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Spinal trauma

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https://www.readbyqxmd.com/read/28645598/efficacy-of-early-surgery-for-neurological-improvement-in-spinal-cord-injury-without-radiographic-evidence-of-trauma-in-the-elderly
#1
Tomoo Inoue, Shinsuke Suzuki, Toshiki Endo, Hiroshi Uenohara, Teiji Tominaga
OBJECT: The optimal timing for surgery for patients with spinal cord injury without radiographic evidence of trauma (SCIWORET) remains unclear. This is especially true in the elderly, because most studies are done with younger patients to avoid age-related comorbidities. We therefore aimed to compare the efficacy of early (less than 24 hours post-injury) versus late (more than 24 hours post-injury) surgery in patients with SCIWORET aged 65 years or older. METHODS: We identified patients aged 65 years or older who underwent surgery for SCIWORET between January 1995 and February 2016...
June 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28640037/epidemiology-of-major-depressive-disorder-disability-in-the-us-military-fy-2007-2012
#2
Elizabeth R Packnett, Hoda Elmasry, Christine F Toolin, David N Cowan, Michael R Boivin
This study assesses the incidence of major depressive disorder (MDD) disability discharge and retirement in the Army, Navy, Marine Corps and Air Force and describes MDD comorbidity. Service members with a disability discharge for either MDD (n = 2,882) or any nonpsychiatric disability (n = 56,145), between fiscal years 2007 and 2012, were included in the study population. Those with MDD disability at first evaluation but not at last evaluation were excluded. The incidence of MDD disability discharge increased significantly in the Army and Air Force between fiscal years 2007 and 2012...
June 20, 2017: Journal of Nervous and Mental Disease
https://www.readbyqxmd.com/read/28639826/imaging-appearance-of-advanced-chronic-adhesive-arachnoiditis-a-retrospective-review
#3
Tara L Anderson, Jonathan M Morris, John T Wald, Amy L Kotsenas
OBJECTIVE: Chronic adhesive arachnoiditis (CAA) is rare and has potentially devastating clinical consequences. The objective of this article is to review the clinical features of CAA and describe its appearance on imaging, to increase radiologists' awareness of this challenging diagnosis. MATERIALS AND METHODS: Twenty-nine cases of advanced CAA seen at our institution over 18 years (1995-2013) were retrospectively reviewed. Chart review was performed, with attention given to data on clinical presentation, suspected cause, and interventions performed...
June 22, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28637118/asymptomatic-chiari-type-i-malformation-should-patients-be-advised-against-participation-in-contact-sports
#4
Robert Spencer, Paul Leach
BACKGROUND: Chiari type I malformation (CM-I) is characterised by caudal displacement of the cerebellar tonsils through the foramen magnum, crowding the craniocervical junction. It is being increasingly diagnosed in asymptomatic patients due to the widespread availability of MRI, and there are case reports of these patients suffering sudden death or neurological injury following head or neck trauma, raising the issue of whether they should be prohibited from contact sport participation, given the likelihood of frequent trauma...
March 2, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28636962/reactive-astrocytes-production-function-and-therapeutic-potential
#5
REVIEW
Shane A Liddelow, Ben A Barres
Astrocytes constitute approximately 30% of the cells in the mammalian central nervous system (CNS). They are integral to brain and spinal-cord physiology and perform many functions important for normal neuronal development, synapse formation, and proper propagation of action potentials. We still know very little, however, about how these functions change in response to immune attack, chronic neurodegenerative disease, or acute trauma. In this review, we summarize recent studies that demonstrate that different initiating CNS injuries can elicit at least two types of "reactive" astrocytes with strikingly different properties, one type being helpful and the other harmful...
June 20, 2017: Immunity
https://www.readbyqxmd.com/read/28631748/ccl-2-as-a-possible-early-marker-for-remission-after-traumatic-spinal-cord-injury
#6
R A Heller, T F Raven, T Swing, K Kunzmann, V Daniel, P Haubruck, M Akbar, P A Grützner, G Schmidmaier, B Biglari, A Moghaddam
STUDY DESIGN: Prospective observational study. OBJECTIVES: To describe the correlation between CCL-2, CCL-3, CCL-4 and CXCL-5 serum levels and remission after traumatic spinal cord injury (SCI) in a human protocol compared with animal studies. SETTING: Germany, Rhineland-Palatinate (Rheinland-Pfalz). METHODS: We examined the serum levels of CCL-2, CCL-3, CCL-4 and CXCL-5 over a 12-week period; in particular, at admission and 4, 9 and 12 h, 1 and 3 days and 1, 2, 4, 8 and 12 weeks after trauma...
June 20, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28631747/optimization-of-the-mean-arterial-pressure-and-timing-of-surgical-decompression-in-traumatic-spinal-cord-injury-a-retrospective-study
#7
A Dakson, D Brandman, G Thibault-Halman, S D Christie
STUDY DESIGN: A retrospective comparative study. OBJECTIVES: This study aims to investigate the extent to which early surgical decompression and maintenance of MAP ⩾85 mm Hg for 5 days postinjury affected neurological recovery utilizing internal controls for comparison of outcomes in patients with traumatic spinal cord injury. SETTING: Acute trauma center, Halifax, Nova Scotia, Canada. METHODS: We identified 94 cases of traumatic SCI...
June 20, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28628531/costs-and-length-of-stay-for-the-acute-care-of-patients-with-motor-complete-spinal-cord-injury-following-cervical-trauma-the-impact-of-early-transfer-to-specialized-acute-sci-center
#8
Andréane Richard-Denis, Debbie Ehrmann Feldman, Cynthia Thompson, Étienne Bourassa-Moreau, Jean-Marc Mac-Thiong
OBJECTIVE: Acute spinal cord injury (SCI) centers aim to optimize outcome following SCI. However, there is no timeframe to transfer patients from regional to SCI centers in order to promote cost-efficiency of acute care. Our objective was to compare costs and length of stay (LOS) following early and late transfer to the SCI center. DESIGN: A retrospective cohort study involving 116 individuals was conducted. Group 1 (n = 87) was managed in an SCI center promptly after the trauma, whereas group 2 (n = 29) was transferred to the SCI center only after surgery...
July 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28624897/corrosion-of-harrington-rod-in-idiopathic-scoliosis-long-term-effects
#9
Beth Sherman, Tanya Crowell
PURPOSE: Metal implants have been used to treat adolescent idiopathic scoliosis since the 1960s. Only recently, however, it has the issue of metal-bone breakdown secondary to metal corrosion in situ come to light, raising concerns of possible long-term complications from the resulting metallosis and inflammation of spinal tissues. We present a case of a patient with neurological deficit, pain, and disability with Harrington rod in place for over 30 years, to bring attention to the issue of bio-corrosion of metal implants and its effect on human tissue...
June 17, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28612061/management-of-vesicoureteral-reflux-in-neurogenic-bladder
#10
REVIEW
Charlotte Q Wu, Israel Franco
Vesicoureteral reflux (VUR) is a significant risk factor for pyelonephritis and renal scarring. VUR can occur through a defective ureterovesical junction (UVJ) or an overwhelmed normal UVJ mechanism such as in bladder dysfunction of congenital, acquired, or behavioral etiology. There are numerous causes for the development of a neurogenic bladder from spinal dysraphisms to spinal cord trauma and even centrally based abnormalities in children with apparently normal motor function (inappropriately termed nonneurogenic neurogenic bladder)...
June 2017: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/28607823/traumatic-spondyloptosis-of-the-cervical-spine-a-case-report-and-discussion-of-worldwide-treatment-trends
#11
Kelly E Wong, Peter S Chang, Mark S Monasky, Rodney M Samuelson
BACKGROUND: Cervical spondyloptosis is defined as the dislocation of the spinal column most often caused by trauma. Due to compression or transection of the spinal cord, severe neurological deficits are common. Here, we review the literature and report a case of traumatic C5-6 spondyloptosis that was successfully treated using an anterior-only surgical approach. METHODS: The patient presented with quadriplegia and absent sensation distal to the C5 dermatome following a rollover motor vehicle accident...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28604489/risk-factors-and-prognosis-for-acute-progression-of-myelopathic-symptoms-in-patients-with-ossification-of-the-posterior-longitudinal-ligament-after-minor-trauma
#12
Jong-Myung Jung, Chun Kee Chung, Chi Heon Kim, Yunhee Choi
STUDY DESIGN: Retrospective Cohort study. OBJECTIVE: To identify the risk factors for acute progression of myelopathic symptoms (PMS) associated with ossification of the posterior longitudinal ligament (OPLL) after minor trauma and to compare the prognosis between an acute PMS group and a chronic PMS group. SUMMARY OF BACKGROUD DATA: Although the prevalence of OPLL among patients with cervical myelopathy is high, few studies have been published regarding the risk factors for acute PMS associated with OPLL after minor trauma...
June 9, 2017: Spine
https://www.readbyqxmd.com/read/28603566/current-concepts-in-pediatric-cervical-spine-trauma
#13
Kunal Shah, Agnivesh Tikoo, Manish K Kothari, Abhay Nene
BACKGROUND: Pediatric spinal trauma is rare and challenging entity. Although cervical spine is commonly affected, it is often missed on routine imaging investigations. Therefore better understanding of growing spine and its patho-physiology is crucial. METHODS: Articles related to pediatric cervical trauma were searched on Pubmed and other online research data banks. We have summarized unique anatomy of pediatric spine, investigations followed by common injury patterns, their diagnostic challenges and management...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28594515/cervical-spine-injuries-in-the-athlete
#14
Gregory D Schroeder, Alexander R Vaccaro
Cervical spine injuries are common and range from relatively minor injuries, such as cervical muscle strains, to severe, life-threatening cervical fractures with spinal cord injuries. Although cervical spine injuries are most common in athletes who participate in contact and collision sports, such as rugby and American football, they also have been reported in athletes who participate in noncontact sports, such as baseball, gymnastics, and diving. Cervical spine injuries in athletes are not necessarily the result of substantial spine trauma; some athletes have chronic conditions, such as congenital stenosis, that increase their risk for a serious cervical spine injury after even minor trauma...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28589067/intraoperative-dexmedetomidine-induced-polyuric-syndrome
#15
Shannon Granger, David Ninan
A 23-year-old male trauma patient with a cervical spine fracture underwent an anterior and posterior discectomy and spinal fusion surgery. The patient presented to the operating room with a stabilizing halo fixation device in place, and a fiberoptic intubation was performed with dexmedetomidine for sedation. During the surgical procedure, general anesthesia was maintained with a propofol and remifentanil infusion as the patient was monitored using somatosensory and motor evoked potentials. The patient's urine output increased gradually during the nine-hour surgical procedure from 150 mL/hour to over 700 mL/hour in the eighth hour of the procedure, where it remained until the end of the procedure...
May 3, 2017: Curēus
https://www.readbyqxmd.com/read/28583099/magnetic-resonance-imaging-of-bacterial-and-tuberculous-spondylodiscitis-with-associated-complications-and-non-infectious-spinal-pathology-mimicking-infections-a-pictorial-review
#16
REVIEW
Yogesh Kumar, Nishant Gupta, Avneesh Chhabra, Takeshi Fukuda, Neetu Soni, Daichi Hayashi
Magnetic resonance (MR) imaging plays an important role in the evaluation of bacterial and tuberculous spondylodiscitis and associated complications. Owing to its high sensitivity and specificity, it is a powerful diagnostic tool in the early diagnosis of ongoing infections, and thus provides help in prompt initiation of appropriate, therapy which may be medical or surgical, by defining the extent of involvement and detection of complications such as epidural and paraspinal abscesses. More specifically, MR imaging helps in differentiating bacterial from tuberculous infections and enables follow up of progression or resolution after appropriate treatment...
June 5, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28580859/isolated-spinal-cord-compression-syndrome-revealing-delayed-extensive-superficial-siderosis-of-the-central-nervous-system-secondary-to-cervical-root-avulsion
#17
Amina Nasri, Imen Kacem, Youssef Sidhom, Mouna Ben Djebara, Amina Gargouri, Riadh Gouider
CONTEXT: Cervical root avulsion secondary to traumatic plexus injury is a rare etiology of superficial siderosis (SS) of the central nervous system (CNS). We describe the case of an isolated progressive compressive myelopathy revealing this complication and discuss the pathogenesis of such a presentation, its clinical and imaging peculiarities with a literature review. FINDINGS: We report on the case of a 48-year-old man with history of left brachial plexus injury at the age of 2 years...
June 5, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28574329/spinal-epidural-hematomas-personal-experience-and-literature-review-of-more-than-1000-cases
#18
Maurizio Domenicucci, Cristina Mancarella, Giorgio Santoro, Demo Eugenio Dugoni, Alessandro Ramieri, Maria Felice Arezzo, Paolo Missori
OBJECTIVE The goal of this study was to identify factors that contribute to the formation of acute spinal epidural hematoma (SEH) by correlating etiology, age, site, clinical status, and treatment with immediate results and long-term outcomes. METHODS The authors reviewed their series of 15 patients who had been treated for SEH between 1996 and 2012. In addition, the authors reviewed the relevant international literature from 1869 (when SEH was first described) to 2012, collecting a total of 1010 cases. Statistical analysis was performed in 959 (95%) cases that were considered valid for assessing the incidence of age, sex, site, and clinical status at admission, correlating each of these parameters with the treatment results...
June 2, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28571219/bi-pedicle-fixation-of-affected-vertebra-in-thoracolumbar-burst-fracture
#19
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/28559442/cxcl12%C3%AE-sdf-1-from-perisynaptic-schwann-cells-promotes-regeneration-of-injured-motor-axon%C3%A2-terminals
#20
Samuele Negro, Francesca Lessi, Elisa Duregotti, Paolo Aretini, Marco La Ferla, Sara Franceschi, Michele Menicagli, Elisanna Bergamin, Egle Radice, Marcus Thelen, Aram Megighian, Marco Pirazzini, Chiara M Mazzanti, Michela Rigoni, Cesare Montecucco
The neuromuscular junction has retained through evolution the capacity to regenerate after damage, but little is known on the inter-cellular signals involved in its functional recovery from trauma, autoimmune attacks, or neurotoxins. We report here that CXCL12α, also abbreviated as stromal-derived factor-1 (SDF-1), is produced specifically by perisynaptic Schwann cells following motor axon terminal degeneration induced by α-latrotoxin. CXCL12α acts via binding to the neuronal CXCR4 receptor. A CXCL12α-neutralizing antibody or a specific CXCR4 inhibitor strongly delays recovery from motor neuron degeneration in vivo Recombinant CXCL12α in vivo accelerates neurotransmission rescue upon damage and very effectively stimulates the axon growth of spinal cord motor neurons in vitro These findings indicate that the CXCL12α-CXCR4 axis plays an important role in the regeneration of the neuromuscular junction after motor axon injury...
May 30, 2017: EMBO Molecular Medicine
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