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JOURNAL ARTICLE
Ikuo Kawashita, Wataru Fukumoto, Hidenori Mitani, Keigo Narita, Keigo Chosa, Yuko Nakamura, Masataka Nagao, Kazuo Awai
PURPOSE: The accurate age estimation of cadavers is essential for their identification. However, conventional methods fail to yield adequate age estimation especially in elderly cadavers. We developed a deep learning algorithm for age estimation on CT images of the vertebral column and checked its accuracy. METHOD: For the development of our deep learning algorithm, we included 1,120 CT data of the vertebral column of 140 patients for each of 8 age decades. The deep learning model of regression analysis based on Visual Geometry Group-16 (VGG16) was improved in its estimation accuracy by bagging...
April 7, 2024: Legal Medicine
#2
JOURNAL ARTICLE
Isabella L Pecorari, Vijay Agarwal
BACKGROUND: Neurosurgeons face particularly high rates of litigation compared to physicians in other fields. Malpractice claims are commonly seen after mismanagement of life-threatening medical emergencies, such as epidural haematomas. Due to the lack of legal analysis pertaining to this condition, the aim of this study is to identify risk factors associated with litigation in cases relating to the diagnosis and treatment of epidural haematomas. MATERIALS AND METHODS: Westlaw Edge, an online database, was used to analyze malpractice cases related to epidural haematomas between 1986 and 2022...
April 2024: Annals of Medicine and Surgery
#3
JOURNAL ARTICLE
Christian Schyma, Matthias Berthold
Contact shots to the head often leave behind biological traces inside firearm barrels, a phenomenon of great forensic interest. Until now, the visualization and preservation of these traces presented a significant challenge, lacking a reliable method. This study addresses this gap by searching for a suitable method to extract the traces within a casting. Using alginate or gelatine as suitable materials, the results were hampered by serious adhesion issues and their extraction out of the firearm barrel was impeded...
March 23, 2024: International Journal of Legal Medicine
#4
JOURNAL ARTICLE
Matteo Lorenzoni, Francesco Baldisser, Giovanna Del Balzo, Dario Raniero, Francesco Ausania
Vehicle-assisted ligature strangulation is an extremely rare suicide method. We report a case of a 43-year-old man who secured one end of a nylon rope to a tree and the other end around his neck, then got inside his vehicle and stepped on the gas, leading to an incomplete decapitation. A sharply demarcated encircling ligature mark was found upon external examination, along with a deep laceration in the anterior region of the neck. The severance plane passed between the third and fourth cervical vertebrae, with diffuse haemorrhagic infiltration of the cervical muscles, in accordance with autopsy findings reported in the literature...
December 21, 2023: Legal Medicine
#5
JOURNAL ARTICLE
Luis Azmitia, Simone Grassi, Francesco Signorelli, Laura Filograna, Vincenzo Pascali, Alessandro Olivi, Massimiliano Visocchi, Antonio Oliva
In forensic investigations, the limitations of the traditional purely autoptic approach can be overcome through post-mortem imaging (virtopsy). Virtospy has several applications to the investigation of brain and spinal injuries, whose analysis can be of forensic interest, especially in cases of suspected malpractice. In this scoping review, we briefly describe the main applications of the two most common post-mortem radiological techniques (computed tomography (CT) and magnetic resonance imaging (MRI)) to the forensic investigation of brain and spinal injuries in cases of medical malpractice or traumatic (accidental/homicidal/suicidal) deaths...
2023: Acta Neurochirurgica. Supplement
#6
JOURNAL ARTICLE
Rainer Braunschweig, Daniela Kildal, Michael Meyer-Clement, Rolf Janka, Andreas Tiemann
BACKGROUND: Occupationally related limitations of earning capacity can be recognized under social legislation and may be subject to compensation ("reduction in earning capacity"). For this purpose, legislators have defined a list of occupational diseases ("BK list"). Recognition of an occupational disease requires a legal assessment procedure based on a medical appraisal. The aim of the assessment is to prove the "causality" and the "causality giving rise to liability". METHOD: In addition to clinical findings and workplace analyses, imaging methods (projection radiography, MRI) are primarily used to substantiate liability...
December 21, 2023: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
#7
REVIEW
J Li, L Gössel, B Kunze, O Kessler, Y Alharbi, O Gärtner, V A Mihalca, S Krebs, M Dreimann
INTRODUCTION: Traumatic lumbar disc herniation (TLDH) without fracture in the in-situ motion segment is a rare occurrence compared with degenerative herniation. RESEARCH QUESTION: This study provides a systematic discussion of various aspects related to the diagnosis of TLDH. MATERIAL AND METHODS: This review includes 12 cases of TLDH with MR-images since 2009 published in the PubMed and one adjunct illustration. The cases were categorized into two groups for a comprehensive analysis, TLDH with or without in-situ segment fracture...
2023: Brain Spine
#8
JOURNAL ARTICLE
Christy Lana Davidson, Johan de Klerk, Zina Matejovsky, Inger Fabris-Rotelli, Andre Uys
INTRODUCTION: The anterior nasal spine is a pointed, midline projection of the maxilla. This bony structure dictates the overlying soft tissues providing the phenotypic features of the nose and upper lip and determines the differences in the mid-face morphology. Little data is available on the metric features of the Anterior nasal spine (ANS). This study aimed to perform metric evaluations of the ANS of white and black South African males and females to ascertain if morphological variations exist and if the differences are viable for the use in sex and population identification...
November 27, 2023: International Journal of Legal Medicine
#9
JOURNAL ARTICLE
Ryohei Saito, Shunsuke Fujibayashi, Takayoshi Shimizu, Koichi Murata, Bungo Otsuki, Eijiro Onishi, Shuichi Matsuda, Tadashi Yasuda
BACKGROUND: Wrong-level spine surgery is a rare but serious complication of spinal surgery that increases patient harm and legal risks. Although such surgeries have been reported by many spine surgeons, they have not been adequately investigated. Therefore, this study aimed to examine the causes and preventive measures for wrong-level spine surgeries. METHODS: This study analyzed cases of wrong-level spine surgeries from 10 medical centers. Factors such as age, sex, body mass index, preoperative diagnosis, surgical details, surgeon's experience, anatomical variations, responses, and causes of the wrong-level spine surgeries were studied...
November 22, 2023: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
#10
JOURNAL ARTICLE
Hania Shahzad, Maximillian Lee, Vikas Munjal, Cole Veliky, Elizabeth Yu
» Cannabinoids, such as D9-tetrahydrocannabinol and cannabidiol, interact with endocannabinoid receptors in the central nervous system and immune system, potentially offering pain relief. The entourage effect, resulting from the interaction of multiple cannabis components, may enhance therapeutic impact and efficacy, making them promising candidates for exploring pain relief in spine operations, known to be among the most painful operative procedures.» The use of cannabinoids in pain management requires careful consideration of safety, including their cognitive and psychomotor effects, potential cardiovascular risks, risk of dependence, mental health implications, and drug interactions...
November 1, 2023: JBJS Reviews
#11
JOURNAL ARTICLE
Nicholas Dietz, Victoria Alkin, Nitin Agarwal, Mayur Sharma, Brent Garrison Oxford, Dengzhi Wang, Beatrice Ugiliweneza, Jersey Mettille, Maxwell Boakye, Doniel Drazin
STUDY DESIGN: Retrospective cohort. OBJECTIVE: To identify differences in complication rates following cervical and lumbar fusion over the first postoperative year between those with and without cannabis use disorder (CUD) and to assess how CUD affects opioid prescription patterns. SUMMARY OF BACKGROUND DATA: Cannabis is legal for medical purposes in 36 states and recreational use in 18 states. Cannabis has multisystem effects and may contribute to transient vasoconstrictive, pro-thrombotic, and inflammatory effects...
November 10, 2023: Spine
#12
JOURNAL ARTICLE
James Paul Agolia, Ekkehard M Kasper
Wrong-level spine surgery, in which an operation is performed at a vertebral level different from the intended one, is a rare but serious complication with wide-ranging medical and legal effects. Although many protocols have been developed to prevent such a serious unfavorable event, the problem has not yet been eliminated. Research into the effectiveness of strategies to prevent wrong-level spine surgery is lacking. Herein, we describe a case of 44-year-old woman presented with neck pain and bilateral upper extremity weakness and numbness...
2023: Acta Neurochirurgica. Supplement
#13
JOURNAL ARTICLE
Jacob Silver, Colin Pavano, Nicholas Bellas, Cory Hewitt, Barrett Torre, Mathew Solomito, Regina Kostyun, Sean Esmende
BACKGROUND: Recently, there has been increasing legalization of marijuana within the United States, however data are mixed with respect to its efficacy in treating acute pain. Our goal was to identify a difference in opioid utilization in patients with known cannabis use before anterior cervical discectomy and fusion (ACDF) compared with those that report no cannabis use. METHODS: This study was a retrospective case-control design using PearlDiver. Patients who underwent a single level ACDF between January 2010 and October 2020, were included...
June 2023: N Am Spine Soc J
#14
MULTICENTER STUDY
Xu Tao, Abhijith V Matur, Syed Khalid, Geet Shukla, Phillip Vorster, Kelly Childress, Rebecca Garner, Justin Gibson, Daryn Cass, Juan C Mejia Munne, Kyle McGrath, Natalie Ivey, Julia Garcia-Vargas, Andrew Wu, Seth Street, Jay Mehta, Louisa Onyewadume, Henry O Duah, Benjamin Motley, Joseph S Cheng, Owoicho Adogwa
STUDY DESIGN: This was a retrospective cohort study. OBJECTIVE: To compare the rates of pseudarthrosis in patients undergoing 1 to 3 level transforaminal lumbar interbody fusion (TLIF) procedures between cannabis users and noncannabis users. SUMMARY OF BACKGROUND DATA: Recreational use of cannabis is common, though it remains poorly studied and legally ambiguous in the United States. Patients with back pain may turn to adjunctive use of cannabis to manage their pain...
March 15, 2024: Spine
#15
JOURNAL ARTICLE
Francesco Costa, Carla Daniela Anania, Umberto Agrillo, Assietti Roberto, Bernucci Claudio, Bistazzoni Simona, Bongetta Daniele, Brembilla Carlo, Cappelletto Barbara, Cocciaro Ardico, Costella Giovanni Battista, De Falco Raffaele, De Rosa Andrea, Del Vecchio Carlo, Dobran Mauro, Fiorenza Vito, Garbossa Diego, Guizzardi Giancarlo, Iaccarino Corrado, Irace Claudio, Incerti Michele, Gualtiero Innocenzi, Landi Alessandro, Lastrucci Giancarlo, Maida Giuseppe, Mastrantuoni Ciro, Maugeri Rosario, Meglio Vincenzo, Montemurro Nicola, Nina Pierpaolo, Parlangeli Andrea, Pinna Giovanni, Pretti Pier Federico, Rapanà Armando, Ricci Alessandro, Rispoli Rossella, Romoli Stefano, Per Filippo Sbaffi, Somma Teresa, Tessitore Enrico, Vitali Matteo, Alberto Zerbi, Zona Gianluigi, Andrea Barbanera
Cervical spondylotic myelopathy (CSM) is a progressively growing pathology to afford by a spinal surgeon due to the aging of the population, associated with better treatment management and the best diagnosis and treatment solutions are greatly discussed. Nowadays that scientific literature is progressively increasing to identify the gold standard in diagnosis and treatment can be very challenging. This is particularly evident in spinal surgery with many different indications not only in different countries but also in the same local reality...
June 2023: Neurospine
#16
JOURNAL ARTICLE
Haruki Fukuda, Akira Hayakawa, Hiroyuki Tokue, Yoichiro Takahashi, Yoshihiko Kominato, Rie Sano
With the widespread use of postmortem computed tomography (PMCT) beside forensic autopsies for investigation of causes of death, three-dimensional (3D) reconstruction and fusion imaging using PMCT data are now becoming common. In the present study, the applicability of virtual reassembly from PMCT data was investigated in three cases involving fragmentation of the skull or spine due to high-energy trauma, as in such cases it is sometimes difficult to obtain detailed information on fractures using macroscopic observation alone...
June 7, 2023: Legal Medicine
#17
JOURNAL ARTICLE
Muyibat A Adelani, Zachery Hong, Anna N Miller
INTRODUCTION: Orthopaedic surgery is one of the most cited specialties among legal claims. Malpractice lawsuits are financially burdensome, increase defensive practices, and incur a notable emotional toll on defendants. We sought to determine the effect of malpractice lawsuits on professional well-being and self-reported medical errors among orthopaedic surgeons. METHODS: We surveyed 305 members of the American Orthopaedic Association to collect information on experiences with medical malpractice lawsuits, demographic and practice characteristics, professional well-being on the Professional Fulfillment Index, and self-reported medical errors...
June 12, 2023: Journal of the American Academy of Orthopaedic Surgeons
#18
JOURNAL ARTICLE
Dong Hu, Huawei Liu, Songhua Xiao
OBJECTIVE: The aim of this study was to analyze the characteristics of alleged medical malpractice litigation involving spine surgery in Beijing between 2013 and 2018. METHODS: Two online legal databases, Wusong and Weike, were queried for court verdicts involving spine surgery from January 2013 to December 2018 in Beijing. For all included cases, data pertaining to defendants, plaintiffs, case outcomes, allegations, and verdicts were abstracted, and descriptive analyses were performed...
May 3, 2023: World Neurosurgery
#19
Prasad Krishnan
Paraspinal textilomas are dreaded complications of spinal surgery and rarely reported in view of the medico-legal problems they may create. As many of them are asymptomatic and most are unreported, their true incidence is unknown. They must be kept in mind when re-operating for any mass lesion seen on magnetic resonance imaging in the vicinity of a previously operated spine. We present the case of a 40-year-old man found to have a textiloma as a result of a previous surgery, describe his imaging and histological findings, discuss the causes that might lead to the same, and enumerate preventive strategies to avoid such a complication...
March 2023: Asian Journal of Neurosurgery
#20
JOURNAL ARTICLE
Camilla Bernardinangeli, Carolina Giannace, Simone Cerciello, Vincenzo M Grassi, Maria Lodise, Giuseppe Vetrugno, Fabio De-Giorgio
The number of legal disputes in the field of medical liability has increased exponentially in the last decades. The aim of this study is to investigate the outcomes of criminal cases against healthcare professionals in Italian criminal courts. The hypothesis is that the majority of cases are dismissed and/or most professionals in these cases are acquitted. This retrospective analysis considers criminal proceedings related to medical professional liability registered with the general register of crime reports of the Public Prosecutor's Office of Rome in the time interval between 1 January 2000 and 31 December 2015...
March 28, 2023: Healthcare (Basel, Switzerland)
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