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https://www.readbyqxmd.com/read/28216748/comparison-of-occipitocervical-and-atlantoaxial-fusion-in-treatment-of-unstable-jefferson-fractures
#1
Yong Hu, Zhen-Shan Yuan, Christopher K Kepler, Wei-Xin Dong, Xiao-Yang Sun, Jiao Zhang
BACKGROUND: Controversy exists regarding the management of unstable Jefferson fractures, with some surgeons performing reduction and immobilization of the patient in a halo vest and others performing open reduction and internal fixation. This study compares the clinical and radiological outcome parameters between posterior atlantoaxial fusion (AAF) and occipitocervical fusion (OCF) constructs in the treatment of the unstable atlas fracture. MATERIALS AND METHODS: 68 consecutive patients with unstable Jefferson fractures treated by AAF or OCF between October 2004 and March 2011 were included in this retrospective evaluation from institutional databases...
January 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28187803/management-of-acute-traumatic-spinal-cord-injuries
#2
C D Shank, B C Walters, M N Hadley
Acute traumatic spinal cord injury (SCI) is a devastating disease process affecting tens of thousands of people across the USA each year. Despite the increase in primary prevention measures, such as educational programs, motor vehicle speed limits, automobile running lights, and safety technology that includes automobile passive restraint systems and airbags, SCIs continue to carry substantial permanent morbidity and mortality. Medical measures implemented following the initial injury are designed to limit secondary insult to the spinal cord and to stabilize the spinal column in an attempt to decrease devastating sequelae...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28164055/proximal-tibial-epiphysis-injury-flexion-type-salter-harris-type-1
#3
Pratik Israni, Mangesh Panat
INTRODUCTION: Fractures of the proximal tibial epiphysis rare. It has been estimated that fractures of the upper tibial epiphysis account for 0.5-3.1% of all epiphyseal injuries. Who had no neurovascular deficit, with fixed extension deformity at the left knee was treated early with closed reduction techniques. CASE REPORT: We present a case of a 16-year-old boy who while playing cricket on the road was hit by a car. The patient presented in emergency room with extremely swollen knee and soft tissue swelling (hemarthrosis), he was unable to lift his leg actively due to severe pain because of hamstrings spasm, and he had no wound over his left knee and had no other associated injuries...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28120511/collagen-heparin-sulfate-scaffolds-fabricated-by-a-3d-bioprinter-improved-mechanical-properties-and-neurological-function-after-spinal-cord-injury-in-rats
#4
Chong Chen, Ming-Liang Zhao, Ren-Kun Zhang, Gang Lu, Chang-Yu Zhao, Feng Fu, Hong-Tao Sun, Sai Zhang, Yue Tu, Xiao-Hong Li
Effective treatments promoting axonal regeneration and functional recovery for spinal cord injury (SCI) are still in the early stages of development. Most approaches have been focused on providing supportive substrates for guiding neurons and overcoming the physical and chemical barriers to healing that arise after SCI. Although collagen has become a promising natural substrate with good compatibility, its low mechanical properties restrict its potential applications. The mechanical properties mainly rely on the composition and pore structure of scaffolds...
January 25, 2017: Journal of Biomedical Materials Research. Part A
https://www.readbyqxmd.com/read/28111622/cruciate-paralysis-in-a-20-year-old-male-with-an-undisplaced-type-iii-odontoid-fracture
#5
Mansukhani Sameer A, Tuteja Sanesh V, Dhar Sanjay B
INTRODUCTION: Cruciate Paralysis is a rare incomplete spinal cord syndrome presenting as brachial diplegia with minimal or no involvement of the lower extremities. It occurs as a result of trauma to the cervical spine and is associated with fractures of the axis and/or atlas. Diagnosis is confirmed on MRI and is managed by treatment of the underlying pathology. Prognosis depends on the extent of spinal cord injury and the exact cause. CASE PRESENTATION: A 20-year-old male presented to the casualty with a history of an injury to the back of the head as a result of a fall...
April 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28108406/berry-s-ligament-and-the-inferior-thyroid-artery-as-reliable-anatomical-landmarks-for-the-recurrent-laryngeal-nerve-rln-a-fresh-cadaveric-study-of-the-cervical-spine-the-rln-relevant-to-spine
#6
Ali Rajabian, Michael Walsh, Nasir A Quraishi
BACKGROUND CONTEXT: Although most cadaveric studies of the Recurrent Laryngeal Nerve (RLN) have focused on course variations, they have usually been done on preserved (fixed and embalmed) cadavers, which renders the RLN immobile and of less surgical landmark value. PURPOSE: Our aim was to perform a thorough exposure in fresh cadavers, with the intention of investigating the Inferior Thyroid Artery (ITA) and Berry's ligament as reliable landmarks for the identification of the RLN in anterior cervical spine surgery...
March 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28103119/iatrogenic-spinal-cord-injury-in-a-trauma-patient-with-ankylosing-spondylitis
#7
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/28078473/traumatic-atlantoaxial-rotatory-fixation-in-an-adult-patient
#8
María A García-Pallero, Cristina V Torres, Juan Delgado-Fernández, R G Sola
INTRODUCTION: Atlantoaxial rotational fixation (AARF) is a rare entity in adults, with only a few cases reported in the English literature and often associated with a traumatic mechanism. It is an underdiagnosed condition that must be taken into account in the initial assessment of all craniocervical trauma. Both diagnostic and therapeutic delay may be a potential cause of severe neurological damage or even death of the patient. The therapeutic management is controversial given the difficulty of achieving optimum stability and permanent reduction...
January 11, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28062308/bone-trauma-causes-massive-but-reversible-changes-in-spinal-circuitry
#9
Silke Hirsch, Alaa Ibrahim, Laura Krämer, Fabiola Escolano-Lozano, Tanja Schlereth, Frank Birklein
: Bone fracture with subsequent immobilization of the injured limb can cause complex regional pain syndrome (CRPS) in humans. Mechanisms of CRPS are still not completely understood but bone fracture with casting in mice leads to a similar post-traumatic inflammation as seen in humans and might therefore be an analog to human CRPS. In this article we report behavioral and spinal electrophysiological changes in mice that developed swelling of the paw, warming of the skin, and pain in the injured limb after bone fracture...
January 3, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28046323/su-f-t-642-sub-millimeter-accurate-setup-of-more-than-three-vertebrae-in-spinal-sbrt-with-6d-couch
#10
X Wang, Z Zhao, J Yang, J Yang, M McAleer, P Brown, J Li, A Ghia
PURPOSE: To assess the initial setup accuracy in treating more than 3 vertebral body levels in spinal SBRT using a 6D couch. METHODS: We retrospectively analyzed last 20 spinal SBRT patients (4 cervical, 9 thoracic, 7 lumbar/sacrum) treated in our clinic. These patients in customized immobilization device were treated in 1 or 3 fractions. Initial setup used ExacTrac and Brainlab 6D couch to align target within 1 mm and 1 degree, following by a cone beam CT (CBCT) for verification...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28005155/on-scene-treatment-of-spinal-injuries-in-motor-sports
#11
REVIEW
M Kreinest, M Scholz, P Trafford
Because spinal cord injuries can have fatal consequences for injured race car drivers, prehospital treatment of spinal injuries is a major concern in motor sports. A structured procedure for assessing trauma patients and their treatment should follow established ABCDE principles. Only then, a stable patient could be further examined and appropriate measures can be undertaken. For patients in an acute life-threatening condition, rapid transport must be initiated and should not be delayed by measures that are not indicated...
December 22, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/27926686/orthopaedic-trauma-care-capacity-assessment-and-strategic-planning-in-ghana-mapping-a-way-forward
#12
Barclay T Stewart, Adam Gyedu, Gavin Tansley, Dominic Yeboah, Forster Amponsah-Manu, Charles Mock, Wilfred Labi-Addo, Robert Quansah
BACKGROUND: Orthopaedic conditions incur more than 52 million disability-adjusted life years annually worldwide. This burden disproportionately affects low and middle-income countries, which are least equipped to provide orthopaedic care. We aimed to assess orthopaedic capacity in Ghana, describe spatial access to orthopaedic care, and identify hospitals that would most improve access to care if their capacity was improved. METHODS: Seventeen perioperative and orthopaedic trauma care-related items were selected from the World Health Organization's Guidelines for Essential Trauma Care...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27875927/what-is-being-trained-how-divergent-forms-of-plasticity-compete-to-shape-locomotor-recovery-after-spinal-cord-injury
#13
J Russell Huie, Kazuhito Morioka, Jenny Haefeli, Adam R Ferguson
Spinal cord injury (SCI) is a devastating syndrome that produces dysfunction in motor and sensory systems, manifesting as chronic paralysis, sensory changes, and pain disorders. The multi-faceted and heterogeneous nature of SCI has made effective rehabilitative strategies challenging. Work over the last 40 years has aimed to overcome these obstacles by harnessing the intrinsic plasticity of the spinal cord to improve functional locomotor recovery. Intensive training after SCI facilitates lower extremity function and has shown promise as a tool for retraining the spinal cord by engaging innate locomotor circuitry in the lumbar cord...
January 13, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27856380/t9-versus-t10-as-the-upper-instrumented-vertebra-for-correction-of-adult-deformity-rationale-and-recommendations
#14
Hwee Weng Dennis Hey, Kimberly-Anne Tan, Christabel Shao-En Neo, Eugene Tze-Chun Lau, Denise Ai-Wen Choong, Leok-Lim Lau, Gabriel Ka-Po Liu, Hee-Kit Wong
BACKGROUND CONTEXT: Adult spinal deformity correction sometimes involves long posterior pedicle screw constructs extending from the lumbosacral spine to the thoracic vertebra. As fusion obliterates motion and places supraphysiological stress on adjacent spinal segments, it is crucial to ascertain the ideal upper instrumented vertebra (UIV) to minimize risk of proximal junctional failure (PJF). The T10 vertebra is often chosen to allow bridging of the thoracolumbar junction into the immobile thoracic vertebrae on the basis that it is the lowest immobile thoracic vertebra strut by the rib cage...
November 14, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27789329/porous-silicon-nanoparticle-as-a-stabilizing-support-for-chondroitinase
#15
Sara Daneshjou, Bahareh Dabirmanesh, Fereshteh Rahimi, Khosro Khajeh
Chondroitinase ABCI (cABCI) from Proteus vulgaris is a drug enzyme that can be used to treat spinal cord injuries. One of the main problems of chondroitinase ABC1 is its low thermal stability. The objective of the current study was to stabilize the enzyme through entrapment within porous silicon (pSi) nanoparticles. pSi was prepared by an electrochemical etch of p-type silicon using hydrofluoric acid/ethanol. The size of nanoparticles were determined 180nm by dynamic light scattering and the mean pore diameter was in the range of 40-60nm obtained by scanning electron microscopy...
January 2017: International Journal of Biological Macromolecules
https://www.readbyqxmd.com/read/27783647/bumetanide-an-inhibitor-of-nkcc1-na-k-2cl-cotransporter-isoform-1-enhances-propofol-induced-loss-of-righting-reflex-but-not-its-immobilizing-actions-in-neonatal-rats
#16
Yukihide Koyama, Tomio Andoh, Yoshinori Kamiya, Tomoyuki Miyazaki, Koichi Maruyama, Takayuki Kariya, Takahisa Goto
Gamma-aminobutyric acid (GABA) has been shown to induce excitation on immature neurons due to increased expression of Na+-K+-2Cl- co-transporter isoform 1 (NKCC1), and the transition of GABAergic signaling from excitatory to inhibitory occurs before birth in the rat spinal cord and spreads rostrally according to the developmental changes in cation-chloride co-transporter expression. We previously showed that midazolam activates the hippocampal CA3 area and induces less sedation in neonatal rats compared with adolescent rats in an NKCC1-dependent manner...
2016: PloS One
https://www.readbyqxmd.com/read/27748690/cervical-spine-immobilization-during-extrication-of-the-awake-patient-a-narrative-review
#17
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
https://www.readbyqxmd.com/read/27718129/the-readiness-of-emergency-and-trauma-care-in-low-and-middle-income-countries-a-cross-sectional-descriptive-study-of-42-public-hospitals-in-albania
#18
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
https://www.readbyqxmd.com/read/27683698/kyphotic-deformity-after-laminectomy-surgery-for-a-gunshot-wound-to-the-spine-a-case-report
#19
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: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/27683694/cervical-spine-immobilization-in-the-elderly-population
#20
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: Journal of Spine Surgery (Hong Kong)
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