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Injuries of the thoracolumbar spine

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https://www.readbyqxmd.com/read/29781783/clinical-and-radiological-outcome-of-non-surgical-management-of-thoracic-and-lumbar-spinal-fracture-dislocations-a-historical-analysis-in-the-era-of-modern-spinal-surgery
#1
Andrei Fernandes Joaquim, Gregory D Schroeder, Alpesh A Patel, Alexander R Vaccaro
CONTEXT: It is well established that traumatic spinal dislocations (AO Type C injuries) should be surgically treated. However, no recent comparative study of surgical versus non-surgical management of type C injuries was found attesting the superiority of surgical treatment. OBJECTIVE: Due to the lack of information about the natural history of non-surgical management of type C injuries, we evaluated the outcome of historical conservative treatment of type C injuries...
May 21, 2018: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29772857/-posterior-spinal-canal-decompression-with-screw-fixation-and-reconstruction-of-three-vertebral-column-for-thoracolumbar-burst-fractures-complicated-with-nerve-injury
#2
Li-Yong Wu, Xue-Mei Huang, Yue Wang, Zhao-Bo Yang, Sheng-Hui Su, Chun Wang
OBJECTIVE: To explore the feasibility and clinical effect of posterior spinal canal decompression with pedicle screw fixation and reconstruction of anterior and middle vertebral column for thoracolumbar burst fractures complicated with nerve injury. METHODS: A total of 36 patients with thoracolumbar burst fractures treated from March 2011 to April 2016 were enrolled in the retrospective study. There were 20 males and 16 females, aged from 21 to 52 years old with an average of 37...
April 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29769491/management-of-traumatic-unstable-thoracolumbar-spine-conservative-versus-operative-treatment
#3
M M Rahman, N A Islam, M S Islam, M M Rahman, M A Islam, M K Alamgir, M H Sarker
Traumatic thoracolumbar spine injury result in significant instability of the spine and leads to an acute on delayed neurological deficit. Objective of the study is to find a better option in the management of unstable traumatic thoracolumbar spine with incomplete neurological lesion. This was quasi-experimental study. The study was carried out at National Institute of Traumatology & Orthopedic Rehabilitation (NITOR), Dhaka, Bangladesh from January 2006 to December 2008. A total number of 40 patients with traumatic thoracolumbar spine injuries with incomplete neurological lesion were selected purposively...
April 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29721244/epidemiology-of-vertebral-fractures-in-pediatric-and-adolescent-patients
#4
Dominik Saul, Klaus Dresing
Spinal injuries in children and adolescents are rare injuries, but consequences for the growing skeleton can be devastating. Knowledge of accident causes, clinical symptoms and diagnostics should be part of every trauma department treating these patients. We retrospectively analyzed patients with radiographically proven vertebral fractures of the spine. After clinical examination and tentative diagnosis the fractures and injuries were proven with conventional X-ray, computed tomography (CT) scans or magnetic resonance imaging (MRI)...
March 22, 2018: Pediatric Reports
https://www.readbyqxmd.com/read/29712534/a-scoping-review-on-health-economics-in-neurosurgery-for-acute-spine-trauma
#5
Brian C F Chan, B Catharine Craven, Julio C Furlan
OBJECTIVE Acute spine trauma (AST) has a relatively low incidence, but it often results in substantial individual impairments and societal economic burden resulting from the associated disability. Given the key role of neurosurgeons in the decision-making regarding operative management of individuals with AST, the authors performed a systematic search with scoping synthesis of relevant literature to review current knowledge regarding the economic burden of AST. METHODS This systematic review with scoping synthesis included original articles reporting cost-effectiveness, cost-utility, cost-benefit, cost-minimization, cost-comparison, and economic analyses related to surgical management of AST, whereby AST is defined as trauma to the spine that may result in spinal cord injury with motor, sensory, and/or autonomic impairment...
May 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29709750/reliability-and-agreement-of-different-spine-fracture-classification-systems-an-independent-intra-and-inter-observer-study
#6
Miguel Pishnamaz, Stephan Balosu, Inez Curfs, Daniel Uhing, Markus Laubach, Christian Herren, Christian Weber, Frank Hildebrand, Paul Willems, Philipp Kobbe
OBJECTIVE: Currently, no spinal classification system has achieved universal acceptance. Therefore, it is important to choose a reliable classification within clinical practice. The objective of this study was to determine and compare the intra- and inter-observer agreement of the Load Sharing Classification (LSC), the Thoracolumbar Injury Classification System (TLICS) and the AOSpine Thoracolumbar Spine Injury Classification System. METHODS: In this web-based intra- and inter-observer study (www...
April 27, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29702425/impact-of-frailty-on-complications-in-patients-with-thoracic-and-thoracolumbar-spinal-fracture
#7
Remi A Kessler, Rafael De la Garza Ramos, Taylor E Purvis, A Karim Ahmed, C Rory Goodwin, Daniel M Sciubba, Muhammad M Abd-El-Barr
OBJECTIVES: It is well-documented that geriatric patients are at risk for serious injuries after fracture due to pre-existing medical conditions, physical changes of aging, and medication effects. Frailty has been demonstrated to be a predictor of morbidity and mortality in inpatient head and neck surgery, and for surgical intervention for adult spinal deformity and degenerative spine disease. However, the impact of frailty on complications following thoracolumbar/thoracic fractures are unknown and has not been previously assessed in the literature, particularly in a nationwide setting...
April 9, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29607271/anatomical-study-of-the-extreme-lateral-transpsoas-lumbar-interbody-fusion-with-application-to-minimizing-injury-to-the-kidney
#8
Joe Iwanaga, Emre Yilmaz, Tamir Tawfik, Amir Abdul-Jabbar, Marc Vetter, Marc Moisi, Koichi Watanabe, Koh-Ichi Yamaki, R Shane Tubbs, Rod J Oskouian
Objective Since the extreme lateral lumbar interbody fusion procedure was first reported by Ozgur in 2006, a large number of clinical studies have been published. Anatomical studies which explore methods to avoid visceral structures, such as the kidney, with this approach have not been examined in detail. We dissected the retroperitoneal space to analyze how the extreme lateral transpsoas approach to the lumbar spine could damage the kidney and related structures. Methods Eight sides from four fresh Caucasian cadavers were used for this study...
January 29, 2018: Curēus
https://www.readbyqxmd.com/read/29550597/buckling-collapse-of-mid-cervical-spine-secondary-to-neurofibromatosis
#9
Kunal C Shah, Akshay Gadia, Premik Nagad, Shekhar Bhojraj, Abhay Nene
Buckling collapse is the term typically used to describe severe kyphosis more than 100 degrees, characteristically seen in thoracolumbar tuberculosis. Neurofibromatosis is rarely associated with severe cervical kyphosis. Dystrophic changes in vertebra make surgical correction and fusion challenging. Single stage cervical osteotomies (pedicle subtraction osteotomy, vertebral column resection etc) are commonly done in cervico-thoracic junction. However it is technically challenging and associated with high risk of vertebral artery injury, neural injury etc when performed in higher cervical spine...
March 14, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29550593/spine-trauma-as-a-component-of-essential-neurosurgery-an-outcomes-analysis-from-cambodia
#10
Michelle H Chua, Raksmey Hong, Tytim Rydeth, Iv Vycheth, Sam Nang, Din Vuthy, Kee B Park
INTRODUCTION: In recent years, delivery of cost-effective "essential neurosurgery" in resource-limited communities has been recognized as an indispensable part of health care and a global health priority. The purpose of this study was to review outcomes from operative management of spine trauma at a resource limited government hospital in Phnom Penh, Cambodia, and to provide an epidemiologic report to guide prevention programs. METHODS: A retrospective review of a prospective neurosurgical database was performed to identify risk factors for spine trauma and severe spinal cord injury (ASIA A or ASIA B) and to evaluate the cost-effectiveness of surgery for patients treated at Preah Kossamak Hospital for subaxial and thoracolumbar spine trauma from 2013 to 2016...
March 14, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29535875/posttraumatic-spinal-cord-injury-without-radiographic-abnormality
#11
REVIEW
Kivanc Atesok, Nobuhiro Tanaka, Andrew O'Brien, Yohan Robinson, Dachling Pang, Donald Deinlein, Sakthivel Rajaram Manoharan, Jason Pittman, Steven Theiss
"Spinal Cord Injury without Radiographic Abnormality" (SCIWORA) is a term that denotes objective clinical signs of posttraumatic spinal cord injury without evidence of fracture or malalignment on plain radiographs and computed tomography (CT) of the spine. SCIWORA is most commonly seen in children with a predilection for the cervical spinal cord due to the increased mobility of the cervical spine, the inherent ligamentous laxity, and the large head-to-body ratio during childhood. However, SCIWORA can also be seen in adults and, in rare cases, the thoracolumbar spinal cord can be affected too...
2018: Advances in Orthopedics
https://www.readbyqxmd.com/read/29504580/muscular-changes-after-minimally-invasive-versus-open-spinal-stabilization-of-thoracolumbar-fractures-a-literature-review
#12
Miguel Pishnamaz, Ulrike Schemmann, Christian Herren, Klemens Horst, Philipp Lichte, Frank Hildebrand, Hans-Christoph Pape, Philipp Kobbe
PURPOSE: This review addressed the question of whether minimally invasive surgery after traumatic thoracolumbar spine fractures can reduce paraspinal muscle injury, limit changes in muscular structure and function, and lead to better functional outcome. Special emphasis was given to studies using imaging techniques or electromyography to evaluate the lumbar multifidus muscle structure and function. METHODS: The authors searched the literature in the PubMed/Medline, EMBASE, by cross-referencing and additional hand search...
March 1, 2018: Journal of Musculoskeletal & Neuronal Interactions
https://www.readbyqxmd.com/read/29489661/complete-fracture-dislocation-of-the-thoracolumbar-spine-without-neurological-deficit-a-case-report-and-review-of-the-literature
#13
REVIEW
Junfeng Zeng, Quan Gong, Hao Liu, Xin Rong, Chen Ding
RATIONALE: Traumatic fracture of the thoracolumbar junction (T10-L2) is the most common fracture of the spinal column. Due to the disruption of the entire vertebrae column, the fracture-dislocation of the thoracolumbar spine is almost invariably associated with neurological injury. A complete fracture-dislocation of the thoracolumbar spine without neurological deficit is a rare entity. PATIENT CONCERNS: A 38-year-old man presented with severe low back pain after an accident when he was building a house...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29462034/acute-thoracolumbar-spinal-cord-injury-relationship-of-cord-compression-to-neurological-outcome
#14
Peta Skeers, Camila R Battistuzzo, Jillian M Clark, Stephen Bernard, Brian J C Freeman, Peter E Batchelor
BACKGROUND: Spinal cord injury in the cervical spine is commonly accompanied by cord compression and urgent surgical decompression may improve neurological recovery. However, the extent of spinal cord compression and its relationship to neurological recovery following traumatic thoracolumbar spinal cord injury is unclear. The purpose of this study was to quantify maximum cord compression following thoracolumbar spinal cord injury and to assess the relationship among cord compression, cord swelling, and eventual clinical outcome...
February 21, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29447489/compulsory-use-of-the-backboard-is-associated-with-increased-frequency-of-thoracolumbar-imaging
#15
Brian M Clemency, Christopher T Tanski, Jennifer Gibson Chambers, Michael O'Brien, Andrew S Knapp, Alexander J Clark, Patrick McGoff, Johanna Innes, Heather A Lindstrom, David Hostler
BACKGROUND: Backboards have been shown to cause pain in uninjured patients. This may alter physical exam findings, leading emergency department (ED) providers to suspect a spinal injury when none exists resulting in additional imaging of the thoracolumbar spine. New York had previously employed a "Spinal Immobilization" protocol that included compulsory backboard application for all patients with suspected spinal injuries. In 2015, New York instituted a new "Spinal Motion Restriction" protocol that made backboard use optional for these patients...
February 15, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29428017/long-term-functional-outcomes-after-traumatic-thoracic-and-lumbar-spine-fractures
#16
Ashley P Marek, Jean Dominique Morancy, Jeffrey G Chipman, Rachel M Nygaard, Robert M Roach, Michele M Loor
The incidence of thoracolumbar spine fractures in blunt trauma is 4 to 5 per cent. These fractures may lead to neurologic injury, chronic back pain, and disability. Most studies from United States trauma centers focus on neurologic sequelae and/or compare treatment modalities. However, most patients with spine fractures do not have a neurologic deficit. Our primary objective was to determine the long-term outcome of traumatic thoracolumbar spine fractures, specifically addressing quality of life, chronic pain, and employment using a validated patient outcome survey...
January 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29422365/in-hospital-medical-complications-after-non-operative-and-operative-treatment-of-thoracolumbar-fractures-in-patients-over-75-years-of-age
#17
Taylor E Purvis, Rafael De la Garza Ramos, Eric W Sankey, Isaac O Karikari, C Rory Goodwin, Daniel M Sciubba
Management of spine fractures among the elderly is complicated by preexisting comorbidities and increased risk of osseous nonunion. Whether operative treatment is superior for the management of thoracolumbar fractures in the aged is unknown. The purpose of this study was to investigate the rates of in-hospital medical complications after non-operative and operative treatment of thoracolumbar fractures in elderly patients. The Nationwide Inpatient Sample database from 2002 to 2011 was used to identify patients over 75 years of age with a principal discharge diagnosis of thoracolumbar fracture without spinal cord injury...
April 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29419718/delayed-fatal-lumbar-artery-bleeding-following-less-invasive-posterolateral-decompression-and-fusion
#18
Dimitrios Ntourantonis, Vasileios Tsekouras, Panagiotis Korovessis
STUDY DESIGN: A case report. OBJECTIVE: To outline the potential risks of late bleeding from the segmental vessels following less invasively dorsolateral approaches to the thoracolumbar spine. SUMMARY OF BACKGROUND DATA: A low risk of major intraoperative bleeding, associated traditional dorsolateral approach to the lumbar spine is reported , but segmental arteries and great vessels may be rarely damaged. Spine surgeons who are involved with these approaches should be aware of these rare but potential dangerous vascular complication because they could be life threatening, particularly in elderly patients with increased morbidity, and/or metastatic disease to the spine...
February 6, 2018: Spine
https://www.readbyqxmd.com/read/29412065/a-simplified-treatment-algorithm-for-treating-thoracic-and-lumbar-spine-trauma
#19
Andrei F Joaquim, Alpesh A Patel, Gregory D Schroeder, Alexander R Vaccaro
Context Current treatment of TLST should consider injury morphology, neurological status, clinical status (pain and disability) and also multimodal radiological evaluation (MMRE) with CT, MRI and dynamic/ standing plain radiographs. Methods A narrative literature review was performed to propose a treatment algorithm to guide the management of thoracolumbar spinal trauma (TLST). In order to classify injuries and surgical indications, we utilized the two most recent classification systems (TLICS and new AO spine classification) and related recent literature...
February 7, 2018: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29404636/-frequency-and-age-distribution-of-combined-sternovertebral-injuries-analysis-of-routine-data-from-german-hospitals-2005-2012
#20
S Krinner, S Schmitt, S Grupp, F F Hennig, A Langenbach, S Schulz-Drost
BACKGROUND: Combinations of sternal and spinal fractures often occur due to high velocity accidents and are associated with a high incidence of concomitant injuries. The anterior thoracic wall is described as the fourth column of torso stability, which is why sternovertebral injuries (SVI) present a high risk of sagittal deformation of the trunk, in particular injuries of the thoracic spine. To date, no studies have been published on the frequency distribution of the involved vertebral bodies in large patient groups...
February 5, 2018: Der Unfallchirurg
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