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Injuries of the thoracolumbar spine

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https://www.readbyqxmd.com/read/29114089/angiographic-and-clinical-characteristics-of-thoracolumbar-spinal-epidural-and-dural-arteriovenous-fistulas
#1
Hiro Kiyosue, Yuji Matsumaru, Yasunari Niimi, Keisuke Takai, Tomoya Ishiguro, Masafumi Hiramatsu, Kotaro Tatebayashi, Toshinori Takagi, Shinichi Yoshimura
BACKGROUND AND PURPOSE: The purpose of this study is to compare the angiographic and clinical characteristics of spinal epidural arteriovenous fistulas (SEAVFs) and spinal dural arteriovenous fistulas (SDAVFs) of the thoracolumbar spine. METHODS: A total of 168 cases diagnosed as spinal dural or extradural arteriovenous fistulas of the thoracolumbar spine were collected from 31 centers. Angiography and clinical findings, including symptoms, sex, and history of spinal surgery/trauma, were retrospectively reviewed...
November 7, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29073499/management-of-major-vascular-injury-during-pedicle-screw-instrumentation-of-thoracolumbar-spine
#2
Aleem K Mirza, Mohammed Ali Alvi, Ryan M Naylor, Panagiotis Kerezoudis, William E Krauss, Michelle J Clarke, Daniel L Shepherd, Ahmad Nassr, Randall R DeMartino, Mohamad Bydon
OBJECTIVES: Vascular injury is a rare complication of spinal instrumentation. Presentation can vary from immediate hemorrhage to pseudoaneurysm formation. In the literature, surgical approach to repair has varied based on anatomy, acuity of diagnosis, infection, and available technology. In this manuscript, we aim to describe our institutional experience with vascular injuries in thoraco-lumbar spine surgery. PATIENTS AND METHODS: We report our institutional experience of three cases of vascular injury secondary to pedicle screw misplacement and their management, as well as a review of the literature...
October 16, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29066098/brown-s%C3%A3-quard-syndrome-and-cervical-post-traumatic-subarachnoid-hematoma
#3
Fernando Rascón-Ramírez, Josué M Avecillas-Chasín, Albert Trondin, M Javier Arredondo
Cervical Traumatic SSH are very rare in literature. They are usually caused by cardiopulmonary diseases that increase vascular pressure causing spinal vessels rupture. In thoracolumbar spine, the spinal puncture is the most common cause. The ventrolateral position is even more unusual. In traumatic brain injury (TBI), an abrupt extension-flexion movement could have caused the rupture of subarachnoid vessels. This, accompanied by the slowed blood "wash out" (probably due to the previous osteoarthrosis and spinal canal stenosis), led to the formation of an organized clot, which caused an acute spinal cord compression syndrome...
October 20, 2017: Neurocirugía
https://www.readbyqxmd.com/read/29037653/adolescent-idiopathic-scoliosis-the-tethered-spine-iii-is-fascial-spiral-the-key
#4
Lucy Whyte Ferguson
This article reports on an observational and treatment case series involving 22 adolescents and preadolescents treated over a 15 year period who had or appeared to be developing idiopathic scoliosis (IS). Common patterns of muscle and fascial asymmetry were observed and treated. Most of these individuals had spinal area pain and the trigger points (TrPs) apparently responsible for this pain were located in muscles at some distance from the spine, yet referred pain to locations throughout the thoracolumbar spine...
October 2017: Journal of Bodywork and Movement Therapies
https://www.readbyqxmd.com/read/28937462/instability-in-thoracolumbar-trauma-is-a-new-definition-warranted
#5
Salman Abbasi Fard, Jesse Skoch, Mauricio J Avila, Apar S Patel, Kamran V Sattarov, Christina M Walter, Ali A Baaj
STUDY DESIGN: Review of the articles. OBJECTIVE: The objective of this study was to review all articles related to spinal instability to determine a consensus statement for a contemporary, practical definition applicable to thoracolumbar injuries. SUMMARY OF BACKGROUND DATA: Traumatic fractures of the thoracolumbar spine are common. These injuries can result in neurological deficits, disability, deformity, pain, and represent a great economic burden to society...
October 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28937458/transpedicular-corpectomy-and-cage-placement-in-the-treatment-of-traumatic-lumbar-burst-fractures
#6
Martin H Pham, Alexander Tuchman, Thomas C Chen, Frank L Acosta, Patrick C Hsieh, John C Liu
STUDY DESIGN: Retrospective review. OBJECTIVE: To review the feasibility of a posterior-only approach for instrumented reconstruction in lumbar burst fractures. BACKGROUND: Burst fractures of the lumbar spine have been treated through a variety of techniques, including anterior, posterior, or combined approaches. Here we review series of patients undergoing posterior-only transpedicular corpectomy with instrumented fusion for traumatic lumbar burst fracture...
October 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28930904/spontaneous-reduction-of-fractured-thoracolumbar-spine-with-complete-dislocation-case-report-with-literature-review
#7
Chen Zhao, Bing Zhang, Jiandang Shi, Yaping Li, Long Pang
Fractures and dislocations with complete lateral displacement of the spine at the lumbar and thoracic levels are some of the most severe types of thoracolumbar trauma. They are usually caused by high-energy trauma and accompanied by extreme, life-threatening injuries and neurological deficits that vary in severity, which may delay operative intervention. It is often difficult to reduce such a complex fracture-dislocation because of the force that the muscles exert on the bone and the injured part of the spinal cord...
September 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28913694/emergency-neurological-life-support-traumatic-spine-injury
#8
Deborah M Stein, William A Knight
Traumatic spine injuries (TSIs) carry significantly high risks of morbidity, mortality, and exorbitant health care costs from associated medical needs following injury. For these reasons, TSI was chosen as an ENLS protocol. This article offers a comprehensive review on the management of spinal column injuries using the best available evidence. Though the review focuses primarily on cervical spinal column injuries, thoracolumbar injuries are briefly discussed as well. The initial emergency department (ED) clinical evaluation of possible spinal fractures and cord injuries, along with the definitive early management of confirmed injuries, are also covered...
September 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28884108/characteristics-and-clinical-aspects-of-patients-with-spinal-cord-injury-undergoing-surgery
#9
João Simão de Melo-Neto, Lara Eduarda Leite Vidotto, Fabiana de Campos Gomes, Dionei Freitas de Morais, Waldir Antonio Tognola
OBJECTIVE: To identify the characteristics of patients with spinal cord injury (SCI) undergoing surgery. METHODS: Previously, 321 patients with SCI were selected. Clinical and socio-demographic variables were collected. RESULTS: A total of 211 patients were submitted to surgery. Fall and injuries in the upper cervical and lumbosacral regions were associated with conservative treatment. Patients with lesions in the lower cervical spine, worse neurological status, and unstable injuries were associated with surgery...
June 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28816877/fractures-in-spinal-ankylosing-disorders-a-narrative-review-of-disease-and-injury-types-treatment-techniques-and-outcomes
#10
Tarush Rustagi, Doniel Drazin, Cumhur Oner, Jonathan York, Gregory D Schroeder, Alexander R Vaccaro, Rod J Oskouian, Jens R Chapman
INTRODUCTION: Spinal ankylosing disorders encompass ankylosing spondylitis (AS), disseminated hyperostosis of the spine, and end-stage spondylosis. All these result in a stiffened and frequently deformed spinal column. This makes the spinal column highly susceptible to severe injuries that are commonly associated with unfavorable outcomes. Improved understanding of the underlying disease processes and clinical comorbidities may alter the poor injury related morbidity and mortality outcomes...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28816874/does-surgical-intervention-or-timing-of-surgery-have-an-effect-on-neurological-recovery-in-the-setting-of-a-thoracolumbar-burst-fracture
#11
So Kato, Jean-Christophe Murray, Brian K Kwon, Gregory D Schroeder, Alexander R Vaccaro, Michael G Fehlings
Traumatic thoracolumbar burst fractures are one of the most common forms of spinal trauma with the majority occurring at the junctional area where mechanical load is maximal (AOSpine Thoracolumbar Spine Injury Classification System Subtype A3 or A4). Burst fractures entail the involvement of the middle column, and therefore, they are typically associated with bone fragment in the spinal canal, which may cause compression of the spinal cord, conus medullaris, cauda equina, or a combination of these. Fortunately, approximately half of the patients with thoracolumbar burst fractures are neurologically intact due to the wide canal diameter...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28816871/aospine-classification-systems-subaxial-thoracolumbar
#12
Klaus J Schnake, Gregory D Schroeder, Alexander R Vaccaro, Cumhur Oner
Numerous classification systems for subaxial and thoracolumbar spine injuries were proposed in the past with the attempt to facilitate communication between physicians. The AO-Magerl, thoracolumbar system, and Subaxial Cervical Spine Injury Classification systems are all well known, but did not achieve universal international adoption. A group of international experienced spine trauma surgeons were brought together by AOSpine with the goal to develop a comprehensive yet simple classification system for spinal trauma...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28816869/spine-trauma-what-are-the-current-controversies
#13
Cumhur Oner, Shanmuganathan Rajasekaran, Jens R Chapman, Michael G Fehlings, Alexander R Vaccaro, Gregory D Schroeder, Said Sadiqi, James Harrop
Although less common than other musculoskeletal injuries, spinal trauma may lead to significantly more disability and costs. During the last 2 decades there was substantial improvement in our understanding of the basic patterns of spinal fractures leading to more reliable classification and injury severity assessment systems but also rapid developments in surgical techniques. Despite these advancements, there remain unresolved issues concerning the management of these injuries. At this moment there is persistent controversy within the spinal trauma community, which can be grouped under 6 headings...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28815158/does-the-spine-surgeon-s-experience-affect-fracture-classification-assessment-of-stability-and-treatment-plan-in-thoracolumbar-injuries
#14
Shanmuganathan Rajasekaran, Rishi Mugesh Kanna, Gregory D Schroeder, Frank Cumhur Oner, Luiz Vialle, Jens Chapman, Marcel Dvorak, Michael Fehlings, Ajoy Prasad Shetty, Klaus Schnake, Frank Kandziora, Alexander R Vaccaro
STUDY DESIGN: Prospective survey-based study. OBJECTIVES: The AO Spine thoracolumbar injury classification has been shown to have good reproducibility among clinicians. However, the influence of spine surgeons' clinical experience on fracture classification, stability assessment, and decision on management based on this classification has not been studied. Furthermore, the usefulness of varying imaging modalities including radiographs, computed tomography (CT) and magnetic resonance imaging (MRI) in the decision process was also studied...
June 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28648115/complete-thoracolumbar-fracture-dislocation-with-intact-neurologic-function-explanation-of-a-novel-cord-saving-mechanism
#15
Abolfazl Rahimizadeh, Naser Asgari, Ava Rahimizadeh
BACKGROUND: The thoracolumbar junction from T11 to L2 is a common site of injury in which fracture and dislocations are the most prevalent ones occurring at this location. Fracture dislocation is defined as failure of all three columns of the spine with gross displacement. Considering the significant violence necessary to produce fracture dislocations, these injuries are often associated with major neural deficit, with the majority of casualties becoming paraplegic immediately. Preservation of neurological function following complete fracture dislocation is quite rare entity...
June 26, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28644193/heel-raised-foot-posture-do-not-affect-trunk-and-lower-extremity-biomechanics-during-a-barbell-back-squat-in-recreational-weightlifters
#16
Szu-Ping Lee, Carrie Gillis, Javier J Ibarra, Derek Oldroyd, Ryan Zane
It is claimed that weightlifting shoes with a raised heel may lead to a more upright trunk posture, and thus reduce the risk of back injuries during a barbell back squat. These proclaimed biomechanical effects have not been thoroughly investigated. The purpose of this study was to compare trunk and lower extremity biomechanics during barbell back squats in 3 foot postures.14 recreational weightlifters (7 male and 7 female) between the ages of 18-50 performed barbell back squats in 3 conditions (barefoot on a flat surface, barefoot on a heel-raised platform, and wearing heel-raised weightlifting shoes) at 80% of their 1-RM...
June 19, 2017: Journal of Strength and Conditioning Research
https://www.readbyqxmd.com/read/28572150/percutaneous-spinal-ablation-in-a-sheep-model-protective-capacity-of-an-intact-cortex-correlation-of-ablation-parameters-with-ablation-zone-size-and-correlation-of-postablation-mri-and-pathologic-findings
#17
A N Wallace, T J Hillen, M V Friedman, Z S Zohny, B H Stephens, S C Greco, M R Talcott, J W Jennings
BACKGROUND AND PURPOSE: Despite the growing use of percutaneous ablation therapy for the treatment of metastatic spine disease, several issues have yet to be fully addressed. Our aims were to determine whether the vertebral body cortex protects against ablation-induced spinal cord injury; correlate radiofrequency, cryo-, and microwave ablation parameters with resulting spinal ablation zone dimensions and describe normal spinal marrow postablation changes on MR imaging. MATERIALS AND METHODS: Ten thoracolumbar vertebrae in 3 sheep were treated with radiofrequency ablation, cryoablation, or microwave ablation under fluoroscopic guidance...
June 1, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28571219/bi-pedicle-fixation-of-affected-vertebra-in-thoracolumbar-burst-fracture
#18
Pravin Padalkar, Varshil Mehta
INTRODUCTION: Burst fractures of the spine account for 14% of all spinal injuries and more than 50% of all thoracolumbar trauma. However, there is ambiguity while choosing the right treatment plan. Short Segment Pedicle screw Fixation (SSPF) has become an increasingly popular method of treatment of thoracolumbar burst fractures, providing the advantage of incorporating fewer motion segments in the fixation. Various biomechanical studies showed that the use of pedicle screws could achieve stable construct within short-segment fixation...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28557903/functional-recovery-following-early-kyphoplasty-versus-conservative-management-in-stable-thoracuolumbar-fractures-in-parachute-jumpers-a-randomized-clinical-trial
#19
Mohammad S Masoudi, Ali Haghnegahdar, Fariborz Ghaffarpasand, Ghazal Ilami
STUDY DESIGN: A randomized clinical trial. OBJECTIVE: To compare the functional recovery between early kyphoplasty and conservative care in paratroopers with stable thoracolumbar fractures. SUMMARY OF BACKGROUND DATA: Treatment of traumatic stable thoracolumbar fractures in young individuals is still a debate. Conservative management and kyphoplasty are options of therapy. But enough data are not available for supporting each. METHODS: We included 70 paratroopers with stable thoracolumbar fractures (A1 and A2 classification according to AOSpine thoracolumbar spine injury classification system) presenting <60 days after trauma and hyperintensity in T2-weighted magnetic resonance imaging...
May 26, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28547575/incomplete-burst-fractures-of-the-thoracolumbar-spine-a-review-of-literature
#20
REVIEW
U J Spiegl, C Josten, B M Devitt, C-E Heyde
PURPOSE: The purpose of this review was to analyze the biomechanical basis of incomplete burst fractures of the thoracolumbar spine, summarize the available treatment options with evidence from the literature, and to propose a method to differentiate fracture severity. METHODS: The injury pattern, classification, and treatment strategies of incomplete burst fractures of the thoracolumbal spine have been described following a review of the literature. All level I-III studies, studies with long-term results and comparative studies were included and summarized...
May 25, 2017: European Spine Journal
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