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Injuries of the thoracolumbar spine

Ahmad Jabir Rahyussalim, Ifran Saleh, M Fajrin Armin, Tri Kurniawati, Ahmad Yanuar Safri
INTRODUCTION: Intraoperative neurophysiologic monitoring (IONM) had important role related to the complications in spinal surgery. Somatosensory Evoked Potential (SSEP), Transcranial electric Muscle Evoked Potentials (tceMEPs), and free run EMG are parameters used to asses functional integrity of the nervous system during surgical procedures. Once warning signal was recognized, surgeon have to make a precise decision to overcome that problem. PRESENTATION OF CASE: We present a 47-year old male with back pain due to compression fracture of thoracic vertebra T12 and lumbar vertebrae L1...
September 23, 2016: International Journal of Surgery Case Reports
M S Reich, A J Dolenc, T A Moore, H A Vallier
BACKGROUND: Previous work established resuscitation parameters that minimize complications with early fracture management. This Early Appropriate Care (EAC) protocol was applied to patients with advanced age to determine if they require unique parameters to mitigate complications. METHODS: Between October 2010 and March 2013, 376 consecutive skeletally mature patients with unstable fractures of the pelvis, acetabulum, thoracolumbar spine, and/or proximal or diaphyseal femur fractures were treated at a level I trauma center and were prospectively studied...
September 26, 2016: Journal of Orthopaedic Surgery and Research
Julio J Jauregui, Dean C Perfetti, Frank S Cautela, David B Frumberg, Qais Naziri, Carl B Paulino
BACKGROUND: Although rare, spinal injuries associated with abuse can have potentially devastating implications in the pediatric population. We analyzed the association of pediatric spine injury in abused children and determined the anatomic level of the spine affected, while also focusing on patient demographics, length of stay, and total hospital charges compared with spine patients without a diagnosis of abuse. METHODS: A retrospective review of the Kids' Inpatient Database was conducted from 2000 to 2012 to identify pediatric patients (below 18 y) who sustained vertebral column fractures or spinal cord injuries...
September 22, 2016: Journal of Pediatric Orthopedics
Tack Geun Cho, Seung Won Park, Young Baeg Kim
OBJECTIVE: The objective of this study is to establish an animal model of chronic paraspinal muscle injury in rat. METHODS: Fifty four Sprague-Dawley male rats were divided into experimental group (n=30), sham (n=15), and normal group (n=9). Incision was done from T7 to L2 and paraspinal muscles were detached from spine and tied at each level. The paraspinal muscles were exposed and untied at 2 weeks after surgery. Sham operation was done by paraspinal muscles dissection at the same levels and wound closure was done without tying...
September 2016: Journal of Korean Neurosurgical Society
Shari Cui, Gennadiy A Busel, Aki S Puryear
BACKGROUND: Pediatric spine trauma often results from high-energy mechanisms. Despite differences in healing potential, comorbidities, and length of remaining life, treatment is frequently based on adult criteria; ligamentous injuries are fused and bony injuries are treated accordingly. In this study, we present short-term results of a select group of adolescent patients treated using percutaneous pedicle screw instrumentation without fusion. METHODS: An IRB-approved retrospective review was performed at a level 1 pediatric trauma center for thoracolumbar spine fractures treated by percutaneous pedicle screw instrumentation...
October 2016: Journal of Pediatric Orthopedics
Mona Saffarzadeh, R Caresse Hightower, Jennifer W Talton, Anna N Miller, Joel D Stitzel, Ashley A Weaver
OBJECTIVE: This study aimed to quantify lumbar volumetric bone mineral density (vBMD) for 873 seriously injured Crash Injury Research and Engineering Network (CIREN) motor vehicle crash occupants (372 male, 501 female) from 8 centers using phantomless computed tomography scans and to associate vBMD with age, fracture incidence, and osteopenia/osteoporosis diagnoses. The novelty of this work is that it associates vBMD with region of injury by applying an established method for vBMD measurement using phantomless computed tomography (CT)...
September 2016: Traffic Injury Prevention
Hesham M Soliman, Ha Son Nguyen, Anjishnu Banerjee, Frank Pintar, Narayan Yoganandan, Shekar Kurpad, Dennis Maiman
BACKGROUND: The Abbreviated Injury Scale (AIS) is an anatomical-based coding system created by the Association for the Advancement of Automotive Medicine, utilized to classify and code injuries resulting from trauma, in order of severity. According to the latest version, all Thoraco-Lumbar Compression Fractures (TLCF), even without injury to other spine components and with >20% loss of height, were branded AIS 3 injuries, reflecting a serious threat to life or permanent disability...
September 2016: Traffic Injury Prevention
Kavin Khatri, Kamran Farooque, Vijay Sharma, Babita Gupta, Shivanand Gamanagatti
STUDY DESIGN: Retrospective study. PURPOSE: To outline the etiology, complications and management difficulties encountered in the management of neglected thoracolumbar spine injuries. OVERVIEW OF LITERATURE: The English literature describes overlooked diagnosis as the most common cause of neglected spine injuries. However, the reasons differ in developing or under-developed nations. Moreover, there is scarcity of literature about the neglected spinal injuries...
August 2016: Asian Spine Journal
Giovanni Andrea La Maida, Francesco Luceri, Marcello Ferraro, Carlo Ruosi, Giuseppe Vincenzo Mineo, Bernardo Misaggi
INTRODUCTION: The anatomy and biomechanics of the thoracolumbar spine place these segments at high risk of trauma injuries. Treatment options are either conservative or surgical, and there is a lack of consensus about the right indications. International scientific publications agree only on basic surgical principles: vertebral stability, deformity correction, protection of neurological structures and fast functional recovery. The most commonly used approach is the posterior approach, which allows the best management of most vertebral fracture patterns...
August 20, 2016: Injury
Hassan Albadawi, John W Chen, Rahmi Oklu, Yue Wu, Gregory Wojtkiewicz, Benjamin Pulli, John D Milner, Richard P Cambria, Michael T Watkins
Purpose To evaluate whether noninvasive molecular imaging technologies targeting myeloperoxidase (MPO) can reveal early inflammation associated with spinal cord injury after thoracic aortic ischemia-reperfusion (TAR) in mice. Materials and Methods The study was approved by the institutional animal care and use committee. C57BL6 mice that were 8-10 weeks old underwent TAR (n = 55) or sham (n = 26) surgery. Magnetic resonance (MR) imaging (n = 6) or single photon emission computed tomography (SPECT)/computed tomography (CT) (n = 15) studies targeting MPO activity were performed after intravenous injection of MPO sensors (bis-5-hydroxytryptamide-tetraazacyclododecane [HT]-diethyneletriaminepentaacetic acid [DTPA]-gadolinium or indium 111-bis-5-HT-DTPA, respectively)...
August 10, 2016: Radiology
Yoshihiro Katsuura, James Michael Osborn, Garrick Wayne Cason
PURPOSE: To describe the epidemiology of thoracolumbar fractures and associated injuries in blunt trauma patients. METHODS: A systematic review and metaanalysis was performed based on a MEDLINE database search using MeSH terms for studies matching our inclusion criteria. The search yielded 21 full-length articles, each sub-grouped according to content. Data extraction and multiple analyses were performed on descriptive data. RESULTS: The rate of thoracolumbar fracture in blunt trauma patients was 6...
December 2016: Journal of Orthopaedics
W Reith, N Harsch, C Kraus
CLINICAL/METHODICAL ISSUE: Patients who have experienced high energy trauma have a particularly high risk of suffering from fractures of the thoracic and lumbar spine. The detection of spinal injuries and the correct classification of fractures before surgery are not only absolute requirements for the implementation of appropriate surgical treatment but they are also decisive for the choice of surgical procedure. STANDARD RADIOLOGICAL METHODS: By the application of spiral computed tomography (CT) crucial additional information on the morphology of the fracture can be gained in order to estimate the fracture type and possibly the indications for specific surgical treatment options...
August 2016: Der Radiologe
Ufuk Aydinli, Nilesh Kumar Mohan, Kursat Kara
BACKGROUND: Charcot spine arthropathy (posttraumatic neuroarthropathy of the spine) has been reported to be a very late and rare complication of spinal cord injury. Charcot of the cervicothoracic and upper thoracic region rarely is reported in the literature. Charcot spinal arthropathy is a cause of progressive deformity and may present as late as 30 years after the original spinal cord injury. This is more common in paraplegic patients who are actively ambulating. CASE DESCRIPTION: A 56-year-old patient with complete paraplegia for approximately 20 years after spinal cord injury presented with severe kyphous deformity and instability of thoracolumbar spine...
October 2016: World Neurosurgery
Yogesh Kumar, Daichi Hayashi
Magnetic resonance imaging (MRI) has been playing an increasingly important role in the spinal trauma patients due to high sensitivity for detection of acute soft tissue and cord injuries. More and more patients are undergoing MRI for spinal trauma in the emergency settings, thus necessitating the interpreting physicians to be familiar with MRI findings in spinal trauma. In this pictorial review, we will first describe the normal anatomy of various ligamentous structures. Indications of MRI in spinal trauma as well as the role of MRI in diagnosing spinal cord and soft tissue injuries will then be discussed...
2016: BMC Musculoskeletal Disorders
Arjun S Sebastian, Bradford L Currier, Michelle J Clarke, Dirk Larson, Paul M Huddleston, Ahmad Nassr
STUDY DESIGN: Retrospective matched cohort analysis. OBJECTIVE: The majority of the literature on venous thromboembolism (VTE) after spine surgery is limited to studies of thoracolumbar surgery. Less is known regarding the incidence of VTE and associated risk factors following cervical spine surgery. METHODS: A total of 5,405 patients at our institution underwent cervical diskectomy, laminectomy, corpectomy, laminoplasty, or fusion between 1995 and 2012; 85 of the 5,405 patients (1...
August 2016: Global Spine Journal
Jonathan Cheah, Alan L Zhang, Bobby Tay
STUDY DESIGN: Retrospective cohort analysis of a national database between 2005 and 2011. OBJECTIVE: To investigate the current usage of neuromonitoring in patients undergoing multilevel thoracolumbar spine surgery. We hypothesize that the use of neuromonitoring would be associated with a reduced incidence of postoperative neurological injuries. SUMMARY OF BACKGROUND DATA: Intraoperative neuromonitoring is a common technique utilized in spine surgery to improve safety and reduce neurological injuries...
July 11, 2016: Clinical Spine Surgery
Hesham M Soliman, Ha Nguyen, Frank A Pintar, Narayan Yoganandan, Shekar N Kurpad, Dennis J Maiman
INTRODUCTION: According to the latest version of the Abbreviated Injury Scale (AIS), all Thoraco-Lumbar Compression Fractures (TLCF) with >20% loss of height, were branded code 3 injuries, reflecting a threat for life or permanent disability. However, clinical observation suggests that that TLCF with <40% loss of height and without neurological deficits, have been noted to have a better clinical prognosis, prompting the need to segregate these injuries differently, revise the classification, and review outcomes...
August 2016: Neurosurgery
Hao Liu, Bang-Ping Qian, Yong Qiu, Sai-Hu Mao, Zhe Qu, Bin Wang, Yang Yu, Ze-Zhang Zhu
STUDY DESIGN: A prospective magnetic resonance imaging (MRI) study. OBJECTIVE: To investigate the change in aortic traversing length in patients with thoracolumbar kyphosis secondary to ankylosing spondylitis (AS) after closing wedge osteotomy (CWO). SUMMARY OF BACKGROUND DATA: The CWO has been widely adopted for the correction of thoracolumbar kyphosis caused by AS. During this procedure, the aorta may be elongated in the instrumented area, which implies a potential risk of the aortic injury...
July 7, 2016: Spine
Ho Jun Yi, Je Hoon Jeong, Soo Bin Im, Jung Kil Lee
We retrospectively compared the clinical and radiological results of percutaneous vertebroplasty with those of conservative treatment in the management of thoracolumbar osteoporotic compression fractures. Sixty-five patients who could be followed up for more than 2 years with thoracic and lumbar spine osteoporotic compression fractures, between January 2005 and October 2010, were reviewed. The patients were divided into 2 groups according to the type of management: group 1, non-operated group treated conservatively; group 2, operated group that underwent percutaneous vertebroplasty...
July 2016: Pain Physician
Sergei Goldstein, Yossi Smorgick, Yigal Mirovsky, Yoram Anekstein, Ronen Blecher, Sigal Tal
Osteoporotic compression spine fractures have a different clinical course and outcomes when compared to spinal fractures occurring in the younger population. Only a few studies have investigated the risk factors for progressive osteoporotic compression spine fractures. The purpose of this study was to investigate clinical and radiological factors related to progressive collapse following acute osteoporotic compression spine fractures. We retrospectively identified all patients treated for thoracolumbar fractures in our institution between January 2008 and July 2013...
September 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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