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https://www.readbyqxmd.com/read/28820364/patterns-of-c-2-fracture-in-the-elderly-comparison-of-etiology-treatment-and-mortality-among-specific-fracture-types
#1
Ingrid Radovanovic, Jennifer C Urquhart, Parham Rasoulinejad, Kevin R Gurr, Fawaz Siddiqi, Christopher S Bailey
OBJECTIVE Previous studies have focused on Type II odontoid fractures and have failed to report on the effect of other C-2 fracture types on treatment and outcome. The purpose of this study was to compare patient characteristics, cause of injury, predisposing factors to fracture, treatments, and mortality rates among C-2 fracture types in a cohort of elderly patients 70 years of age and older. METHODS A retrospective cohort study design was used. Patients who sustained a C-2 fracture between 2002 and 2011 and who were admitted to the authors' Level 1 trauma center were identified using the Discharge Abstract Database and the International Statistical Classification of Diseases and Related Health Problems (ICD-10) code S12...
August 18, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28818826/test-retest-and-interreader-reproducibility-of-semiautomated-atlas-based-analysis-of-diffusion-tensor-imaging-data-in-acute-cervical-spine-trauma-in-adult-patients
#2
D J Peterson, A M Rutman, D S Hippe, J G Jarvik, F H Chokshi, M R Reyes, C H Bombardier, M Mossa-Basha
BACKGROUND AND PURPOSE: DTI is a tool for microstructural spinal cord injury evaluation. This study evaluated the reproducibility of a semiautomated segmentation algorithm of spinal cord DTI. MATERIALS AND METHODS: Forty-two consecutive patients undergoing acute trauma cervical spine MR imaging underwent 2 axial DTI scans in addition to their clinical scan. The datasets were put through a semiautomated probabilistic segmentation algorithm that selected white matter, gray matter, and 24 individual white matter tracts...
August 17, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28816874/does-surgical-intervention-or-timing-of-surgery-have-an-effect-on-neurological-recovery-in-the-setting-of-a-thoracolumbar-burst-fracture
#3
So Kato, Jean-Christophe Murray, Brian K Kwon, Gregory D Schroeder, Alexander R Vaccaro, Michael G Fehlings
Traumatic thoracolumbar burst fractures are one of the most common forms of spinal trauma with the majority occurring at the junctional area where mechanical load is maximal (AOSpine Thoracolumbar Spine Injury Classification System Subtype A3 or A4). Burst fractures entail the involvement of the middle column, and therefore, they are typically associated with bone fragment in the spinal canal, which may cause compression of the spinal cord, conus medullaris, cauda equina, or a combination of these. Fortunately, approximately half of the patients with thoracolumbar burst fractures are neurologically intact due to the wide canal diameter...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28807778/cervical-cord-canal-mismatch-a-new-method-for-identifying-predisposition-to-spinal-cord-injury
#4
REVIEW
Aria Nouri, Julio Montejo, Xin Sun, Justin Virojanapa, Luis E Kolb, Khalid M Abbed, Joseph Cheng
The risk for spinal cord injuries (SCIs) ranging from devastating traumatic injuries, compression due to degenerative pathology, and neurapraxia is increased in patients with congenital spinal stenosis. Classical diagnostic criteria include an absolute anteroposterior diameter of <12-13mm or a Torg-Pavlov Ratio of <0.80-0.82; however, these factors do not take into account the size of the spinal cord, which varies across patients independent of canal size. Recent large MRI studies of population cohorts have allowed newer methods to emerge that account for both cord and canal size by measuring a spinal cord occupation ratio (SCOR)...
August 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28791891/the-economic-burden-of-urinary-tract-infection-and-pressure-ulceration-in-acute-traumatic-spinal-cord-injury-admissions-evidence-for-comparative-economics-and-decision-analytics-from-a-matched-case-control-study
#5
Barry White, Nicolas Dea, John Street, Christiana L Cheng, Carly S Rivers, Najmedden Attabib, Brian K Kwon, Charles G Fisher, Marcel F Dvorak
Secondary complications of spinal cord injury (SCI) are a burden to afflicted individuals and the rest of society. However, there is limited evidence of the economic burden or cost of complications in SCI populations in Canada, which is necessary for comparative economic analyses and decision analytic modeling of possible solutions to these common health problems. Comparative economic analyses can inform resource allocation decisions, but the outputs are only as good as the inputs. In this article, new evidence of the excess or incremental costs of urinary tract infection (UTI) and pressure ulceration (PU) in acute traumatic SCI from an exploratory case series analysis of admissions to a Level I specialized Canadian spine facility (2008-2013) is presented...
August 9, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28781306/cervical-flexion-myelopathy-eleven-years-after-a-cervical-spinal-cord-injury
#6
Hiroto Nakano, Kenji Sakai, Kazuo Iwasa, Masahito Yamada
We herein describe a 37-year-old man who developed cervical flexion myelopathy 11 years after suffering a cervical spinal cord injury. Cervical magnetic resonance imaging 11 years after the accident demonstrated atrophy and hyperintense lesions at the C6 and C7 levels in the cervical cord with an abnormal alignment of the vertebrae. In the neck flexion position, an anterior shift of the cervical cord was evident. Our patient's condition suggests that an abnormal alignment of the cervical spine and spinal cord injury due to a traumatic accident could be risk factors in the subsequent development of cervical flexion myelopathy...
August 1, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28776505/effects-of-cathodal-trans-spinal-direct-current-stimulation-on-lower-urinary-tract-function-in-normal-and-spinal-cord-injury-mice-with-overactive-bladder
#7
Zaghloul Ahmed
OBJECTIVE: Lower urinary tract (LUT) dysfunction is a monumental problem affecting quality of life following neurotrauma, such as spinal cord injury (SCI). Proper function of the bladder and its associated structures depends on coordinated activity of the neuronal circuitry in the spinal cord and brain. Disconnection between the spinal and brain centers controlling the LUT causes fundamental changes in the mechanisms involved in the micturition and storage reflexes. We investigated the effects of cathodal trans-spinal direct current stimulation (c-tsDCS) of the lumbosacral spine on bladder and external urinary sphincter (EUS) functions...
August 4, 2017: Journal of Neural Engineering
https://www.readbyqxmd.com/read/28776131/pure-distraction-injury-of-t1-2-with-quad-fever
#8
Jun-Yeong Seo, Chae-Moon Lim, Young-Hoon Kim, Kee-Yong Ha
INTRODUCTION: We report a pure distraction injury of the upper thoracic spine and uncontrolled hyperthermia without an infectious cause. Quad fever appears in the first several weeks to months after a cervical or upper thoracic SCI and is characterized by an extreme elevation in body core temperature beyond 40 °C without an infectious cause. Discriminating between infectious and noninfectious causes is important, and a thorough clinical assessment is required. MATERIALS AND METHODS: A 52-year-old male visited the emergency room complaining of back pain with complete paralysis [American Spinal Injury Association (ASIA) A] of both lower extremities after a pedestrian-motor vehicle accident...
August 3, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28763433/injury-and-liability-associated-with-spine-surgery
#9
Rachel Kutteruf, Deva Wells, Linda Stephens, Karen L Posner, Lorri A Lee, Karen B Domino
BACKGROUND: Although spine surgery is associated with significant morbidity, the anesthesia liability profile for spine surgery is not known. We examined claims for spine procedures in the Anesthesia Closed Claims Project database to evaluate patterns of injury and liability. MATERIALS AND METHODS: A retrospective cohort study was performed. Inclusion criteria were anesthesia claims provided for surgical procedures in 2000 to 2014. We compared mechanisms of injury for cervical spine to thoracic or lumbar spine procedures using χ and the Fisher exact test...
July 31, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28761518/factors-affecting-outcome-of-acute-cervical-spine-injury-a-prospective-study
#10
Bhavanam Hanuma Srinivas, Alugolu Rajesh, A K Purohit
BACKGROUND: Injury to the spine and spinal cord is one of the common cause of disability and death. Several factors affect the outcome; but which are these factors (alone and in combination), are determining the outcomes are still unknown. The aim of the study was to evaluate the factors influencing the outcome following acute cervical spine injury. MATERIALS AND METHODS: A prospective observational study at single-center with all patients with cervical spinal cord injury (SCI), attending our hospital within a week of injury during a period of October 2011 to July 2013 was included for analysis...
July 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28761411/the-crossed-phrenic-phenomenon
#11
REVIEW
Michael George Zaki Ghali
The cervical spine is the most common site of traumatic vertebral column injuries. Respiratory insufficiency constitutes a significant proportion of the morbidity burden and is the most common cause of mortality in these patients. In seeking to enhance our capacity to treat specifically the respiratory dysfunction following spinal cord injury, investigators have studied the "crossed phrenic phenomenon", wherein contraction of a hemidiaphragm paralyzed by a complete hemisection of the ipsilateral cervical spinal cord above the phrenic nucleus can be induced by respiratory stressors and recovers spontaneously over time...
June 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/28744321/an-18-f-positron-emitting-fluorescent-cerebrospinal-fluid-probe-for-imaging-damage-to-the-brain-and-spine
#12
Harikrishna Kommidi, Hua Guo, Nandi Chen, Dohyun Kim, Bin He, Amy P Wu, Omer Aras, Richard Ting
Fluorescein is modified to bear (18)F so that it can act as both a positron emitter, and a fluorophore, allowing detection by positron emission tomography (PET), scintillation, and fluorescent imaging (FL). [(18)F]-2 is injected into the intrathecal space of rats and used to observe the cerebrospinal fluid (CSF) that bathes the brain and spine. Injury in three different applications is visualized with [(18)F]-2: 1) detection of a 0.7 mm paranasal-sinus CSF leak (CSFL); 2) detection of 0.5 mm puncture damage to the thoracic spine (acute spinal cord injury); and 3) detection of intracerebral hemorrhage/edema because of traumatic brain injury...
2017: Theranostics
https://www.readbyqxmd.com/read/28739474/traumatic-subaxial-cervical-facet-subluxation-and-dislocation-epidemiology-radiographic-analyses-and-risk-factors-for-spinal-cord-injury
#13
Ryan D Quarrington, Claire F Jones, Petar Tcherveniakov, Jillian M Clark, Simon J I Sandler, Yu Chao Lee, Shabnam Torabiardakani, John J Costi, Brian J C Freeman
BACKGROUND CONTEXT: Distractive-flexion injuries (DFIs) of the subaxial cervical spine are major contributors to spinal cord injury (SCI). Prompt assessment and early intervention of DFIs associated with SCI is crucial to optimize patient outcome; however, neurological examination of patients with subaxial cervical injury is often difficult, as patients commonly present with reduced levels of consciousness. Therefore, it is important to establish potential associations between injury epidemiology and radiographic features, and neurological involvement...
July 21, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28731391/malpractice-litigation-following-spine-surgery
#14
Alan H Daniels, Roy Ruttiman, Adam E M Eltorai, J Mason DePasse, Bielinsky A Brea, Mark A Palumbo
OBJECTIVE Adverse events related to spine surgery sometimes lead to litigation. Few studies have evaluated the association between spine surgical complications and medical malpractice proceedings, outcomes, and awards. The aim of this study was to identify the most frequent causes of alleged malpractice in spine surgery and to gain insight into patient demographic and clinical characteristics associated with medical negligence litigation. METHODS A search for "spine surgery" spanning February 1988 to May 2015 was conducted utilizing the medicolegal research service VerdictSearch (ALM Media Properties, LLC)...
July 21, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28725486/consequences-of-traumatic-spinal-cord-injury-during-pregnancy-in-pakistan
#15
Aatik Arsh, Haider Darain, Syed Muhammad Ilyas, Amir Zeb
INTRODUCTION: Traumatic spinal cord injury (SCI) is one of the major causes for poor outcomes of pregnancy. Injury during pregnancy is uncommon; therefore, outcome data are scarce. This case series presents outcomes of pregnancy in five women who sustained SCI during their pregnancies. CASE PRESENTATION: Five women who sustained SCIs during pregnancy (age range: 24-38 years) were identified and included in this case series. The causes of SCI in this population were fall from heights (cases 1 and 2), road traffic accidents (cases 3 and 4) and firearm injury (case 5)...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28720987/management-of-post-traumatic-neglected-cervical-facet-dislocation
#16
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/28716636/a-simplified-clinical-prediction-rule-for-prognosticating-independent-walking-after-spinal-cord-injury-a-prospective-study-from-a-canadian-multicenter-spinal-cord-injury-registry
#17
Katharine E Hicks, Yichen Zhao, Nader Fallah, Carly Rivers, Vanessa Noonan, Tova Plashkes, Eugene K Wai, Darren M Roffey, Eve Tsai, Jerome Paquet, Najmedden Attabib, Travis Marion, Henry Ahn, Philippe Phan
BACKGROUND: Context: Traumatic spinal cord injury (SCI) is a debilitating condition with limited treatment options for neurological or functional recovery. The ability to predict the prognosis of walking post-injury with emerging prediction models could aid in rehabilitation strategies and reintegration into the community. PURPOSE: To re-validate an existing clinical prediction model for independent ambulation (van Middendorp et al. 2011) utilising acute and long-term post-injury follow-up data, and to investigate the accuracy of a simplified model using prospectively collected data from a Canadian multicenter SCI database, the Rick Hansen Spinal Cord Injury Registry (RHSCIR)...
July 14, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28705774/american-spinal-injury-association-a-sensory-and-motor-complete-is-not-different-from-american-spinal-injury-association-b-sensory-incomplete-motor-complete-in-gunshot-related-spinal-cord-injury
#18
Eric McCoy, Nima Eftekhary, Kenneth Nwosu, Dudley Fukunaga, Charles Liu, Kevin Rolfe
BACKGROUND CONTEXT: We receive a large number of patients with spinal cord injury (SCI) due to penetrating gunshot wounds (GSW) at our national rehabilitation center. Although many patients are labeled American Spinal Injury Association (ASIA) B sensory incomplete because of sensory sparing, especially deep anal pressure, with purported prognostic value, we have not observed a clinical difference from patients labeled ASIA A complete. We hypothesized that sensory sparing, if meaningful, should reduce the occurrence of pressure ulcers...
July 10, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28697027/impact-of-venous-thromboembolism-chemoprophylaxis-on-postoperative-hemorrhage-following-operative-stabilization-of-spine-fractures
#19
John P Sharpe, Wade C Gobbell, Maranda Pahlkotter, Michael S Muhlbauer, Francis X Camillo, Timothy C Fabian, Martin A Croce, Louis J Magnotti
BACKGROUND: Prophylactic anticoagulation may decrease the risk of venous thromboembolism (VTE) in patients with spine fractures following blunt trauma, but comes with the threat of postoperative bleeding in patients requiring stabilization of these fractures. The purpose of this study was to evaluate the impact of preoperative anticoagulation on VTE and bleeding complications in patients with blunt spine fractures requiring operative stabilization. METHODS: All patients with blunt spine fractures requiring operative stabilization over a 6-year period were identified...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28694593/experimental-study-on-pressure-response-to-graded-spinal-canal-compromise-in-an-in-vitro-burst-fracture-mode
#20
Jonathan Bourget-Murray, Mahdi Bassi, Ariana Frederick, Jerod Hines, Peter F Jarzem
BACKGROUND: Spinal cord compression is a known cause of spinal cord injury. The purpose of this study is to measure pressure response during graded spinal cord compression. This information will be important in evaluating the amount of canal compromise that can be tolerated before risking neurological injury secondary to cord compression. To date, there is no published study that has evaluated pressure response to graded canal compromise in the thoracic and lumbar spine. MATERIALS AND METHODS: A comparative biomechanical investigation using an in vitro burst fracture model of graded spinal canal compromise was performed...
April 2017: Journal of Craniovertebral Junction and Spine
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