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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/28676461/cervical-burst-fracture-in-a-patient-with-contiguous-two-level-cervical-stand-alone-cages-a-case-report
#2
Rui Feng, Joshua Loewenstern, John Caridi
BACKGROUND: Cervical stand-alone interbody cages have seen increasingly wider use over the plate-and-screw construct in single-level anterior cervical discectomy and fusion (ACDF) in the treatment of cervical disc herniation and degenerative spondylotic conditions. Despite positive clinical outcomes, the efficacy and safety of using these devices in contiguous multi-level ACDF, however, has remained controversial. CASE DESCRIPTION: This report discusses a burst fracture seen as a complication in multi-level cervical stand-alone cage use...
July 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28662833/additional-vertebral-augmentation-with-posterior-instrumentation-for-unstable-thoracolumbar-burst-fractures
#3
Fu-Cheng Kao, Ming-Kai Hsieh, Chia-Wei Yu, Tsung-Ting Tsai, Po-Liang Lai, Chi-Chien Niu, Lih-Huei Chen, Wen-Jer Chen
BACKGROUND: To investigate the role of vertebral augmentation in kyphosis reduction, vertebral fracture union, and correction loss after surgical management of thoracolumbar burst fracture. DESIGN: Retrospective chart and radiographic review. SETTING: Level 1 trauma center. METHODS: The analysis included patients treated between April 2007 and June 2015, who received pedicle-screw-rod distraction and reduction within two days following acute traumatic thoracolumbar burst fracture with a load sharing score >6...
June 20, 2017: Injury
https://www.readbyqxmd.com/read/28660396/resolution-of-traumatic-vertebral-artery-dissection-and-occlusion-after-repositioning-and-posterior-c1-ring-osteosynthesis-of-a-displaced-jefferson-burst-fracture
#4
Andy Ottenbacher, Martin Bettag
A 70-year-old male sustained a Jefferson burst fracture with unilateral vertebral artery dissection and occlusion by displaced fragments. We performed reduction and posterior C1-ring osteosynthesis. We present a description of the intraoperative manual assessment of atlantoaxial stability. The vertebral artery was found with a good anterograde flow posteroperatively, and MRA showed reperfusion of the vessel. The patient was free of pain with preserved C1-C2 rotation after 6 weeks. Function-preserving posterior C1-ring osteosynthesis after reduction in a displaced Jefferson burst fracture complicated by vertebral artery dissection and occlusion may restore blood flow...
June 29, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28641907/is-fusion-superior-to-non-fusion-for-the-treatment-of-thoracolumbar-burst-fracture-a-systematic-review-and-meta-analysis
#5
Tao Lan, Yang Chen, Shi-Yu Hu, Ao-Lin Li, Xin-Jian Yang
OBJECTIVE: The purpose of this meta-analysis was to compare the efficacy and safety between patients with thoracolumbar burst fracture who underwent posterior fixation alone (non-fusion) and supplemented with fusion. METHODS: A comprehensive search of related literature was performed in PubMed, Embase and the Cochrane library. Clinical outcomes (LBOS and VAS), surgical outcomes (operation time, blood loss, hospital stay and perioperative complications), and radiographic outcomes (kyphotic angle, decreased vertebral body height and segmental motion) were assessed in the meta-analysis...
June 19, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28619021/treatment-of-thoracolumbar-burst-fractures-by-short-segment-pedicle-screw-fixation-using-a-combination-of-two-additional-pedicle-screws-and-vertebroplasty-at-the-level-of-the-fracture-a-finite-element-analysis
#6
Jen-Chung Liao, Weng-Pin Chen, Hao Wang
BACKGROUND: Traditional one-above and one-below four-screw posterior short-segment instrumentation is used for unstable thoracolumbar burst fractures. However, this method has a high rate of implant failure and early loss of reduction. The purpose of this study was to use finite element (FE) analysis to determine the effect of treating thoracolumbar burst fractures by short-segment pedicle screw fixation using a combination of two additional pedicle screws and vertebroplasty at the level of the fracture...
June 15, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28593092/aortic-injury-due-to-paragliding-a-case-report
#7
Kazuhiko Omori, Kei Jitsuiki, Takashi Majima, Ikuto Takeuchi, Toshihiko Yoshizaw, Kouhei Ishikawa, Hiromichi Ohsaka, Keiichi Tambara, Youichi Yanagawa
A 64-year-old male fell from an altitude of 10 m while paragliding after stalling due to the wind. The purpose of this case report is to describe the outcomes after multiple injuries sustained during a paragliding accident, including a potentially life-threating injury to the thoracic aorta. The subject sustained a bite wound on his tongue, injuries to his chest (left side) and back, and a right forearm deformity. Enhanced whole body computed tomography (CT) revealed fractures of the bilateral laminae of the second and third cervical bones, right first rib, the tenth thoracic vertebral body (compression type), second lumbar vertebral body (burst type) and the right radius, Other injuries included an injury to the thoracic aortic arch and the presence of intraabdominal fluid collection without perforation of the digestive tract...
June 2017: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/28571219/bi-pedicle-fixation-of-affected-vertebra-in-thoracolumbar-burst-fracture
#8
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/28538596/acute-and-hyper-acute-thoracolumbar-corpectomy-for-traumatic-burst-fractures-using-a-mini-open-lateral-approach
#9
William D Smith, Nick Ghazarian, Ginger Christian
STUDY DESIGN: Retrospective chart review. OBJECTIVE: The study purpose was to examine the feasibility of acute (<24 hours) and hyper-acute (<8 hours) treatment of thoracolumbar burst fractures to maintain or improve spinal injury scores. SUMMARY OF BACKGROUND DATA: Historically, treatment of spinal burst fractures within 24 hours from injury was considered an "acute" treatment timeframe. Patient polytrauma triage, multiple surgical specialty and hospital resource coordination affect time to treatment...
May 22, 2017: Spine
https://www.readbyqxmd.com/read/28350943/controversies-in-spinal-trauma-and-evolution-of-care
#10
James S Harrop, George N Rymarczuk, Alexander R Vaccaro, Michael P Steinmetz, Lindsay A Tetreault, Michael G Fehlings
Management of spinal trauma is a complex and rapidly evolving field. To optimize patient treatment algorithms, an understanding of and appreciation for current controversies and advancing technologies in the field of spinal trauma is necessary. Therefore, members of the AOSpine Knowledge Forum Trauma initiative used a modified Delphi method to compile a list of controversial issues and emerging technologies in the field of spinal trauma, and a list of the 14 most relevant topics was generated. A total of 45 440 manuscripts covering the breadth of spine and spinal trauma were initially identified...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28343026/comparison-of-unilateral-versus-bilateral-pedicle-screw-fixation-at-the-level-of-fracture-using-posterior-short-segment-pedicle-instrumentation-in-the-treatment-of-severe-thoracolumbar-burst-fractures
#11
Chao Sun, Xinhui Liu, Jiwei Tian, Guoping Guan, Hailong Zhang
BACKGROUND: Thoracolumbar burst fractures (TBFs) are often followed by bilateral pedicle screw fixation (BPSF) at the level of fracture using posterior short-segment pedicle instrumentation (SSPI). There has been increasing support for unilateral pedicle screw fixation (UPSF) in an attempt to reduce complications and costs. The aim of this study was to compare the clinical and radiologic results of UPSF versus BPSF at the level of fracture using SSPI in the treatment of severe TBFs. METHODS: The records of 42 consecutive patients with severe TBFs who underwent SSPI were divided into 2 groups according to the number of screws in the fracture level, including 20 patients (five screws) in UPSF group and 22 patients (six screws) in BPSF...
March 22, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28323709/single-stage-transpedicular-vertebrectomy-and-expandable-cage-placement-for-treatment-of-unstable-mid-and-lower-lumbar-burst-fractures
#12
Jong-Il Choi, Bum-Joon Kim, Sung-Kon Ha, Sang-Dae Kim, Dong-Jun Lim, Se-Hoon Kim
STUDY DESIGN: Retrospective clinical and radiographic study. OBJECTIVE: To examine the efficacy and safety of vertebrectomy and expandable cage placement by a single-stage posterior approach for unstable mid and lower lumbar burst fractures (below the L3). SUMMARY OF BACKGROUND DATA: Patients with unstable mid and lower lumbar burst fractures require surgical treatment to relieve pain, address paralysis, and stabilize the spine to prevent further segmental deformity...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28293752/acoustic-emission-signatures-during-failure-of-vertebra-and-long-bone
#13
Brian D Goodwin, Frank A Pintar, Narayan Yoganandan
Clinical classification of an injury has traditionally involved medical imaging, patient history, and physical examination. The pathogenesis or process of injury has been viewed as a crucial component to estimating fracture stability and direct treatment. However, injury classification systems generally exclude pathogenesis and injury mechanisms because these components are often difficult to elucidate. Furthermore, the development of bone damage relative to the mechanical response is difficult to quantify, which limits the ability to define injury and develop injury criteria...
June 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28216750/early-results-of-thoraco-lumbar-burst-fracture-treatment-using-selective-corpectomy-and-rectangular-cage-reconstruction
#14
Bowei Liang, Guofeng Huang, Luobing Ding, Liangqi Kang, Mo Sha, Zhenqi Ding
BACKGROUND: Subsidence and late fusion are commonly observed in anterior subtotal corpectomy and reconstruction for treating thoracolumbar burst fractures. The subsidence rate of this surgical method was reported from 19.6% to 75% in the literatures, which would cause treatment failure. Thus, an improvement of anterior surgery technique should be studied to reduce these complications. MATERIALS AND METHODS: 130 patients of thoracolumbar burst fractures treated by minimal corpectomy, decompression and U cage, between January 2009 and December 2010 were included in this study...
January 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28178133/does-the-fracture-fragment-at-the-anterior-column-in-thoracolumbar-burst-fractures-get-enough-attention
#15
Luo Deqing, Lian Kejian, Li Teng, Zou Weitao, Lin Dasheng
Prospective cohort study. To evaluate whether failure of the fracture fragment at the anterior column reduction in thoracolumbar fracture has an influence on the final radiologic and clinical outcomes.Cervical teardrop fracture has caused wide concern in spinal surgery field. Although similar fracture fragment at the anterior column was also observed in thoracolumbar burst fractures, the conception of teardrop fracture in thoracolumbar fractures was rarely mentioned in the literature, let alone a study.Fifty patients who suffered from thoracolumbar burst fractures with a fracture fragment at the anterior column were prospectively analyzed...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28163505/the-association-between-sagittal-index-canal-compromise-loss-of-vertebral-body-height-and-severity-of-spinal-cord-injury-in-thoracolumbar-burst-fractures
#16
Mehmet Onur Yüksel, Mehmet Sabri Gürbüz, Şevki Gök, Numan Karaarslan, Merih İş, Mehmet Zafer Berkman
AIM: Our aim was to determine whether a combination of sagittal index (SI), canal compromise (CC), and loss of vertebral body height (LVBH) is associated with the severity of neurological injury in patients with thoracolumbar burst fractures. MATERIALS AND METHODS: Seventy-four patients with thoracolumbar burst fracture undergoing instrumentation between 2010 and 2015 were analyzed retrospectively. The degree of neurological injury was determined using the American Spinal Injury Association (ASIA) scoring system...
December 2016: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28138771/l5-corpectomy-the-lumbosacral-segmental-geometry-and-clinical-outcome-a-consecutive-series-of-14-patients-and-review-of-the-literature
#17
Martin Vazan, Yu-Mi Ryang, Julia Gerhardt, Felix Zibold, Insa Janssen, Florian Ringel, Jens Gempt, Bernhard Meyer
PURPOSE: We analyzed the lumbosacral segmental geometry and clinical outcome in patients undergoing L5 corpectomy. METHODS: Fourteen consecutive patients who underwent L5 (n = 12) or L4 + 5 (n = 2) corpectomy at our department between January 2010 and April 2015 were included. All patients underwent a baseline physical and neurologic examination on admission. The diagnostic routine included MRI and CT scans and, if possible, an upright X-ray of the lumbar spine before and after surgery...
June 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28120091/emg-guided-percutaneous-placement-of-cement-augmented-pedicle-screws-for-osteoporotic-thoracolumbar-burst-fractures
#18
Domenico Gerardo Iacopino, Francesco Certo, Francesca Graziano, Luigi Basile, Carlo Gulì, Massimiliano Visocchi, Alfredo Conti, Rosario Maugeri
BACKGROUND: Percutaneous techniques have increasingly gained popularity in recent years. The application of technological innovation, including neuromonitoring techniques, has the potential to increase the safety and efficacy of these procedures. METHODS: Thirty patients suffering from osteoporotic dorsolumbar burst fracture were prospectively enrolled in this study. The patients underwent percutaneous fenestrated pedicle screw fixation augmented with polymethylmethacrylate (PMMA) injection...
2017: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/28116138/dural-penetration-caused-by-a-vertebral-bone-fragment-in-a-lumbar-burst-fracture-a-case-report
#19
Chikara Ushiku, Kota Suda, Satoko Matsumoto, Miki Komatsu, Masahiko Takahata, Norimasa Iwasaki, Akio Minami
INTRODUCTION: This case report describes an unusual case of lumbar burst fracture in which a bone fragment from the vertebral body penetrated into the dorsal dura through the ventral dura mater, requiring bone fragment extraction via an intradural approach. CASE PRESENTATION: A 23-year-old male involved in a motor vehicle accident was admitted to our hospital complaining of right leg paresis and bladder-bowel disorder. Computed tomography (CT) revealed an L5 burst fracture of type B by the Denis classification scheme, with a bone fragment from the vertebral body that had perforated the ventral aspect of the dura mater and penetrated dorsally...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28101655/percutaneous-vertebral-augmentation-in-fragility-fractures-indications-and-limitations
#20
REVIEW
O Gonschorek, S Hauck, T Weiß, V Bühren
INTRODUCTION: There is still no general consensus about the management of osteoporotic vertebral fractures. Recommendations depend on type of fracture, grade of instability, bone quality, and general conditions of the patient. Spontaneous fractures may be considered to be treated different compared to cases with high-velocity trauma. METHODS: According to the DVO, patients without trauma should first be treated conservatively. However, there is no more strict time protocol of 3 or 6 week conservative treatment before operations may be indicated...
February 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
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