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https://www.readbyqxmd.com/read/28728206/-subaxial-cervical-spine-injuries-treatment-recommendations-of-the-german-orthopedic-and-trauma-society
#1
Philipp Schleicher, Matti Scholz, Frank Kandziora, Andreas Badke, Florian Hans Brakopp, Helmut Klaus Friedrich Ekkerlein, Erol Gercek, Rene Hartensuer, Philipp Hartung, Jan-Sven Gilbert Jarvers, Philipp Kobbe, Stefan Matschke, Robert Morrison, Christian W Müller, Miguel Pishnamaz, Maximilian Reinhold, Klaus John Schnake, Gregor Schmeiser, Gregor Stein, Bernhard Ullrich, Thomas Weiß, Volker Zimmermann
In a consensus process during four sessions in 2016, the working group "lower cervical spine" of the German Society for Orthopedic and Trauma Surgery (DGOU), formulated "Therapeutic Recommendations for the Lower Cervical Spine", taking into consideration the current literature. Therapeutic goals are a permanently stable, painless cervical spine and the protection against secondary neurologic damage while retaining the greatest possible amount of motion and spinal profile. Due to its ease of use and its proven good reliability, the AOSpine classification for subaxial cervical injuries should be used...
July 20, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28727580/increase-in-intracranial-pressure-by-application-of-a-rigid-cervical-collar-a-pilot-study-in-healthy-volunteers
#2
Iscander M Maissan, Rein Ketelaars, Boris Vlottes, Sanne E Hoeks, Dennis den Hartog, Robert J Stolker
OBJECTIVES: Rigid cervical collars are known to increase intracranial pressure (ICP) in severe traumatic brain injury (TBI). Cerebral blood flow might decrease according to the Kellie Monroe doctrine. For this reason, the use of the collar in patients with severe TBI has been abandoned from several trauma protocols in the Netherlands. There is no evidence on the effect of a rigid collar on ICP in patients with mild or moderate TBI or indeed patients with no TBI. As a first step we tested the effect in healthy volunteers with normal ICPs and intact autoregulation of the brain...
July 19, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28727357/-spontaneous-carotid-and-vertebral-dissections
#3
Roman Sztajzel, Fabienne Perren, Patrik Michel
Dissections of the cervical arteries account for approximately 15-20 % of all strokes in young patients. Clinically they present with laterocervical and/or hemicranial pain associated to a Horner syndrome in case of carotid dissection and a posterior cervical pain associated to headache in the occipital area in case of vertebral dissection. A multifactorial origin is often suggested, resulting from the combination of a weakness of the arterial wall, hereditary or not, of environmental factors such minor trauma or a previous infection and also of the presence of a certain number of vascular risk factors such as high blood pressure or migraines...
April 26, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28724333/the-impact-of-acute-management-on-the-occurrence-of-medical-complications-during-the-specialized-spinal-cord-injury-acute-hospitalization-following-motor-complete-cervical-spinal-cord-injury
#4
Andréane Richard-Denis, Debbie Erhmann Feldman, Cynthia Thompson, Jean-Marc Mac-Thiong
CONTEXT/OBJECTIVE: Determine the impact of early admission and complete perioperative management in a specialized spinal cord injury (SCI) trauma center (SCI-center) on the occurrence of medical complications following tetraplegia. DESIGN: A retrospective comparative cohort study of prospectively collected data involving 116 individuals was conducted. Group 1 (N=87) was early managed in a SCI-center promptly after the trauma, whereas Group 2 (N=29) was surgically and preoperatively managed in a non-specialized (NS) center before being transferred to the SCI-center...
July 19, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28723840/cervical-spine-evaluation-and-clearance-in-the-intoxicated-patient-a-prospective-western-trauma-association-multi-institutional-trial-and-survey
#5
Matthew J Martin, Lisa D Bush, Kenji Inaba, Saskya Byerly, Martin Schreiber, Kimberly A Peck, Galinos Barmparas, Jay Menaker, Joshua P Hazelton, Raul Coimbra, Martin D Zielinski, Carlos V R Brown, Chad G Ball, Jill R Cherry-Bukowiec, Clay Cothren Burlew, Julie Dunn, C Todd Minshall, Matthew M Carrick, Gina M Berg, Demetrios Demetriades, William Long
INTRODUCTION: Intoxication often prevents clinical clearance of the cervical spine (Csp) after trauma leading to prolonged immobilization even with a normal CT scan. We evaluated the accuracy of CT at detecting clinically significant Csp injury, and surveyed participants on related opinions and practice. METHODS: A prospective multicenter study (2013-2015) at 17 centers. All adult blunt trauma patients underwent structured clinical examination and imaging including a Csp CT, with follow-up thru discharge...
July 19, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28720989/trapezius-perforator-flap-for-reconstruction-of-a-posterior-cervical-defect
#6
Ricardo Nascimento, Joana Costa, Ricardo Horta, Álvaro Silva
The use of free flaps is considered the "gold standard" for reconstruction of head and neck defects. Locoregional flaps allows a better aesthetic result compared to free flaps, whenever there's an external skin defect. However the use of free flaps is not always adequate in the presence of preoperative comorbidities or previous surgeries. Since the description of the trapezius myocutaneous flap in the 1980's, many authors have published the results of the applicability of this flap in head and neck salvage reconstructive surgery...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28720407/mechanical-properties-of-the-human-spinal-cord-under-the-compressive-loading
#7
Alireza Karimi, Ahmad Shojaei, Pedram Tehrani
The spinal cord as the most complex and critical part of the human body is responsible for the transmission of both motor and sensory impulses between the body and the brain. Due to its pivotal role any types of physical injury in that disrupts its function following by shortfalls, including the minor motor and sensory malfunctions as well as complicate quadriplegia and lifelong ventilator dependency. In order to shed light on the injuries to the spinal cord, the application of the computational models to simulate the trauma impact loading to that are deemed required...
July 15, 2017: Journal of Chemical Neuroanatomy
https://www.readbyqxmd.com/read/28713667/absent-congenital-cervical-pedicle-nearly-misdiagnosed-as-a-facet-dislocation-a-case-report
#8
Scott Safir, Jonathan Rasouli, Jeremy Steinberger, Branko Skovrlj, Amish Doshi, Konstantinos Margetis, Saadi Ghatan
BACKGROUND: Cervical spinal injury encompasses up to 1.5% of all pediatric injuries. Children, and more specifically infants, are a difficult subset of patients to obtain neurological exam in the setting of trauma, thus necessitating the use of cervical X-rays, CT scans, and MRI imaging. CASE DESCRIPTION: A healthy, 15-month-old boy had an unwitnessed fall down a flight of stairs and received a CT scan of the head and cervical spine in the emergency department due to cephalohematoma and mechanism of injury...
September 2017: Interdisciplinary Neurosurgery: Advanced Techniques and Case Management
https://www.readbyqxmd.com/read/28712898/iatrogenic-vertebral-artery-injury-during-anterior-cervical-spine-surgery-a-systematic-review
#9
REVIEW
Qing Guan, Long Chen, Ye Long, Zhou Xiang
BACKGROUND: Iatrogenic vertebral artery injury (VAI) during anterior cervical surgery is rare but potentially catastrophic. METHOD: The causes, presentation, diagnosis, management, prognosis, and prevention of VAI were reviewed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. English-language studies and case reports published from 1980 to 2017 were retrieved. Data on diagnosis, surgical procedures and approach, site and cause of VAI, management, outcomes, and VA status were extracted...
July 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28711623/prioritized-cervical-or-lumbar-surgery-for-coexisting-cervical-and-lumbar-stenosis-prognostic-analysis-of-222-case
#10
Haoxi Li, Zhaoxiong Chen, Xinhua Li, Tao Liu, Bin Shen, Yufeng Huang, Desheng Wu
BACKGROUND CONTEXT: Single-stage surgery is usually applied to improving the symptoms of coexisting cervical and lumbar stenosis. In most cases, patients' willingness, surgery affordability, surgical trauma, surgical complications and patients' tolerance to surgery all limit the application of single-stage surgery. For patients who cannot receive single-stage surgery, we hope that we can find out by weighing up merits and flaws of the two surgical sites in order to make decision of prioritize one of the two surgery, so as to bring more benefits to the patients...
July 12, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28705344/-claude-bernard-horner-syndrome-revealing-spontaneous-aneurysm-of-the-vertebral-artery
#11
M Zoulati, T Bakkali, N Aghoutane, B Bensaid, Y Lyazidi, Y Ouharakat, H Chtata, M Taberkant
False aneurysms of the extracranial vertebral artery (FAVA) are rare because of the path of the artery at the level of the transverse holes. They can be secondary to penetrating cervical trauma, spontaneous in the course of an angiopathy such as Ehlers-Danlos syndrome, or iatrogenic. We report the case of a 31-year-old woman who presented a syndrome of Claude Bernard-Horner related to a spontaneous FAVA. The angioscanner confirmed the diagnosis and the patient underwent successful surgical treatment of the false aneurysm with ligature of the vertebral artery...
July 2017: J Med Vasc
https://www.readbyqxmd.com/read/28694217/the-magnitude-of-angular-and-translational-displacement-of-dens-fractures-is-dependent-on-the-sagittal-alignment-of-the-cervical-spine-rather-than-the-force-of-injury
#12
Sabina R Blizzard, Bala Krishnamoorthy, Matthew Shinseki, Marcel Betsch, Jung Yoo
BACKGROUND CONTEXT: Although it is generally believed that the magnitude of dens fracture displacement is proportional to the amount of force applied to the cervical spine during injury, the factors responsible for displacement have not been studied. PURPOSE: Our aim was to determine factors which contribute to horizontal and angular displacement of dens fractures. STUDY DESIGN/SETTING: We conducted a retrospective review of adult patients who were admitted to our level one trauma center between 1/1/2008 and 12/31/2013...
July 7, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28691569/anatomical-features-of-the-cervical-spinal-canal-in-chiari-i-deformity-with-presyrinx-a-case-control-study
#13
Judith A Gadde, Vinil Shah, Greta B Liebo, Geir A Ringstad, I Jonathan Pomeraniec, Soren J Bakke, Radek Fric, Alexander Ksendzovsky, John A Jane, Erin S Schwartz, Victor Haughton
Purpose The relationship between syringomyelia and presyrinx, characterized by edema in the spinal cord, has not been firmly established. Patients with syringomyelia have abnormal spinal canal tapering that alters cerebrospinal fluid flow dynamics, but taper ratios in presyrinx have never been reported. We tested the hypothesis that presyrinx patients have abnormal spinal canal tapering. Materials and methods At six medical institutions, investigators searched the PACS system for patients with Chiari I and spinal cord edema unassociated with tumor, trauma, or other evident cause...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28689948/endovascular-treatment-of-penetrating-injury-to-the-vertebral-artery-by-a-stab-wound-case-report-and-literature-review
#14
Dafne Braga Diamante Leiderman, Antonio Eduardo Zerati, Nelson Wolosker, Henry Augusto Hoffmann Melo, Erasmo Simão Da Silva, Nelson De Luccia
BACKGROUND: We describe a unique case of a patient with penetration of the cervical region by a stab wound, who required emergency care for the controlled removal of the knife and for vertebral artery trauma (VAT) treatment. Although rare, VAT causes high morbidity and mortality. METHODS: A patient admitted for emergency care was diagnosed with traumatic complete section of the vertebral artery by a knife, and underwent to removal of the knife under radioscopic supervision and vertebral artery embolization with coils...
July 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28687344/anterior-cervical-discectomy-and-fusion-versus-posterior-laminoplasty-for-multilevel-cervical-myelopathy-a-meta-analysis
#15
REVIEW
Liping Xu, Hong Sun, Zhenhuan Li, Xiaodong Liu, Guanghui Xu
OBJECT: Anterior cervical discectomy with fusion (ACDF) and laminoplasty (LAMP) are used for the treatment of multilevel cervical myelopathy. Despite their widespread applications certain differences are noted between the ACDF and LAMP procedures. A meta-analysis was conducted in order to compare the clinical outcomes, complications, and surgical trauma between ACDF and LAMP for the treatment of multilevel cervical myelopathy. METHODS: Medline, EMBASE, Google Scholar, and Cochrane databases were used for the search of relevant studies until September 2016...
July 4, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28683592/functional-outcomes-in-very-early-5-hours-and-early-5-24-hours-surgical-decompression-in-traumatic-cervical-spinal-cord-injury-analysis-of-neurological-improvement-from-the-austrian-spinal-cord-injury-study-ascis
#16
Georg Mattiassich, Maria Gollwitzer, Franz Gaderer, Martina Blocher, Michael Osti, Markus Lill, Reinhold Ortmaier, Thomas Haider, Wolfgang Hitzl, Herbert Resch, Stephanie Aschauer-Wallner
Our study aim was to assess the neurological outcomes of surgical decompression and stabilisation within 5 and 24 h after injury. We performed a multicentre, retrospective cohort study in adults aged 15-85 presenting cervical spinal cord injury (CSCI) at one of 6 Austrian trauma centres participating in the Austrian Spinal Cord Injury Study (ASCIS). Neurological outcomes were measured using the American Spinal Injury Association Impairment Scale (AIS) grade according to the international standards for neurological classification of spinal cord injury (ISNCSCI) form after at least 6 months of follow-up (FU)...
July 6, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28678026/transoral-closed-reduction-of-fixed-atlanto-axial-rotatory-subluxation-aars-in-childhood-and-adolescence
#17
Dezsoe Jeszenszky, Tamas Fekete, Frank Kleinstück, Daniel Haschtmann, Markus Loibl
Atlanto-axial rotatory-subluxation (AARS) is the most common pediatric cervical spine injury. Patients usually present with contralateral rotation and inclination of the upper cervical spine after minor trauma, or associated with an infection of the upper respiratory tract. According to the authors, initial management of patients with acute and chronic AARS type I-II should comprise closed reduction and immobilization with a cervical collar or a Halo-Body-Jacket. Surgical options of open reduction or C1/2 fusion should be restricted to irreducible or recurrent subluxations...
July 3, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28670403/risk-factors-for-failure-of-nonoperative-treatment-for-unilateral-cervical-facet-fractures
#18
Carola Francisca van Eck, Mitchell Stephen Fourman, Amir Mohamad Abtahi, Louis Alarcon, William Fielding Donaldson, Joon Yung Lee
STUDY DESIGN: Retrospective clinical study. PURPOSE: The purpose of this study was to determine what percentage of patients who underwent nonoperative management of unilateral non-displaced or minimally displaced facet fractures progressed radiographically and to determine what percentage of patients required surgical intervention and to identify risk factors for failure of conservative management. OVERVIEW OF LITERATURE: According to most commonly used classification systems, unilateral, non-and minimally displaced facet fractures are be amendable to nonoperative management...
June 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28666040/internal-carotid-artery-dissection-after-indirect-blunt-cervical-trauma-in-an-ice-hockey-goaltender
#19
Ryan M Degen, Matthew E Fink, Lisa Callahan, Kenton Fibel, Jim Ramsay, Bryan T Kelly
Internal carotid artery dissections are rare injuries that can result from both direct cervical trauma and indirect trauma causing sudden cervical hyperextension. Depending on the magnitude of the dissection, clinical presentation ranges from neurologic symptoms, such as Horner syndrome, to relatively mild but persistent headache symptoms, as in the case reported in this article. High clinical suspicion with subsequent neuroimaging is recommended in similar clinical scenarios. Our patient, an ice hockey goaltender, was conservatively treated with rest and serial neuroimaging studies to ensure resolution of the dissection...
May 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28665242/changes-in-use-of-cervical-spine-magnetic-resonance-imaging-for-pediatric-patients-with-nonaccidental-trauma
#20
Ahyuda Oh, Michael Sawvel, David Heaner, Amina Bhatia, Andrew Reisner, R Shane Tubbs, Joshua J Chern
OBJECTIVE Past studies have suggested correlations between abusive head trauma and concurrent cervical spine (c-spine) injury. Accordingly, c-spine MRI (cMRI) has been increasingly used in radiographic assessments. This study aimed to determine trends in cMRI use and treatment, and outcomes related to c-spine injury in children with nonaccidental trauma (NAT). METHODS A total of 503 patients with NAT who were treated between 2009 and 2014 at a single pediatric health care system were identified from a prospectively maintained database...
June 30, 2017: Journal of Neurosurgery. Pediatrics
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