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C1-2 injuries

Panupol Rajinda, Sirisomboon Towiwat, Piyawat Chirappapha
PURPOSE: To compare the clinical and radiological outcomes of posterior atlantoaxial fixation and fusion using C1 lateral mass-C2 pedicle screws (screw-rod constructs, SRC) with C1-C2 transarticular screws (TAS). METHODS: A retrospective review was conducted of 105 patients with atlantoaxial instability who underwent posterior C1-C2 fixation and fusion by SRC group (60 pt) and TAS group (45 pt). The follow-up period was minimum 2 years. Clinical outcomes measurements included the Numeric Rating Scale (NRS) for pain assessment, the Neck Disability Index (NDI), the Japanese Orthopedic Association (JOA) score and the American Spinal Injury Association (ASIA) impairment scale for the functional and neurological outcomes that were assessed...
October 22, 2016: European Spine Journal
Efe Levent Aras, Cody Bunger, Ebbe Stender Hansen, Rikke Søgaard
BACKGROUND AND PURPOSE: There is a lack of evidence on the broad health-care costs of treating spine trauma patients without neurological deficits conservatively. The aim of the present study was to estimate the primary and secondary health-care sector costs associated with conservative treatment of spine fractures as well as their determinants. METHODS: Patients were identified between 1999 and 2008 in the hospital's administrative system based on relevant diagnostic codes...
October 21, 2016: European Spine Journal
Lisa K Schroder, Erich M Gauger, Jeffrey A Gilbertson, Peter A Cole
BACKGROUND: This study's purpose was to assess patient-based functional outcomes following open reduction and internal fixation (ORIF) of displaced scapular body and glenoid neck fractures. This series represents a 9-year experience at a level-I trauma center and referral destination for this injury. METHODS: A database was established to record surgical and functional outcomes of scapular fractures treated with ORIF. For this report, the cases of all patients who had a glenoid neck or scapular body fracture (AO/OTA 14-A3 or 14-C1) without intra-articular involvement were reviewed...
October 5, 2016: Journal of Bone and Joint Surgery. American Volume
Jinrong Fu, Furong Guo, Cheng Chen, Xiaoman Yu, Ke Hu, Mingjiang Li
The optimal treatment for chronic intermittent hypoxia (CIH)-induced cardiovascular injuries has yet to be determined. The aim of the current study was to explore the potential protective effect and mechanism of a C1 inhibitor in CIH in the myocardium. The present study used a rat model of CIH in which complement regulatory protein, known as C1 inhibitor (C1INH), was administered to the rats in the intervention groups. Cardiomyocyte apoptosis was detected by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling...
October 2016: Experimental and Therapeutic Medicine
Friso de Beer, Wim Lagrand, Gerie J Glas, Charlotte J P Beurskens, Gerard van Mierlo, Diana Wouters, Sacha Zeerleder, Joris J T H Roelofs, Nicole P Juffermans, Janneke Horn, Marcus J Schultz
Complement activation plays an important role in the pathogenesis of pneumonia. We hypothesized that inhibition of the complement system in the lungs by repeated treatment with nebulized plasma-derived human C1-esterase inhibitor reduces pulmonary complement activation and subsequently attenuates lung injury and lung inflammation. This was investigated in a rat model of severe Streptococcus pneumoniae pneumonia. Rats were intra-tracheally challenged with S. pneumoniae to induce pneumonia. Nebulized C1-esterase inhibitor or saline (control animals) was repeatedly administered to rats, 30 min before induction of pneumonia and every 6 h thereafter...
September 28, 2016: Cell Biochemistry and Biophysics
K Chan, K Guy, G Shah, J Golla, H M Flett, J Williams, K E Musselman
STUDY DESIGN: This is a retrospective chart review. OBJECTIVES: The objective of this study was to evaluate the convergent validity, internal consistency and use of the Community Balance & Mobility Scale (CB&M) in individuals with incomplete spinal cord injury (iSCI) during inpatient rehabilitation. SETTING: This study was conducted in an SCI rehabilitation center in Canada. METHODS: Inpatient charts from January 2009 to October 2015 were screened...
September 27, 2016: Spinal Cord
Sophie Jörgensen, Susanne Iwarsson, Jan Lexell
BACKGROUND: Many individuals with a spinal cord injury (SCI) have lived several decades with their injury, leading to a need for a deeper understanding of factors associated with healthy aging in people with long-term SCI. OBJECTIVES: To (1) describe secondary health conditions, activity limitations, and life satisfaction in older adults with long-term SCI, and to (2) investigate how sociodemographics, injury characteristics, and secondary health conditions are associated with their activity limitations and life satisfaction...
September 17, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Pravin Padalkar
UNLABELLED: Atlantoaxial rotatory fixation (AARF) is a rare condition and delayed diagnosis. We report a case of chronic neglected atlantoaxial rotatory subluxation in adolescence child that was treated by serial skull traction followed by posterior fusing by method pioneered by Goel et al. A 15-year-old male presented with signs of high cervical myelopathy 2 years after trauma to neck childhood. There was upper cervical kyphosis, direct tenderness over C2 spinous process, atrophy of both hand muscles with weakness in grip strength...
July 2016: Journal of Craniovertebral Junction and Spine
P Vaněk, Ondřej Bradáč, P de Lacy, R Konopková, J Lacman, V Beneš
There are numerous indications for stabilization using instrumentation of the upper cervical spine. This area is comprised of sophisticated anatomy. There is no study describing bony and vascular anomalies of this area in the middle European population. The main aim of this study was to investigate prevalence of any vertebral artery (VA) variations and osseous anomalies in the region of the craniocervical junction in a large sample of Czech patients based on three-dimensional computed tomographic angiography (3D CTA)...
September 13, 2016: Neurosurgical Review
Oluwaseun O Akinduro, Griffin R Baum, Brian M Howard, Gustavo Pradilla, Jonathan A Grossberg, Gerald E Rodts, Faiz U Ahmad
BACKGROUND: Iatrogenic vascular injury is a feared complication of posterior atlanto-axial instrumentation. A better understanding of clinical outcome and management options following this injury will allow surgeons to better care for these patients. The object of the study was to systematically review the neurologic outcomes after iatrogenic vascular injury during atlanto-axial posterior instrumentation. METHODS: We performed a systematic review of the Medline database following PRISMA guidelines...
November 2016: Clinical Neurology and Neurosurgery
A Schäffler, B König, B Feinauer, T Freude, U Stöckle, F Stuby
Introduction: Pelvic ring injuries occur in 3-8 % of patients with fractures. They are rare, with an annual incidence of only 19-37 per 100,000 people annually. There have been publications on the generation of these injuries, as well as their diagnosis and treatment concepts, but there is little information on how these injuries impact the ability to work. Patients: The study covered all hospitalised patients between January 2003 and December 2011 with a pelvic ring injury, who had already been included in the data collection of the AG Becken III and who had had a work-related accident...
September 9, 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Lang Li, Feng Gao, Qi Huang, Qiang Li, Lin Xie, Bin Zhang
OBJECTIVE: To investigate midterm follow-up results on Asian femoral intramedullary nail in treating segmental and comminuted femoral fractures. METHODS: Between June 2011 and October 2012,16 patients with segmental and comminuted femoral fractures were treated with minimally invasive reset and Asian femoral intramedullary nail under extension table. Among them, there were 10 males and 6 females aged from 21 to 49 years old with an average of 34.5 years old; the time from injury to operation ranged from 3 to 24 d with an average of 9...
June 2016: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Loren B Mead, Paul W Millhouse, Jonathan Krystal, Alexander R Vaccaro
The atlas is subject to fracture under axial load, often due to traumatic injuries such as shallow dives and automobile accidents. These fractures account for 2-13 % of injuries to the cervical spine [Marcon RM et al. Clinics (Sao Paulo) 68(11):1455-61, 2013]. Fractures of the C1 vertebra are often difficult to diagnose, as there is often no neurological deficit or easily identifiable findings on radiographs. However, injuries to the atlas can be associated with vertebral artery injury and atlantoaxial or atlanto-occipital instability, making prompt and accurate diagnosis imperative...
September 2016: Current Reviews in Musculoskeletal Medicine
Michael Wild, Kai Fischer, Florian Hilsenbeck, Mohssen Hakimi, Marcel Betsch
INTRODUCTION: Anterior tension wiring using Kirschner wires (K-wires) is still considered the standard treatment for patella fractures, despite its high complication rate. The objective of this prospective clinical study was to evaluate intra- and perioperative complications as well as the clinical outcome of patients with patella fracture treated with a new developed bilateral, polyaxial, fixed-angle 2.7mm patella plate. PATIENTS AND METHODS: Between 2011 and 2014 all patients with a patella fracture were included in this prospective study and treated with a fixed-angle patella plate...
August 2016: Injury
Eduardo Martinez-Del-Campo, Jay D Turner, Leonardo Rangel-Castilla, Hector Soriano-Baron, Samuel Kalb, Nicholas Theodore
OBJECTIVE If left untreated, occipitocervical (OC) instability may lead to serious neurological injury or death. Open internal fixation is often necessary to protect the neurovascular elements. This study reviews the etiologies for pediatric OC instability, analyzes the radiographic criteria for surgical intervention, discusses surgical fixation techniques, and evaluates long-term postoperative outcomes based on a single surgeon's experience. METHODS The charts of all patients < 18 years old who underwent internal OC fixation conducted by the senior author were retrospectively reviewed...
June 10, 2016: Journal of Neurosurgery. Pediatrics
Zachary Child, Daniel Rau, Michael J Lee, Randall Ching, Richard Bransford, Jens Chapman, Carlo Bellabarba
BACKGROUND CONTEXT: Craniocervical dissociation is a rare but serious condition, and missed injuries have been associated with poor neurologic outcomes and deterioration. A fluoroscopic traction test is employed to interrogate the craniocervical ligaments when clinical and imaging findings are equivocal. However, no specific protocol or known parameters with respect to traction or force applied have been established. PURPOSE: This study sought to define the parameters of the radiographic traction test with sequential sectioning of the primary ligamentous restraints under controlled distraction of the craniocervical junction in a biomechanical model...
September 2016: Spine Journal: Official Journal of the North American Spine Society
Parvathi S Kumar, Haree K Pallera, Pamela S Hair, Magdielis Gregory Rivera, Tushar A Shah, Alice L Werner, Frank A Lattanzio, Kenji M Cunnion, Neel K Krishna
BACKGROUND: Acute hemolytic transfusion reactions have a broad clinical presentation from mild and transitory signs and symptoms to shock, disseminated intravascular coagulation, renal failure, and death. We have recently developed a rat model of acute intravascular hemolysis showing that the classical complement pathway mediates antibody-dependent hemolysis. The objective of this study was to evaluate the role of the classical pathway inhibitor peptide inhibitor of complement C1 (PIC1) in this animal model...
August 2016: Transfusion
Fei Chen, Yijun Kang, Haisheng Li, Guohua Lv, Chang Lu, Jing Li, Bing Wang, Weihua Chen, Zhehao Dai
STUDY DESIGN: Retrospective analysis of 16 patients. SUMMARY OF BACKGROUND DATA: The lumbar split fracture-dislocation is a rare but severe injury, which is type C1.2.1 fracture in the AO/ASIF spine fracture classification. The axial compressive and torsional force shattered the vertebral body into two halves and displaced them rotationally. This kind of fracture is so highly unstable that the treatment is very challenging. PURPOSE: The purpose of this study was to report and compare on clinical outcome and complications of patients with lumbar split fracture-dislocation which had been treated either short- or long-segment posterior fixation and anterior fusion...
June 3, 2016: Clinical Spine Surgery
S C Jordan, J Choi, J Kahwaji, A Vo
Therapeutic interventions aimed at the human complement system are recognized as potentially important strategies for the treatment of inflammatory and autoimmune diseases because there is often evidence of complement-mediated injury according to pathologic assessments. In addition, there are a large number of potential targets, both soluble and cell bound, that might offer potential for new drug development, but progress in this area has met with significant challenges. Currently, 2 drugs are approved aimed at inhibition of complement activation...
April 2016: Transplantation Proceedings
Hamed Aminiahidashti, Sajad Shafiee, Mohammad Sazegar, Nazanin Nosrati
INTRODUCTION: The abducent nucleus is located in the upper part of the rhomboid fossa beneath the fourth ventricle in the caudal portion of the pons. The abducent nerve courses from its nucleus, to innervate the lateral rectus muscle. This nerve has the longest subarachnoid course of all the cranial nerves, it is the cranial nerve most vulnerable to trauma. It has been reported that 1% to 2.7% of all head injuries are followed by unilateral abducent palsy, but bilateral abducent nerve palsy is extremely rare...
February 2016: Trauma Monthly
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