries-a-consensus-of-opinion
#11
John C France, Michael Karsy, James S Harrop, Andrew T Dailey
Study Design Survey. Objective Sports-related spinal cord injury (SCI) represents a growing proportion of total SCIs but lacks evidence or guidelines to guide clinical decision-making on return to play (RTP). Our objective is to offer the treating physician a consensus analysis of expert opinion regarding RTP that can be incorporated with the unique factors of a case for clinical decision-making. Methods Ten common clinical scenarios involving neurapraxia and stenosis, atlantoaxial injury, subaxial injury, and general cervical spine injury were presented to 25 spine surgeons from level 1 trauma centers for whom spine trauma is a significant component of their practice...
December 2016: Global Spine Journal
https://www.readbyqxmd.com/read/27852147/rna-binding-protein-hur-is-translocated-in-astrocytes-following-spinal-cord-injury-and-promotes-the-inflammatory-response
#12
Thaddaeus Kwan, Candace L Floyd, Soojin Kim, Peter H King
Inflammation plays a prominent role in the events following traumatic injury to the central nervous system (CNS). The initial inflammatory response is driven by mediators such as TNF-α and IL-1β which are produced by activated astrocytes and microglia at the site of injury. These factors are regulated post-transcriptionally by RNA binding proteins (RBP) that interact with adenylate and uridylate rich elements (ARE) in the 3'-untranslated region of the mRNA. HuR is one of these RBPs and generally functions as a positive regulator of ARE-containing mRNAs...
November 16, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27849317/efficiacy-of-resveratrol-and-quercetin-after-experimental-spinal-cord-injury
#13
Ulvi Çiftçi, Emre Delen, Murat Vural, Onur Uysal, Didem Turgut Coşan, Canan Baydemir, Fulya Doğaner
BACKGROUND: The aim of this study was to investigate the effect of natural antioxidants resveratrol and quercetin on oxidative stress and secondary cell damage in rats with acute spinal cord injury. METHODS: In this experimental study, 42 male Sprague-Dawley rats were used. Spinal cord injury was performed with clip compression method at level of T4-5. The study was conducted using 6 groups: control, trauma, trauma and solvent, trauma and resveratrol, trauma and quercetin, and trauma with combined resveratrol and quercetin...
September 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/27845888/experimental-spinal-cord-trauma-a-review-of-mechanically-induced-spinal-cord-injury-in-rat-models
#14
Dauda Abdullahi, Azlina Ahmad Annuar, Masro Mohamad, Izzuddin Aziz, Junedah Sanusi
It has been shown that animal spinal cord compression (using methods such as clips, balloons, spinal cord strapping, or calibrated forceps) mimics the persistent spinal canal occlusion that is common in human spinal cord injury (SCI). These methods can be used to investigate the effects of compression or to know the optimal timing of decompression (as duration of compression can affect the outcome of pathology) in acute SCI. Compression models involve prolonged cord compression and are distinct from contusion models, which apply only transient force to inflict an acute injury to the spinal cord...
November 15, 2016: Reviews in the Neurosciences
https://www.readbyqxmd.com/read/27815845/the-craniocervical-junction-embryology-anatomy-biomechanics-and-imaging-in-blunt-trauma
#15
REVIEW
Curtis Edward Offiah, Emily Day
: Imaging of the blunt traumatic injuries to the craniocervical junction can be challenging but central to improving morbidity and mortality related to such injury. The radiologist has a significant part to play in the appropriate management of patients who have suffered injury to this vital junction between the cranium and the spine. Knowledge of the embryology and normal anatomy as well as normal variant appearances avoids inappropriate investigations in these trauma patients. Osseous injury can be subtle while representing important radiological red flags for significant underlying ligamentous injury...
November 4, 2016: Insights Into Imaging
https://www.readbyqxmd.com/read/27802777/prognostic-factor-analysis-after-surgical-decompression-and-stabilization-for-cervical-spinal-cord-injury
#16
Jin Hoon Park, Jeoung Hee Kim, Sung Woo Roh, Seung Chul Rhim, Sang Ryong Jeon
INTRODUCTION: Several studies have demonstrated the role of decompression surgery in preventing secondary injury and improving the neurological outcome after spinal cord injury (SCI). We retrospectively analyzed the prognostic factors affecting the outcomes of decompression surgery in patients with SCI. METHODS: We performed one-level decompression and fusion surgery on 73 patients with cervical SCI. We classified all patients based on their interval to decompression, sex, age, surgical level, presence of high signal intensity, American Spinal Injury Association Impairment scale (AIS) before surgery, blood pressure at admission, the amount of cord compression, surgical time, estimated blood loss during surgery, and steroid use...
November 2, 2016: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/27794548/local-resiniferatoxin-induces-long-lasting-analgesia-in-a-rat-model-of-full-thickness-thermal-injury
#17
Margaux M Salas, John L Clifford, Jessica R Hayden, Michael J Iadarola, Dayna L Averitt
OBJECTIVE:  Opioid-based analgesics are a major component of the lengthy pain management of burn patients, including military service members, but are problematic due to central nervous system-mediated side effects. Peripheral analgesia via targeted ablation of nociceptive nerve endings that express the transient receptor potential vanilloid channel 1 (TRPV1) may provide an improved approach. We hypothesized that local injection of the TRPV1 agonist resiniferatoxin (RTX) would produce long-lasting analgesia in a rat model of pain associated with burn injury...
October 29, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27781082/contemporary-views-on-inflammatory-pain-mechanisms-trping-over-innate-and-microglial-pathways
#18
REVIEW
Zhonghui Guan, Judith Hellman, Mark Schumacher
Tissue injury, whether by trauma, surgical intervention, metabolic dysfunction, ischemia, or infection, evokes a complex cellular response (inflammation) that is associated with painful hyperalgesic states. Although in the acute stages it is necessary for protective reflexes and wound healing, inflammation may persist well beyond the need for tissue repair or survival. Prolonged inflammation may well represent the greatest challenge mammalian organisms face, as it can lead to chronic painful conditions, organ dysfunction, morbidity, and death...
2016: F1000Research
https://www.readbyqxmd.com/read/27780743/the-prevalence-and-effect-of-problematic-spasticity-following-traumatic-spinal-cord-injury
#19
Kaila A Holtz, Rachel Lipson, Vanessa K Noonan, Brian K Kwon, Patricia B Mills
OBJECTIVE: To evaluate the prevalence and impact of spasticity following traumatic spinal cord injury (SCI). DESIGN: Prospective cohort study of the Rick Hansen Spinal Cord Injury Registry (RHSCIR) and retrospective review of inpatient medical charts. SETTING: Quaternary trauma centre, rehabilitation centre, and community settings in British Columbia, Canada. PARTICIPANTS: Individuals with a traumatic SCI between 2005 and 2014 prospectively enrolled in the Vancouver site RHSCIR were eligible for inclusion...
October 22, 2016: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/27767903/neurosurgical-sequelae-of-domestic-dog-attacks-in-children
#20
Ramesh Kumar, Frederic W B Deleyiannis, Corbett Wilkinson, Brent R O'Neill
OBJECTIVE The authors' goals in this study were to describe a series of dog attacks on children that required neurosurgical consultation and to better understand the pattern of injuries inflicted, the circumstances that place children at risk for attack, and the dog breeds involved. In addition, the authors review the surgical and medical management of these patients. METHODS The authors performed a retrospective review of all children requiring neurosurgical consultation for dog bite at a regional Level 1 pediatric trauma center over a 15-year period...
October 21, 2016: Journal of Neurosurgery. Pediatrics
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