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Medico-legal spine

Michael J Moses, Jared C Tishelman, Saqib Hasan, Peter L Zhou, Ioanna Zevgaras, Justin S Smith, Aaron J Buckland, Yong Kim, Afshin Razi, Themistocles S Protopsaltis
STUDY DESIGN: Cross-Sectional Study. OBJECTIVE: The goal of this study is to investigate how surgeons differ in collar and narcotic use, as well as return to driving recommendations following cervical spine surgeries and the associated medico-legal ramifications of these conditions. SUMMARY OF BACKGROUND DATA: Restoration of quality of life is one of the main goals of cervical spine surgery. Patients frequently inquire when they may safely resume driving after cervical spine surgery...
March 9, 2018: Spine
Melvin C Makhni, Paul J Park, Jesus Jimenez, Comron Saifi, Jon-Michael Caldwell, Alex Ha, Bianca Figueroa-Santana, Ronald A Lehman, Mark Weidenbaum
BACKGROUND CONTEXT: Because of the limited and confidential nature of most legal data, scarce literature is available to physicians about reasons for litigation in spine surgery. To optimally compensate patients while protecting physicians, further understanding of the medicolegal landscape is needed for high-risk procedures such as spine surgery. Based on these, surgeons can explore ways to better protect both their patients and themselves. PURPOSE: To characterize the current medicolegal environment of spine surgery by analyzing a recent dataset of malpractice litigation...
February 2018: Spine Journal: Official Journal of the North American Spine Society
Luis E Aguerrevere, Matthew R Calamia, Kevin W Greve, Kevin J Bianchini, Kelly L Curtis, Veronica Ramirez
The Minnesota Multiphasic Personality Inventory (MMPI)-2 Restructured Form (MMPI-2-RF) has been shown to have clinical utility in the assessment of individuals with chronic pain (e.g., predicting surgical outcomes). The purpose of this study was to explore the ability of the MMPI-2-RF Validity Scales in profiling patients with chronic pain who had external financial incentive (e.g., workers' compensation claims) and determine the associations between Validity Scale response patterns and important outcomes. Cluster analysis identified 2 similarly sized clusters of patients with very different MMPI-2-RF profiles...
June 19, 2017: Psychological Assessment
Greger Lønne, Andrew J Schoenfeld, Thomas D Cha, Øystein P Nygaard, John Anker H Zwart, Tore Solberg
OBJECTIVES: There are no uniform guidelines regarding when to operate or the ideal surgical intervention in Lumbar Spinal Stenosis (LSS). Understanding the presence of practice-based variation between different localities is critical. We sought to compare patient-reported pre-operative pain, disability, and health-related quality of life as indications for surgery between Boston and Norway, and the use of decompression alone vs. decompression and arthrodesis. PATIENTS AND METHODS: This study included 3826 patients; 1886 from Boston and 1940 from Norway...
May 2017: Clinical Neurology and Neurosurgery
Robert S Quigley, Yusuf T Akpolat, Brent D Forrest, Montri D Wongworawat, Wayne K Cheng
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To review past cases and analyze them to determine whether reason for lawsuit led to a defense versus plaintiff verdict when patients sustain spinal cord injury. Secondary objectives included analyzing demographic factors and monetary awards for plaintiff verdicts and settlements. SUMMARY OF BACKGROUND DATA: Evaluating malpractice cases could provide valuable information for the physician who has been sued by a patient...
June 1, 2015: Spine
Padmaja Durga, Barada Prasad Sahu
Anaesthesiologists are often involved in the management of patients with cervical spine disorders. Airway management is often implicated in the deterioration of spinal cord function. Most evidence on neurological deterioration resulting from intubation is from case reports which suggest only association, but not causation. Most anaesthesiologists and surgeons probably believe that the risk of spinal cord injury (SCI) during intubation is largely due to mechanical compression produced by movement of the cervical spine...
November 2014: Indian Journal of Anaesthesia
Soner Sahin, Cem Atabey, Mehmet Simşek, Sait Naderi
BACKGROUND: Textile products commonly used in surgery (e.g., sponges or gauze) have been known to cause complications after spinal surgery. Associated complications usually arise months or even years after the primary surgery. In case of spine surgery, these bodies are often detected during neuroradiological evaluations to investigate reported back pain; however, this complication often remains asymptomatic. AIMS: The research is intended to increase awareness among both spinal surgeons and neuroradiologists of this potential complication...
December 2013: Balkan Medical Journal
Christian Worsfold
Whiplash injury medico-legal reporting has traditionally been focused upon identifying restrictions in range of motion and identifying the presence of tender areas in the cervical spine in an effort both to diagnose the condition and to offer a prognosis. There have been considerable advances in this field over the last decade however that calls into question such a diminutive approach. This paper reviews the contemporary evidence base for the medico-legal assessment of whiplash injury and identifies a body of literature that strongly implicates a Claimant's physiological and psychological stress response as a key medico-legal marker in predicting prognosis following whiplash injury...
July 2014: Journal of Forensic and Legal Medicine
Frederic Savall, Fabrice Dedouit, Norbert Telmon, Daniel Rougé
Candida albicans spondylodiscitis is a fungal infection of the spine which is still unusual in spite of the increasing frequency of predisposing factors. A 22-year-old man received an abdominal stab wound during a physical assault. Initial medical care included surgery, prolonged use of indwelling vascular catheters with administration of broad-spectrum antibiotics, and hospitalization in intensive care. Two months after the event, the victim experienced back pain in the right lumbar region and septic spondylodiscitis secondary to C...
March 2014: Journal of Forensic and Legal Medicine
Michael D Freeman, Anders Eriksson, Wendy Leith
Fatal falls often involve a head impact, which are in turn associated with a fracture of the skull or cervical spine. Prior authors have noted that the degree of inversion of the victim at the time of impact is an important predictor of the distribution of skull fractures, with skull base fractures more common than skull vault fractures in falls with a high degree of inversion. The majority of fatal fall publications have focused on skull fractures, and no research has described the association between fall circumstances and the distribution of fractures in the skull and neck...
January 2014: Journal of Forensic and Legal Medicine
Hrishikesh Pathak, Jaydeo Borkar, Pradeep Dixit, Shailendra Dhawane, Manish Shrigiriwar, Niraj Dingre
Fatalities due to attacks by tigers on humans are uncommon and are rarely described in the medico-legal literature. We herein present a forensic investigation in a unique case of a fatal tiger attack in the wild on a 35 year old female in India by an Indian Bengal tiger (Panthera tigris tigris). The attack resulted in two pairs of puncture wounds over the nape area with occult cervical spine injuries resulting from transfixing of spine due to the tiger canines; multiple puncture wounds, numerous scratches and abrasions consistent with the tiger claw injuries and injury to the right jugulocarotid vessels...
October 10, 2013: Forensic Science International
Ronit Gilad, Mona Boaz, Menachem Sadeh, Anda Eilam, Ron Dabby, Yair Lampl
Traumatic brain injury (TBI) is a major cause of seizures in the general population. Several studies have shown an increased risk of epilepsy after traumatic brain injury, depending on risk factors, such as severity and time post trauma. The aim of our study was to evaluate the appearance of late seizures after a very mild head trauma or whiplash injury. All patients admitted to the emergency room after a very mild head trauma or whiplash injury during 2008-2010 were evaluated prospectively within 24 hours of the event and followed up 1 year later for evaluation of seizure appearance...
March 15, 2013: Journal of Neurotrauma
Dean Girotto, Darko Ledić, Ines Strenja-Linić, Stanislav Peharec, Aron Grubesić
The predominance in performing surgery of major spine injuries by neurosurgeons usually has the consequence of treating all types of spine injuries by neurosurgeons - neurotraumatologists. In the neurosurgical wards of Clinical Hospital Rijeka, we take care of the majority of these patients, following both the major, as well as minor--whiplash injuries of the neck. This article is an overview of the patients admitted in the one year period (October 1st 2009-October 1st 2010) where 1077 cases of neck injuries were analyzed...
September 2011: Collegium Antropologicum
Evan W Matshes, Jeffrey Joseph
When patients die after chiropractic or surgical interventions of the cervical spine, pathologists tasked with the autopsy are frequently overwhelmed by the complicated anatomy, laborious dissections, complex operative procedures and surgical hardware, and the necessity to differentiate artifacts from trauma and disease. However, abundant data can be obtained from careful evaluation of the cervical spine in situ; extensive postmortem diagnostic imaging procedures; detailed dissections of the removed, formalin-fixed and decalcified spine; and histology...
January 2012: Journal of Forensic Sciences
Iwona Ptaszyńska-Sarosiek, Anna Niemcunowicz-Janica, Magdalena Okłota, Zofia Wardaszka, Adam Sackiewicz, Michał Szeremeta
Opinionating in civil proceeding is difficult and carries much responsibility, especially in the period of increasing claiming for damages. The authors analyzed civil opinions issued by the Forensic Medicine Department, Medical University of Białystok, in the years 2004-2008. The above-mentioned opinions addressed neurologic diseases and symptoms. The victims were invited to the Department for examinations which were performed by a forensic medicine expert and a neurologist, alternatively also by other specialists depending on the reported ailments...
April 2010: Archiwum Medycyny Sa̧dowej i Kryminologii
Koichi Terazawa
Based on my personal experience publishing case reports on blunt injuries, I hereby focus on issues that have recently come to my attention. 1. Abrasions: 1) As to whether they occurred ante-mortem or post-mortem; those reddish in color cannot always have occurred antemortem. When they overlap with reddish (-purple) discoloration, as in hypostasis, post-mortem abrasions look reddish as well. Abrasions larger than the tip of the finger or the palm of the hand are often seen post-mortem and are thought to occur due to the touching of putrefied skin post-mortem...
December 2010: Nihon Hōigaku Zasshi, the Japanese Journal of Legal Medicine
Lars Uhrenholt, Lene W T Boel
Injuries to the upper cervical spine (UCS) are common in traumatic deaths and postmortem computed tomography (PMCT) may contribute to the forensic investigation. This study presents PMCT in comparison with autopsy in the examination of UCS injury. Thirteen consecutive cases with UCS fracture and ⁄ or cranio-cervical dislocation were examined with PMCT and autopsy, and the findings were correlated. Neither of the techniques identified all UCS injuries. Fractures of atlas and axis were best visualized with PMCT whereas cranio-cervical dislocation was better identified during autopsy...
November 2010: Journal of Forensic Sciences
Nancy E Epstein
BACKGROUND: To determine whether patients who become quadriplegic following cervical spine surgery are adequately compensated by our present medico-legal system. The outcomes of malpractice suits obtained from Verdict Search (East Islip, NY, USA), a medico-legal journal, were evaluated over a 20-year period. Although the present malpractice system generously rewards many quadriplegic patients with substantial settlements/ Plaintiffs' verdicts, a subset receive lesser reimbursements (verdicts/settlements], while others with defense verdicts receive no compensatory damages...
2010: Surgical Neurology International
Audrey Farrugia, Jean-sébastien Raul, Annie Géraut, Bertrand Ludes
Ricochet of a bullet in the spinal canal is well known by neurosurgeons but relatively not a common event in usual medico-legal autopsy practice. This article presents a homicide case of a penetrating gunshot injury of the lumbar spine through the T12-L1 intervertebral foramen with active movement of the projectile within the spinal canal to the L5-S1 level. This case illustrates a bullet intradural and intramedullary active movement because of a ricochet of the body of T12 with active redirection of the path...
September 2010: Journal of Forensic Sciences
Sławomir Majdanik, Wiesława Orowicz, Krzysztof Borowiak, Barbara Potocka-Banaś
INTRODUCTION: Carbon monoxide intoxications mainly occur as a result of fires in houses and failures of heating systems. Case of fatal accident involving a charcoal factory worker is described in this paper. MATERIAL AND METHODS: Authors based on a medico-legal autopsy protocol and material collected in prosecutor files. Medico-legal autopsy of a 46 year old male was performed in the forensic medicine department. Interlocutory proceedings indicated that the immediate cause of death was a head-crush caused by a hydraulic cover...
2007: Annales Academiae Medicae Stetinensis
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