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Spinal immobilization

Alan Cowley, Ashley Hague, Neal Durge
Techniques for extricating vehicle occupants after road-traffic collisions have evolved largely through fear of worsening a cervical spine injury, rather than being evidence-based. Recent research has looked at the safety of allowing the alert patient to self-extricate, rather than being assisted with equipment such as long spinal boards and semirigid cervical collars. This review aims to elucidate whether it is safe to allow an alert, ambulant patient to self-extricate from a vehicle with minimal or no cervical spine immobilization...
September 29, 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
Rifat Latifi, Jayleen K L Gunn, John A Stroster, Edmond Zaimi, Fatos Olldashi, Agron Dogjani, Mihal Kerci, Xheladin Draçini, Julian Kuçani, Zhaneta Shatri, Agim Kociraj, Arian Boci, Ross I Donaldson
BACKGROUND: Traumatic injuries have become a substantial but neglected epidemic in low- and middle-income countries (LMICs), but emergency rooms (ERs) in these countries are often staffed with healthcare providers who have minimal emergency training and experience. The aim of this paper was to describe the specialized training, available interventions, and the patient management strategies in the ERs in Albanian public hospitals. METHODS: A cross-sectional descriptive study of 42 ERs in the Republic of Albania between September 5, 2014, and December 29, 2014 was performed...
December 2016: International Journal of Emergency Medicine
Ali Babashahi, Morteza Taheri
Spinal kyphotic deformity after spinal laminectomy or laminoplasty is more common in pediatric patients than adults. Laminectomy can lead to decreased cartilage growth, anterior wedging and posterior spinal muscle insufficiency which can result in kyphotic deformity. Herein we outline a case report of a child presenting with kyphotic deformity after receiving a spinal laminectomy to treat a penetrating spinal trauma. The 8-year-old male presented with penetrating spinal trauma following a gunshot wound and subsequently underwent L1 laminectomy and thecal sac decompression to remove the foreign body...
March 2016: J Spine Surg
Prashanth J Rao, Kevin Phan, Ralph J Mobbs, David Wilson, Jonathon Ball
BACKGROUND: Immobilization of the cervical spine is a cornerstone of spinal injury management. In the context of suspected cervical spine injury, patients are immobilized in a 'neutral position' based on the head and trunk resting on a flat surface. It is hypothesized that the increased thoracic kyphosis and loss of cervical lordosis seen in elderly patients may require alternative cervical immobilization, compared with the 'neutral position'. METHODS: To investigate this, an audit of pan-scan CT performed on consecutive major trauma patients aged over 65 years was carried out over a 6-month period...
March 2016: J Spine Surg
Kassiani Harbi, Pavlos Makridis, Christos Koukoumis, Marina Papadionysiou, Theodoros Vgenis, Michael Kornaros, Ioanna Ntaikou, Sinos Giokas, Stefanos Dailianis
The present study evaluates a battery of marine species-based bioassays against chemically characterized municipal wastewater samples (raw and WWTP treated). We estimated Dunaliella tertiolecta growth rate inhibition (24-96h IC50 values), Artemia franciscana immobilization (24h LC50 values), mussel hemocytes viability and lipid peroxidation enhancement (in terms of neutral red retention assay/NRRT and malondialdehyde/MDA content, respectively) in influent- and WWTP effluent-treated species. We found algal growth arrest and stimulation respectively, almost similar 24hLC50 values in Artemia sp...
September 15, 2016: Journal of Hazardous Materials
Liping Wang, Tian-Zhi Guo, Tzuping Wei, Wen-Wu Li, Xiaoyou Shi, J David Clark, Wade S Kingery
BACKGROUND: Bisphosphonates are used to prevent the bone loss and fractures associated with osteoporosis, bone metastases, multiple myeloma, and osteogenesis deformans. Distal limb fractures cause regional bone loss with cutaneous inflammation and pain in the injured limb that can develop into complex regional pain syndrome (CRPS). Clinical trials have reported that antiresorptive bisphosphonates can prevent fracture-induced bone loss, inhibit serum inflammatory cytokine levels, and alleviate CRPS pain...
October 2016: Anesthesia and Analgesia
C Druschel, K Heck, C Kraft, R Placzek
OBJECTIVE: PemberSal osteotomy to improve femoral head coverage by rotating the acetabular roof ventrally and laterally. INDICATIONS: Insufficient coverage of the femoral head, and can be combined with other surgical procedures such as femoral intertrochanteric varus-derotation osteotomy and open reduction for developmental dysplasia and dislocation of the hip or to improve sphericity and containment in Legg-Calvé-Perthes disease. This specific acetabuloplasty can only be performed in patients with an open epiphyseal growth-plate...
September 14, 2016: Operative Orthopädie und Traumatologie
S Weckbach, B Lutz, J V Wölfle-Roos, H Reichel
Spinal infections are relatively rare entities but the incidence is significantly increasing due to the rapidly growing numbers of interventions on the spine. Primary infections of intervertebral discs (spondylodiscitis) and vertebral bodies (spondylitis) are distinguished from secondary postinterventional infections. Treatment relies primarily on either conservative or surgical management. In the absence of indications for surgery, a conservative approach is indicated when the patient is neurologically intact and the bony destruction is minimal...
October 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Hana Macková, Zdeněk Plichta, Vladimír Proks, Ilya Kotelnikov, Jan Kučka, Helena Hlídková, Daniel Horák, Šárka Kubinová, Klára Jiráková
Three-dimensional hydrogel supports for mesenchymal and neural stem cells (NSCs) are promising materials for tissue engineering applications such as spinal cord repair. This study involves the preparation and characterization of superporous scaffolds based on a copolymer of 2-hydroxyethyl and 2-aminoethyl methacrylate (HEMA and AEMA) crosslinked with ethylene dimethacrylate. Ammonium oxalate is chosen as a suitable porogen because it consists of needle-like crystals, allowing their parallel arrangement in the polymerization mold...
July 27, 2016: Macromolecular Bioscience
Kieran Wardman, Robin J D Prestwich, Mark J Gooding, Richard J Speight
Atlas-based autosegmentation is an established tool for segmenting structures for CT-planned head and neck radiotherapy. MRI is being increasingly integrated into the planning process. The aim of this study is to assess the feasibility of MRI-based, atlas-based autosegmentation for organs at risk (OAR) and lymph node levels, and to compare the segmentation accuracy with CT-based autosegmentation. Fourteen patients with locally advanced head and neck cancer in a prospective imaging study underwent a T1-weighted MRI and a PET-CT (with dedicated contrast-enhanced CT) in an immobilization mask...
2016: Journal of Applied Clinical Medical Physics
W Qin, W Zhao, X Li, Y Peng, L M Harlow, J Li, Y Qin, J Pan, Y Wu, L Ran, H Z Ke, C P Cardozo, W A Bauman
: Bone loss after spinal cord injury (SCI) is rapid, severe, and refractory to interventions studied to date. Mice with sclerostin gene deletion are resistant to the severe sublesional bone loss induced by SCI, further indicating pharmacological inhibition of sclerostin may represent a promising novel approach to this challenging medical problem. INTRODUCTION: The bone loss secondary to spinal cord injury (SCI) is associated with several unique pathological features, including the permanent immobilization, neurological dysfunction, and systemic hormonal alternations...
July 20, 2016: Osteoporosis International
Vahe M Zohrabian, Adam E Flanders
The goal of imaging in spine trauma is to gauge the extent of bony, vascular, and neurologic compromise. Neurologic and mechanical stability are key pieces of information that must be efficiently communicated to the referring clinician. From immobilization and steroid therapy, to vascular repair and emergent surgical intervention, clinical outcomes of spine-injured patients depend on timely and well-chosen imaging studies. Multidetector computed tomography (CT) has essentially replaced radiography in clearance of the spine and is the gold standard in evaluation of the bony spinal column...
2016: Handbook of Clinical Neurology
Şaban Akkuş, Şeref Kerem Çorbacıoğlu, Yunsur Çevik, Emine Akıncı, Hüseyin Uzunosmanoğlu
PURPOSE: The purpose of the study is to investigate whether spinal immobilization with a long backboard (LBB) and semirigid cervical collar (CC) at 20° instead of 0° conserve pulmonary functions, including forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio. METHODOLOGY: The study included 56 adult healthy volunteers. Volunteers were randomly divided into 2 groups, and those in the first group (group 1) had LBBs and CCs applied at 0° (n=30), whereas volunteers in the second group (group 2) had LBBs and CCs applied at 20° (n=26)...
July 1, 2016: American Journal of Emergency Medicine
Whitney Jones Rhodes, David Steinbruner, Lani Finck, Kathleen Flarity
OBJECTIVE: The purpose of this study was to qualitatively describe the underpinnings of the successful implementation of a collaborative prehospital spinal immobilization guideline throughout the emergency medical services (EMS) community in two counties in Colorado. We also describe lessons learned that may be beneficial to other communities considering similar initiatives. METHODS: Qualitative data were collected from key informants who were directly involved in the implementation of a new prehospital spinal immobilization guideline among four community hospitals in two different hospital systems and the associated EMS providers within the two counties...
July 13, 2016: Prehospital Emergency Care
Rahul Tyagi
Spinal infections are uncommon but significant causes of morbidity and hospitalization in the paediatric population. These infections encompass a broad range of conditions, from discitis to osteomyelitis and spinal epidural and intramedullary abscesses. Paediatric spinal infections can be caused by a range of bacterial, viral, fungal and parasitic agents. Ultrastructural differences of the vertebrae and associated structures result in distinct mechanisms of pathogenesis of spinal infections in children compared to adults...
December 2016: Journal of Orthopaedics
Hans-Joachim Wilke, Dominik Kaiser, David Volkheimer, Carsten Hackenbroch, Klaus Püschel, Michael Rauschmann
PURPOSE: For the stabilization of the thoracolumbar spine area, various stabilization techniques have been developed in recent decades. The aim of these techniques is to immobilize the treated segment to repositioning or correct the spine and guaranty long-term stability to achieve a reliable fusion. The aim of this study was to simulate in an in vitro experiment the postoperative long-term situation in elderly osteoporotic patients to compare two different stabilization principles; a pedicle screw system and a lamina hook system...
September 2016: European Spine Journal
Z Guo, M Yao, J Wang, K Sun, Z Ji
Objective: This work aims to investigate the efficacy of debridement for paediatric thoracolumbar spinal tuberculosis (TB) by using the anterior approach and the allogeneic bone graft. Methods: The lesions of 16 children diagnosed with thoracolumbar spinal TB were exposed via the anterior approach. The pleura and peritoneum, granulation tissue, pus and dead bones of the TB, and the intervertebral disc with pathological changes and necrosis were completely eliminated...
December 10, 2015: West Indian Medical Journal
Yi-Kan Cheng, Lei Zeng, Shu-Biao Ye, Jian Zheng, Lin Zhang, Peng Sun, Xiao-Bo Jiang, Wen-Zhao Sun, Tao Xu, Lei Chen
OBJECTIVE: To report a novel approach for craniospinal irradiation (CSI) using a supine isocentric technique. METHODS: Patients were treated in the supine position using CT simulation. Half-beam-blocked lateral cranial fields and superior spinal fields have the same isocentre, and their beam divergences match. Tangential irradiation provides a non-divergent junction for the other two full-beam spinal fields. Shielding for cranial fields was generated, and dose distribution was calculated using a three-dimensional planning system...
September 2016: British Journal of Radiology
H W Ham, L Schoonhoven, M J Schuurmans, L P H Leenen
Of all patients in a hospital environment, trauma patients may be particularly at risk for developing (device-related) pressure ulcers (PUs), because of their traumatic injuries, immobility, and exposure to immobilizing and medical devices. Studies on device-related PUs are scarce. With this study, the incidence and characteristics of PUs and the proportion of PUs that are related to devices in adult trauma patients with suspected spinal injury were described. From January-December 2013, 254 trauma patients were visited every 2 days for skin assessment...
2016: Nederlands Tijdschrift Voor Geneeskunde
Kunal R Bansal, Ajay S Chandanwale
INTRODUCTION: Spinal cord injury in children frequently occurs without fracture or dislocation. SCIWORA is a syndrome occurring when the spinal cord sustains neural damage during a traumatic event without positive radiographic findings. The incidence of SCIWORA was found to be 8% to 32% in various studies with very few cases documented in children below the age of 1 year. We report such a case of spinal cord injury without radiological abnormality in an 8 months old female child. CASE REPORT: An 8 months old female child was brought to the emergency room after a history of fall from the bed four days back...
January 2016: Journal of Orthopaedic Case Reports
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