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Injuries of the thoracolumbar spine

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https://www.readbyqxmd.com/read/28913694/emergency-neurological-life-support-traumatic-spine-injury
#1
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 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28884108/characteristics-and-clinical-aspects-of-patients-with-spinal-cord-injury-undergoing-surgery
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/28534496/definitions-of-traumatic-conus-medullaris-and-cauda-equina-syndrome-a-systematic-literature-review
#14
E Brouwers, H van de Meent, A Curt, B Starremans, A Hosman, R Bartels
STUDY DESIGN: A systematic review. OBJECTIVES: Conus medullaris syndrome (CMS) and cauda equina syndrome (CES) are well-known neurological entities. It is assumed that these syndromes are different regarding neurological and functional prognosis. However, literature concerning spinal trauma is ambiguous about the exact definition of the syndromes. METHODS: A MEDLINE, EMBASE and Cochrane literature search was performed. We included original articles in which clinical descriptions of CMS and/or CES were mentioned in patients following trauma to the thoracolumbar spine...
May 23, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28527755/perioperative-neurologic-complications-during-spinal-fusion-surgery-incidence-and-trends
#15
Parthasarathy Thirumala, James Zhou, Piruthiviraj Natarajan, Jeffrey Balzer, Edward Dixon, David Okonkwo, D K Hamilton
BACKGROUND CONTEXT: Perioperative neurologic complications after spine surgery may increase morbidity and health-care costs related to the procedure. PURPOSE: We estimate the national incidence of perioperative neurologic complications following anterior cervical discectomy and fusion (ACDF), posterior cervical fusion, and thoracolumbar fusion procedures using the Nationwide Inpatient Sample (NIS) data from 1999 to 2011. Additionally, we identify risk factors for developing perioperative neurologic complications and the effects of these injuries on quantifiable patient outcomes...
May 17, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28488618/pediatric-thoracolumbar-spinal-injuries-the-etiology-and-clinical-spectrum-of-an-uncommon-entity-in-childhood
#16
R A Babu, Arivazhagan Arimappamagan, Nupur Pruthi, Dhananjaya I Bhat, H R Arvinda, B Indira Devi, Sampath Somanna
BACKGROUND: Pediatric thoracolumbar (TL) spinal injuries are uncommon entities with an incidence of 5-34% of all pediatric spinal injuries. There is a scarcity of studies done on the pediatric population in the developing countries like India. This study aims to review our experience with TL spine injuries in children over a 12-year period. MATERIALS AND METHODS: We retrospectively reviewed the epidemiology, risk factors, mechanisms, patterns of injury and management of pediatric TL injuries in our population...
May 2017: Neurology India
https://www.readbyqxmd.com/read/28458848/delayed-leg-paraplegia-associated-with-hyperextension-injury-in-patients-with-diffuse-idiopathic-skeletal-hyperostosis-dish-case-report-and-review-of-the-literature
#17
Tatsuya Yamamoto, Yoshiomi Kobayashi, Yoji Ogura, Yohei Takahashi, Yoshio Shinozaki, Jun Ogawa
Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by calcifications and ossification of ligaments and tendon insertions. The patients with DISH are susceptible to spinal column injury with trivial trauma due to immobilization of vertebrae and this easily leads to spinal cord injury. However, only few reports on hyperextension injuries of the thoracolumbar spine with DISH exist. Here we report three cases of those who developed delayed leg paraplegia after hyperextension injuries of the thoracolumbar spine with DISH...
March 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28450952/microrna-185-regulates-spinal-cord-injuries-induced-by-thoracolumbar-spine-compression-fractures-by-targeting-transforming-growth-factor-%C3%AE-1
#18
Pengfei Zhao, Shaochun Wang, Yingjie Zhou, Huailiang Zheng, Gang Zhao
The aims of the present study were to examine the expression of transforming growth factor (TGF)-β1 and microRNA (miR)-185 in the bone tissue, blood and cerebrospinal fluid of patients with spinal cord injuries and to evaluate the regulation of spinal cord injuries by miR-185. A total of 44 patients with spinal cord injuries induced by thoracolumbar spine compression fractures, who were hospitalized at Luoyang Orthopedic-Traumatological Hospital between June 2012 and February 2015 were enrolled in the present study...
March 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28383409/clinical-case-series-report-of-traumatic-cauda-equina-herniation-a-pathological-phenomena-occurring-with-thoracolumbar-and-lumbar-burst-fractures
#19
Liang Yan, Yang Liu, Baorong He, Jijun Liu, Zhenguo Luo, Dingjun Hao
RATIONALE: Burst fractures in thoracolumbar and lumbar spine typically occur from severe trauma, which may result in cauda equina herniation (CEH). In this study, we attempted to document the incidence and evaluate the sequelae of CEH that were found during decompression and fusion surgery for patients with burst fractures. PATIENT CONCERNS: A total of 416 patients were enrolled in this study. DIAGNOSES: The patients had been operated on through an anterior or posterior approach for treatments of thoracolumbar and lumbar burst fractures at our department between June 1, 2008 and June 1, 2011...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28367388/delayed-recognition-of-thoracic-and-lumbar-vertebral-compression-fractures-in-minor-accident-cases
#20
Jesse Hatgis, Michelle Granville, Robert E Jacobson
Osteoporotic vertebral compression fractures (VCFs) in the elderly are commonly diagnosed after a minor fall or trauma; however, the majority of these patients have either been previously evaluated for osteoporosis or are already under some form of medical treatment for osteoporosis at the time of the fall. Although accidents are a known cause of VCFs, these fractures are too often undiagnosed. In reviewing a group of patients seen after minor falls or automobile accidents who were complaining of general spine pain, we found a smaller subgroup with previously undiagnosed VCFs...
February 23, 2017: Curēus
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