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Delayed c-spine evaluation

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https://www.readbyqxmd.com/read/29145343/anterior-release-and-nonstructural-bone-grafting-and-posterior-fixation-for-old-lower-cervical-dislocations-with-locked-facets
#1
Chen Ding, Ting-Kui Wu, Quan Gong, Tao Li, Li-Tai Ma, Bei-Yu Wang, Yu-Xiao Deng, Hao Liu
Lower cervical dislocations are often missed at the time of initial injury for several reasons. The treatment of old facet dislocations of the lower cervical spine is difficult, and the optimal method has not been established. The objective of the present study was to evaluate the clinical outcomes of a surgical technique, anterior release, and nonstructural bone grafting combined with posterior fixation, for the treatment of old lower cervical dislocations with locked facets.This was a retrospective study of 17 patients (13 men and 4 women) with old facet dislocations, who underwent the same surgical treatment at our hospital between April 2010 and January 2016...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28904564/the-role-of-pre-reduction-mri-in-the-management-of-complex-cervical-spine-fracture-dislocations-an-ongoing-controversy
#2
Sergiu Botolin, Todd F VanderHeiden, Ernest E Moore, Herbert Fried, Philip F Stahel
BACKGROUND: Cervical spine fracture-dislocations in neurologically intact patients represent a surgical challenge due to the risk of inflicting iatrogenic spinal cord compression by closed reduction maneuvers. The use of MRI for early advanced imaging in these injuries remains controversially debated. CASE PRESENTATION: A 54-year old man sustained a fall over the handlebars of his racing bicycle. The helmeted patient sustained a fall on his head which resulted in a hyperflexion injury of the neck...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28893299/risk-for-surgical-complications-after-previous-stereotactic-body-radiotherapy-of-the-spine
#3
Johannes Roesch, John B C Cho, Daniel K Fahim, Peter C Gerszten, John C Flickinger, Inga S Grills, Maha Jawad, Ronald Kersh, Daniel Letourneau, Frederick Mantel, Arjun Sahgal, John H Shin, Brian Winey, Matthias Guckenberger
OBJECT: Stereotactic body radiotherapy (SBRT) for vertebral metastases has emerged as a promising technique, offering high rates of symptom relief and local control combined with low risk of toxicity. Nonetheless, local failure or vertebral instability may occur after spine SBRT, generating the need for subsequent surgery in the irradiated region. This study evaluated whether there is an increased incidence of surgical complications in patients previously treated with SBRT at the index level...
September 11, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28816877/fractures-in-spinal-ankylosing-disorders-a-narrative-review-of-disease-and-injury-types-treatment-techniques-and-outcomes
#4
Tarush Rustagi, Doniel Drazin, Cumhur Oner, Jonathan York, Gregory D Schroeder, Alexander R Vaccaro, Rod J Oskouian, Jens R Chapman
INTRODUCTION: Spinal ankylosing disorders encompass ankylosing spondylitis (AS), disseminated hyperostosis of the spine, and end-stage spondylosis. All these result in a stiffened and frequently deformed spinal column. This makes the spinal column highly susceptible to severe injuries that are commonly associated with unfavorable outcomes. Improved understanding of the underlying disease processes and clinical comorbidities may alter the poor injury related morbidity and mortality outcomes...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28811992/analysis-of-the-literature-on-cervical-spine-fractures-in-ankylosing-spinal-disorders
#5
REVIEW
Sebastian Hartmann, Anja Tschugg, Christoph Wipplinger, Claudius Thomé
STUDY DESIGN: Narrative literature review. OBJECTIVE: The numbers of low-energy cervical fractures seen in patients suffering from ankylosing spondylitis (also known as Bechterew disease) or diffuse idiopathic skeletal hyperostosis (also known as Forestier disease) have greatly increased over recent decades. These fractures tend to be particularly overlooked, leading to delayed diagnosis and secondary neurological deterioration. The aim of the present evaluation was to summarize current knowledge on cervical fractures in patients with ankylosing spinal disorders (ASDs)...
August 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28720987/management-of-post-traumatic-neglected-cervical-facet-dislocation
#6
Vinay Prabhat, Tankeshwar Boruah, Hitesh Lal, Ramesh Kumar, Ashish Dagar, Harekrushna Sahu
BACKGROUND: Post-traumatic unilateral or bilateral sub-axial cervical spine dislocations with locked facets are quite common. In developing countries like India, many patients with cervical injuries report late due to many reasons like rural backgrounds, lack of infrastructures and skilled surgeons, unawareness, poor socioeconomic status, lack of transportation to the specialized center with proper facility, etc. Early management is essential to maximize better neurological outcome. Delayed or neglected presentation makes treatment more challenging...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28712898/iatrogenic-vertebral-artery-injury-during-anterior-cervical-spine-surgery-a-systematic-review
#7
REVIEW
Qing Guan, Long Chen, Ye Long, Zhou Xiang
BACKGROUND: Iatrogenic vertebral artery injury (VAI) during anterior cervical surgery is rare but potentially catastrophic. METHODS: 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 vertebral artery (VA) status were extracted...
October 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28560607/femoral-nerve-and-lumbar-plexus-injury-after-minimally-invasive-lateral-retroperitoneal-transpsoas-approach-electrodiagnostic-prognostic-indicators-and-a-roadmap-to-recovery
#8
Naomi A Abel, Jacob Januszewski, Andrew C Vivas, Juan S Uribe
Injury to the lumbosacral (LS) plexus is a well-described complication after lateral retroperitoneal transpsoas approaches to the spine. The prognosis for functional recovery after lumbosacral plexopathy or femoral/obturator neuropathy is unclear. We designed a retrospective case-control study with patients undergoing one-level lateral retroperitoneal transpsoas lumbar interbody fusion (LLIF) between January 2011 and June 2016 to correlate electrodiagnostic assessments (EDX) to physiologic concepts of nerve injury and reinnervation, and attempt to build a timeline for patient evaluation and recovery...
May 30, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28468151/tracheal-cartilaginous-sleeve-in-syndromic-craniosynostosis-an-underrecognized-source-of-significant-morbidity-and-mortality
#9
Brent B Pickrell, Jesse D Meaike, Karina T Cañadas, Binoy M Chandy, Edward P Buchanan
Tracheal cartilaginous sleeve (TCS) is a rare and previously unrecognized source of morbidity and mortality in patients with certain craniosynostosis syndromes. There is a paucity of reporting on this airway anomaly, and the true incidence of TCS is largely unknown. The purpose of this study was to investigate the incidence of TCS among patients with syndromic craniosynostosis at our institution. Patients with syndromic craniosynostosis who underwent direct bronchoscopy and laryngoscopy were evaluated retrospectively by pediatric otolaryngologists for the presence of TCS and associated anomalies...
May 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28462043/lack-of-riluzole-efficacy-in-the-progression-of-the-neurodegenerative-phenotype-in-a-new-conditional-mouse-model-of-striatal-degeneration
#10
Grzegorz Kreiner, Katarzyna Rafa-Zabłocka, Piotr Chmielarz, Monika Bagińska, Irena Nalepa
BACKGROUND: Huntington's disease (HD) is a rare familial autosomal dominant neurodegenerative disorder characterized by progressive degeneration of medium spiny neurons (MSNs) located in the striatum. Currently available treatments of HD are only limited to alleviating symptoms; therefore, high expectations for an effective therapy are associated with potential replacement of lost neurons through stimulation of postnatal neurogenesis. One of the drugs of potential interest for the treatment of HD is riluzole, which may act as a positive modulator of adult neurogenesis, promoting replacement of damaged MSNs...
2017: PeerJ
https://www.readbyqxmd.com/read/28451483/epidural-hematoma-following-cervical-spine-surgery
#11
Gregory D Schroeder, Alan S Hilibrand, Paul M Arnold, David E Fish, Jeffrey C Wang, Jeffrey L Gum, Zachary A Smith, Wellington K Hsu, Ziya L Gokaslan, Robert E Isaacs, Adam S Kanter, Thomas E Mroz, Ahmad Nassr, Rick C Sasso, Michael G Fehlings, Zorica Buser, Mohamad Bydon, Peter I Cha, Dhananjay Chatterjee, Erica L Gee, Elizabeth L Lord, Erik N Mayer, Owen J McBride, Emily C Nguyen, Allison K Roe, P Justin Tortolani, D Alex Stroh, Marisa Y Yanez, K Daniel Riew
STUDY DESIGN: A multicentered retrospective case series. OBJECTIVE: To determine the incidence and circumstances surrounding the development of a symptomatic postoperative epidural hematoma in the cervical spine. METHODS: Patients who underwent cervical spine surgery between January 1, 2005, and December 31, 2011, at 23 institutions were reviewed, and all patients who developed an epidural hematoma were identified. RESULTS: A total of 16 582 cervical spine surgeries were identified, and 15 patients developed a postoperative epidural hematoma, for a total incidence of 0...
April 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28387560/clinical-evaluation-of-the-concussed-athlete-a-view-from-the-sideline
#12
REVIEW
Margot Putukian
CONTEXT: The sideline assessment of concussion is challenging, given its variable presentations, the limited sensitivity and specificity of sideline assessment tools, and how the presentation of the injury evolves over time. In addition, the diagnostic process, as well as the tools used to assess and manage concussion, continue to progress as research and what we know about concussion advance. This paper focuses on the initial assessment on the sideline by reviewing the concussion-evaluation literature, drawing from clinical experience to emphasize a standardized approach, and underscoring the importance of both familiarity with the athlete and clinical judgment...
March 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/28184249/atlantoaxial-rotatory-fixation-as-a-rare-complication-from-head-positioning-in-otologic-surgery-report-of-two-cases-in-young-children
#13
Hiroshi Sakaida, Koji Akeda, Akihiro Sudo, Kazuhiko Takeuchi
BACKGROUND: Atlantoaxial rotatory fixation is a condition in which the first and second vertebrae of the cervical spine become interlocked in a rotated position. This condition can result in serious consequences and thus have a significant impact on patients, especially when diagnosis and treatment are delayed. Some cases of atlantoaxial rotatory fixation have been described in association with otologic surgery or plastic surgery involving the ear. We present the cases of two pediatric patients who developed atlantoaxial rotatory fixation following otologic surgery and we review the relevant literature...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28141652/tracheal-cartilaginous-sleeve-in-syndromic-craniosynostosis-an-underrecognized-source-of-significant-morbidity-and-mortality
#14
Brent B Pickrell, Jesse D Meaike, Karina T Cañadas, Binoy M Chandy, Edward P Buchanan
Tracheal cartilaginous sleeve (TCS) is a rare and previously unrecognized source of morbidity and mortality in patients with certain craniosynostosis syndromes. There is a paucity of reporting on this airway anomaly, and the true incidence of TCS is largely unknown. The purpose of this study was to investigate the incidence of TCS among patients with syndromic craniosynostosis at our institution. Patients with syndromic craniosynostosis who underwent direct bronchoscopy and laryngoscopy were evaluated retrospectively by pediatric otolaryngologists for the presence of TCS and associated anomalies...
January 30, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28110925/airway-adverse-events-following-posterior-occipito-cervical-spinal-fusion
#15
Veena Sheshadri, Rebecca Moga, Pirjo Manninen, Christina L Goldstein, Yoga Raja Rampersaud, Eric M Massicotte, Michael G Fehlings, Lashmi Venkatraghavan
Management of the airway may be challenging in patients undergoing occipito-cervical spine fusions (OCF). Changes in the occipito-cervical angle (dOC2A) of fusion after surgery may result in acute airway obstruction, dyspnea and/or dysphagia. Objectives of the study were to review the airway management of patients during posterior OCF, determine the incidence, nature and risk factors for postoperative airway adverse events (AEs), and to determine the relationship between airway AEs and the change in dOC2A. In this retrospective cohort of 59 patients, following extubation in the operating room (OR), there were no complications in 43 (73%) patients (Group 1)...
May 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27993739/septic-arthritis-of-an-atlantoaxial-facet-joint-with-normal-inflammatory-markers-case-report-and-literature-review
#16
REVIEW
Gokhan Kuyumcu, Claus S Simpfendorfer, Maja Babic, Iain H Kalfas, Lucileia Teixeira-Johnson, Carl S Winalski
BACKGROUND: Septic arthritis of the atlantoaxial facet joint is extremely rare. Contiguous spread to the median atlantoaxial joints with subsequent dens erosion can lead to atlantoaxial instability. Misleading normal inflammatory markers can result in delayed diagnosis and catastrophic consequences. CASE DESCRIPTION: A 56-year-old man presented with right-sided neck pain that had lasted for 2 days. He did not have fever or chills, and his serum C-reactive protein and erythrocyte sedimentation rate were normal...
February 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27822361/serious-bicycle-crash-injury-in-chiropractic-practice-a-case-report-of-delayed-diagnosis
#17
Lars Uhrenholt
BACKGROUND: Bicyclists are vulnerable road users and are at risk of serious spinal injury if involved in traffic crashes. In Denmark approximately 25 bicyclists are killed each year and some 20.000 bicycle related casualties are registered in the National Patient Registry each year. In addition to these figures, a large number of casualties remain unregistered despite injury. Many of the casualties will consult chiropractors in primary practice with or without preceding evaluation in the established emergency care facilities...
2016: Chiropractic & Manual Therapies
https://www.readbyqxmd.com/read/27784478/-correlation-between-thigh-muscle-magnetic-resonance-imaging-findings-and-clinical-features-of-congenital-muscular-dystrophies-a-preliminary-study
#18
L L Wang, J Du, X N Fu, Y B Fan, C J Wei, J Ding, D D Tan, J X Xiao, H Xiong
Objective: To analyze the clinical and magnetic resonance imaging (MRI) features of congenital muscular dystrophy (CMD) to improve the diagnostic level. Method: Clinical manifestations and thigh muscle MRI results of 8 cases of CMD diagnosed on genetic level from April 2013 to November 2015 were investigated. MRI was performed on the thigh muscles of all cases. Fatty infiltration of different muscles described in T1WI was graded to evaluate. Clinical symptoms and signs, as well as muscle MRI features were analyzed by statistical description...
October 2, 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/27772759/congenital-insensitivity-to-pain-and-anhidrosis-case-report-and-review-of-findings-along-neuro-immune-axis-in-the-disorder
#19
REVIEW
Aditi Vian Varma, Lori McBride, Michael Marble, Ann Tilton
Congenital insensitivity to pain and anhidrosis (CIPA) is one of the hereditary autonomic and sensory neuropathies. Typically presenting in infancy, it manifests as hyperpyrexia from defects in sweating (autonomic) and self-mutilating injuries from pain insensitivity (sensory). CIPA being rare in North America, diagnosis is often missed due to variable presentation. Subsequent management of its complications is therefore delayed. We report an unusual presentation in a 2-year-old girl with preexisting diagnosis of CIPA who was evaluated for bilateral upper extremity paresis of insidious onset...
November 15, 2016: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/27421267/exome-sequencing-discloses-kalrn-homozygous-variant-as-likely-cause-of-intellectual-disability-and-short-stature-in-a-consanguineous-pedigree
#20
Periklis Makrythanasis, Michel Guipponi, Federico A Santoni, Maha Zaki, Mahmoud Y Issa, Muhammad Ansar, Hanan Hamamy, Stylianos E Antonarakis
BACKGROUND: The recent availability of whole-exome sequencing has opened new possibilities for the evaluation of individuals with genetically undiagnosed intellectual disability. RESULTS: We report two affected siblings, offspring of first-cousin parents, with intellectual disability, hypotonia, short stature, growth hormone deficiency, and delayed bone age. All members of the nuclear family were genotyped, and exome sequencing was performed in one of the affected individuals...
2016: Human Genomics
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