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Spinal immobilization

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https://www.readbyqxmd.com/read/29312839/safety-and-efficacy-of-the-use-of-intrathecal-morphine-for-spinal-three-column-osteotomy
#1
Jason R Audlin, Swamy Kurra, William Lavelle, Richard A Tallarico, Mike H Sun, Nathaniel R Ordway, Elizabeth A Demers Lavelle
Introduction The use of intrathecal morphine has the potential to help alleviate the pain that patients experience undergoing spinal surgeries. Complications can cause immobilization, which can lead to vascular thrombosis and ileus. Studies have shown epidural analgesia significantly lowered postoperative pain scores in scoliosis surgeries. Intrathecal anesthesia has been shown to have good pain control over the initial 24-hour postoperative period. Purpose Determine if intrathecal morphine would reduce postoperative pain with minimal side effects...
November 3, 2017: Curēus
https://www.readbyqxmd.com/read/29310322/effect-of-training-in-advanced-trauma-life-support-on-the-kinematics-of-the-spine-a-simulation-study
#2
Raquel Gordillo Martin, Pedro E Alcaráz, Laura Juguera Rodriguez, Antonio Nieto Fernandez-Pacheco, Elena Marín-Cascales, Tomás T Freitas, Manuel Pardo Rios
More than 7.5 million people in the world are affected by spinal cord injury (SCI). In this study, we aimed to analyze the effect of training in advanced trauma life support (ATLS) on the kinematics of the spine when performing different mobilization and immobilization techniques on patients with suspected SCI. A quasi-experimental study, clinical simulation, was carried out to determine the effect of training in ATLS on 32 students enrolled in the Master's program of Emergency and Special Care Nursing. The evaluation was performed through 2 maneuvers: placing of the scoop stretcher (SS) and spinal board (SB), with an actor who simulated a clinical situation of suspected spinal injury...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29283970/prehospital-spine-immobilization-spinal-motion-restriction-in-penetrating-trauma-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma-east
#3
Catherine G Velopulos, Hasan M Shihab, Lawrence Lottenberg, Marcie Feinman, Ali Raja, Jeffrey Salomone, Elliott R Haut
BACKGROUND: Spine immobilization in trauma has remained an integral part of most emergency medical services (EMS) protocols despite a lack of evidence for efficacy and concern for associated complications, especially in penetrating trauma patients. We reviewed the published evidence on the topic of prehospital spine immobilization or spinal motion restriction in adult patients with penetrating trauma to structure a Practice Management Guideline. METHODS: We conducted a Cochrane style systematic review and meta-analysis, and applied GRADE methodology to construct recommendations...
December 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29244696/selective-spinal-fusion-for-neuromuscular-scoliosis-in-a-patient-with-pompe-disease-a-case-report-and-review-of-the-literature
#4
Atsushi Tanida, Shinji Tanishima, Tokumitsu Mihara, Aya Narita, Yoshihiro Maegaki, Hideki Nagashima
CASE: A 16-year-old girl with Pompe disease underwent surgery for scoliosis. She had been able to walk without any assistance, and kept her balance by swinging her waist. Therefore, we performed posterior selective spinal correction and fusion to avoid any adverse effects on walking ability that could occur with immobilization of the lumbosacral spine. After surgery, she was highly satisfied with her ability to perform the activities of daily living. CONCLUSION: For nonambulatory patients with scoliosis and Pompe disease, long fusion from the upper thoracic spine to the pelvis is generally required...
January 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29231595/-effects-of-electroacupuncture-on-activation-of-microglia-cells-in-spinal-cord-in-rats-with-neuropathic-pain
#5
Sisi Li, Pengpeng Gu, Wenzhan Tu, Xia Jiang, Wenci Chen, Qimiao Hu, Songhe Jiang
OBJECTIVE: To observe the effects of electroacupuncture (EA) on the activation of microglia cells in the L4 to L6 spinal cord in rats with neuropathic pain, so as to investigate whether EA could inhibit the activation of spinal microglial cells and regulate the expression of brain-derived neurotrophic factor (BDNF) to achieve the analgesic effect. METHODS: Forty male Sprague Dawley rats were randomly divided into a normal group, a sham-model group, a model group and an EA group, 10 rats in each one...
April 12, 2017: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
https://www.readbyqxmd.com/read/29203049/the-use-of-clinical-cervical-spine-clearance-in-trauma-patients-a-literature-review
#6
Sandra Larson, Andrew U Delnat, Jill Moore
INTRODUCTION: Five million patients in America are placed in spinal immobilization annually, with only 1% to 2% of these patients suffering from an unstable cervical spine injury. Prehospital agencies are employing selective and limited immobilization practices, but there is concern that this practice misses cervical spine injuries and therefore possibly predisposes patients to worsening injuries. METHODS: A systematic review was conducted that examined literature from the last 5 years that reviewed cervical spine immobilization application and/or clearance in alert trauma patients...
December 1, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/29200479/management-of-sub-axial-cervical-spine-injuries
#7
Gautam Zaveri, Gurdip Das
Sub-axial cervical spine injuries are commonly seen in patients with blunt trauma. They may be associated with spinal cord injury resulting in tetraplegia and severe permanent disability. Immobilization of the neck, maintenance of blood pressure and oxygenation, rapid clinical and radiological assessment of all injuries, and realignment of the spinal column are the key steps in the emergency management of these injuries. The role of intravenous methylprednisolone administration in acute spinal cord injuries remains controversial...
November 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/29171651/pulmonary-embolism-occurring-in-a-patient-treated-with-spinal-cord-stimulation
#8
Tülin Arıcı, Mustafa Kurçaloğlu, Meltem Uyar, Can Eyigör
Spinal cord stimulation (SCS) has been shown to be an effective method for treating many chronic pain syndromes. In addition, providing pain relief with SCS can reduce immobilization and complications related to immobilization. The present case describes pulmonary embolism (PE) that occurred in patient being treated with SCS for post-laminectomy syndrome. The possibility of PE must be kept in mind while treating patients with SCS.
October 2017: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
https://www.readbyqxmd.com/read/29163064/turtle-flexion-reflex-motor-patterns-show-windup-mediated-partly-by-l-type-calcium-channels
#9
Keith P Johnson, Stephen M Tran, Emily A Siegrist, Krishna B Paidimarri, Matthew S Elson, Ari Berkowitz
Windup is a form of multisecond temporal summation in which identical stimuli, delivered seconds apart, trigger increasingly strong neuronal responses. L-type Ca(2+) channels have been shown to play an important role in the production of windup of spinal cord neuronal responses, initially in studies of turtle spinal cord and later in studies of mammalian spinal cord. L-type Ca(2+) channels have also been shown to contribute to windup of limb withdrawal reflex (flexion reflex) in rats, but flexion reflex windup has not previously been described in turtles and its cellular mechanisms have not been studied...
2017: Frontiers in Neural Circuits
https://www.readbyqxmd.com/read/29145180/misoplegia
#10
Montserrat G Delgado, Julien Bogousslavsky
In 1974, Critchley described misoplegia as the phenomenon in which a hemiplegic patient develops a morbid dislike towards the offending immobile limbs. Patients with misoplegia may employ, but more commonly strike their paretic limbs not recognized as self. The pathophysiological mechanism is not well understood. The handful of cases of misoplegia described in the literature, frequently presented a right hemispheric damage. However, patients with chronic spinal cord injury may also present this symptomatology...
2018: Frontiers of Neurology and Neuroscience
https://www.readbyqxmd.com/read/29096367/electrochemical-immunosensors-for-the-detection-of-survival-motor-neuron-smn-protein-using-different-carbon-nanomaterials-modified-electrodes
#11
Shimaa Eissa, Nawal Alshehri, Anas M Abdel Rahman, Majed Dasouki, Khalid M Abu Salah, Mohammed Zourob
Spinal muscular atrophy is an untreatable potentially fatal hereditary disorder caused by loss-of-function mutations in the survival motor neuron (SMN) 1 gene which encodes the SMN protein. Currently, definitive diagnosis relies on the demonstration of biallelic pathogenic variants in SMN1 gene. Therefore, there is an urgent unmet need to accurately quantify SMN protein levels for screening and therapeutic monitoring of symptomatic newborn and SMA patients, respectively. Here, we developed a voltammetric immunosensor for the sensitive detection of SMN protein based on covalently functionalized carbon nanofiber-modified screen printed electrodes...
October 10, 2017: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/29088951/update-on-critical-care-for-acute-spinal-cord-injury-in-the-setting-of-polytrauma
#12
John K Yue, Ethan A Winkler, Jonathan W Rick, Hansen Deng, Carlene P Partow, Pavan S Upadhyayula, Harjus S Birk, Andrew K Chan, Sanjay S Dhall
Traumatic spinal cord injury (SCI) often occurs in patients with concurrent traumatic injuries in other body systems. These patients with polytrauma pose unique challenges to clinicians. The current review evaluates existing guidelines and updates the evidence for prehospital transport, immobilization, initial resuscitation, critical care, hemodynamic stability, diagnostic imaging, surgical techniques, and timing appropriate for the patient with SCI who has multisystem trauma. Initial management should be systematic, with focus on spinal immobilization, timely transport, and optimizing perfusion to the spinal cord...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29040241/barriers-to-implementation-of-recommendations-for-transport-of-children-in-ground-ambulances
#13
Rashida H Woods, Manish Shah, Cara Doughty, Anthony Gilchrest
OBJECTIVES: The National Highway Traffic Safety Administration (NHTSA) released draft recommendations in 2010 on the safe transport of children in ground ambulances. The purpose of this study was to assess awareness of these guidelines among emergency medical service (EMS) agencies and to identify implementation barriers. METHODS: We conducted a cross-sectional, anonymous online survey of 911-responding, ground transport EMS agencies in Texas. Demographics, modes of transport based on case scenarios, and barriers to implementation were assessed...
October 16, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29033382/clinical-pathological-correlations-in-three-patients-with-fibrodysplasia-ossificans-progressiva
#14
Kelly L Wentworth, Katherine Bigay, Tea V Chan, Jennifer P Ho, Blanca M Morales, Joseph Connor, Erin Brooks, M Shahriar Salamat, Henry Charles Sanchez, Geoffrey Wool, Robert J Pignolo, Frederick S Kaplan, Edward C Hsiao
OBJECTIVE: Fibrodysplasia ossificans progressiva (FOP) is an ultra-rare genetic disorder in which heterotopic bone forms in the soft tissues. This often occurs in response to injury or inflammation, leading to joint immobilization and significant disability. There are currently no definitive treatment options for this devastating disease. Although the most dramatic phenotype in FOP is the episodic and progressive heterotopic ossification, patients report a number of symptoms that affect other organ systems...
October 13, 2017: Bone
https://www.readbyqxmd.com/read/28987766/nervous-system-excitability-and-joint-stiffness-following-short-term-dynamic-ankle-immobilization
#15
Alyssa M Stirling, Jeffrey M McBride, Edward K Merritt, Alan R Needle
Joint immobilization has been demonstrated to modify neural excitability in subsets of healthy populations, leading to disinhibition of cortical and reflexive pathways. However, these findings may have limited clinical application as most models have investigated casting and rigid immobilization, while many musculoskeletal injuries often utilize dynamic immobilization devices such as boot immobilizers and pneumatic splints that allow for modified ambulation. We therefore aimed to determine the short-term effects of ambulation in ankle immobilization devices on nervous system excitability and stiffness in able-bodied individuals...
September 23, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28985715/acute-transient-spinal-paralysis-and-cardiac-symptoms-following-an-accidental-epidural-potassium-infusion-a-case-report
#16
Martin Kreutzträger, Marcel A Kopp, Thomas Liebscher
BACKGROUND: To describe a case of an accidental epidural potassium infusion leading to an acute transient spinal paralysis and cardiac symptoms and review the literature on that topic. CASE PRESENTATION: We report the case of an accidental infusion of 900 mg potassium chloride 7.45% (KCl) into the epidural space, which occurred during epidural analgesia in a 74-year-old patient suffering from immobilization due to lumbar back pain as well as from a paralytic Ileus...
October 6, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28976894/spontaneous-spondylodiscitis-epidemiology-clinical-features-diagnosis-and-treatment
#17
REVIEW
Aneta S Petkova, Christo B Zhelyazkov, Borislav D Kitov
Spontaneous spondylodiscitis is a rare but serious infectious disease which is a combination of an inflammatory process, involving one or more adjacent vertebral bodies (spondylitis), the intervertebral discs (discitis) and finally - the neighboring neural structures. In most cases the condition is due to a hematogenous infection and can affect all regions of the spinal cord, but it is usually localized in the lumbar area. The most common clinical symptom is a pronounced, constant and increasing nocturnal paravertebral pain, while consequently different degrees of residual neurological symptoms from nerve roots and/or spinal cord may appear...
September 1, 2017: Folia Medica
https://www.readbyqxmd.com/read/28963125/daily-parathyroid-hormone-administration-enhances-bone-turnover-and-preserves-bone-structure-after-severe-immobilization-induced-bone-loss
#18
Lauren Harlow, Karim Sahbani, Jeffry S Nyman, Christopher P Cardozo, William A Bauman, Hesham A Tawfeek
Immobilization, as a result of motor-complete spinal cord injury (SCI), is associated with severe osteoporosis. Whether parathyroid hormone (PTH) administration would reduce bone loss after SCI remains unclear. Thus, female mice underwent sham or surgery to produce complete spinal cord transection. PTH (80 μg/kg) or vehicle was injected subcutaneously (SC) daily starting on the day of surgery and continued for 35 days. Isolated tibias and femurs were examined by microcomputed tomography scanning (micro-CT) and histology and serum markers of bone turnover were measured...
September 2017: Physiological Reports
https://www.readbyqxmd.com/read/28960819/circumferential-reconstruction-of-subaxial-cervical-and-cervicothoracic-spine-by-simultaneously-combined-anterior-posterior-approaches-in-the-sitting-position
#19
Yue Han, Xin-Long Ma, Yong-Cheng Hu, Jun Miao, Ji-Dong Zhang, Jian-Qiang Bai, Qun Xia
OBJECTIVE: To introduce and analyze the feasibility of a new surgical strategy for circumferential reconstruction of subaxial cervical and cervicothoracic spine by simultaneously combined anterior-posterior approach in the sitting position. METHODS: A retrospective review was performed for seven patients who underwent the above surgical procedure between July 2011 and January 2015. Among the seven patients, there were six men and one woman, with an average age of 52 years (range, 36-79 years)...
August 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28958356/trauma-spinal-cord-injury
#20
REVIEW
Matthew J Eckert, Matthew J Martin
Injuries to the spinal column and spinal cord frequently occur after high-energy mechanisms of injury, or with lower-energy mechanisms, in select patient populations like the elderly. A focused yet complete neurologic examination during the initial evaluation will guide subsequent diagnostic procedures and early supportive measures to help prevent further injury. For patients with injury to bone and/or ligaments, the initial focus should be spinal immobilization and prevention of inducing injury to the spinal cord...
October 2017: Surgical Clinics of North America
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