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https://www.readbyqxmd.com/read/28306628/pediatric-spinal-cord-injury-without-radiographic-abnormality-in-the-era-of-advanced-imaging
#1
Caitlin A Farrell, Megan Hannon, Lois K Lee
PURPOSE OF REVIEW: The current review describes the current evidence on pediatric spinal cord injury without radiographic abnormality (SCIWORA) with attention to the definition, epidemiology, and clinical presentation of the condition, as well as common MRI findings, management strategies, and outcomes. RECENT FINDINGS: Recent literature demonstrates that with more widespread MRI use, our understanding of SCIWORA has improved. The new literature, although still limited, provides a more granular conceptualization of patterns of injury as well as potential prognostic stratification of patients based on MRI findings...
March 16, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28304240/posterior-arch-c-1-screw-technique-a-cadaveric-comparison-study
#2
Marc Moisi, Christian Fisahn, Lara Tkachenko, Shiveindra Jeyamohan, Stephen Reintjes, Peter Grunert, Daniel C Norvell, R Shane Tubbs, Jeni Page, David W Newell, Peter Nora, Rod J Oskouian, Jens Chapman
OBJECTIVE Posterior atlantoaxial stabilization and fusion using C-1 lateral mass screw fixation has become commonly used in the treatment of instability and for reconstructive indications since its introduction by Goel and Laheri in 1994 and modification by Harms in 2001. Placement of such lateral mass screws can be challenging because of the proximity to the spinal cord, vertebral artery, an extensive venous plexus, and the C-2 nerve root, which overlies the designated starting point on the posterior center of the lateral mass...
March 17, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28298579/computed-tomography-of-thoracolumbar-spine-trauma
#3
Teresa G Odle
Thoracolumbar spine trauma typically occurs when high-energy forces damage bony and ligamentous spinal structures and, in severe cases, the spinal cord. These injuries often cause considerable neurological deficits as a result of the damage. Computed tomography (CT) is the imaging method of choice for determining injury severity in most victims of multiple trauma. In addition to describing various types of thoracolumbar trauma, this article discusses the role of CT in emergency diagnosis and management of thoracolumbar injuries...
January 2017: Radiologic Technology
https://www.readbyqxmd.com/read/28263454/neuroplasticity-of-supraspinal-structures-associated-with-pathological-pain
#4
Pere Boadas-Vaello, Judit Homs, Francisco Reina, Anna Carrera, Enrique Verdú
Peripheral nerve and spinal cord injuries, along with other painful syndromes such as fibromyalgia, diabetic neuropathy, chemotherapeutic neuropathy, trigeminal neuralgia, complex regional pain syndrome, and/or irritable bowel syndrome, cause several neuroplasticity changes in the nervous system along its entire axis affecting the different neuronal nuclei. This paper reviews these changes, focusing on the supraspinal structures that are involved in the modulation and processing of pain, including the periaqueductal gray matter, red nucleus, locus coeruleus, rostral ventromedial medulla, thalamus, hypothalamus, basal ganglia, cerebellum, habenula, primary and secondary somatosensory cortex, motor cortex, mammillary bodies, hippocampus, septum, amygdala, cingulated and prefrontal cortex...
March 6, 2017: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
https://www.readbyqxmd.com/read/28255506/spinal-epidural-hematoma-related-to-vertebral-fracture-in-an-atypical-rigid-diffuse-idiopathic-skeletal-hyperostosis-a-case-report
#5
José Ramírez Villaescusa, Marcela Restrepo Pérez, David Ruiz Picazo
INTRODUCTION: Spinal epidural hematoma (SEH) is a rare disease that causes cord compression and neurologic deficit. Spontaneous SEH is related to minor trauma, bleeding disorders, and anticoagulant medications. Posttraumatic SEH has been associated with low-energy spine hyperextension injuries in patients with ankylosing spinal disorders such as ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis (DISH). A variant named atypical DISH-like with SEH is reported. OBJECTIVE: To describe the management, diagnosis, and treatment of an unusual SEH case in a patient causing delayed neurologic deficit with rigid atypical DISH-like spine...
March 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28254420/comparison-of-the-technique-of-anterior-cervical-distraction-and-screw-elevating-pulling-reduction-and-conventional-anterior-cervical-reduction-technique-for-traumatic-cervical-spine-fractures-and-dislocations
#6
REVIEW
Haoxi Li, Yufeng Huang, Changzhi Cheng, Zhoudan Lin, Desheng Wu
INTRODUCTION: To analyze and confirm the advantages of anterior cervical distraction and screw elevating-pulling reduction which are absent in conventional anterior cervical reduction for traumatic cervical spine fractures and dislocations. MATERIALS AND METHODS: A retrospective study was conducted on 86 patients with traumatic cervical spine fractures and dislocations who received one-stage anterior approach treatment for a distraction-flexion injury with bilateral locked facet joints between January 2010 and June 2015...
February 22, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28252264/vasopressor-support-in-managing-acute-spinal-cord-injury-a-knowledge-update
#7
John K Yue, Rachel Tsolinas, John F Burke, Hansen Deng, Pavan S Upadhyayula, Caitlin K Robinson, Young M Lee, Andrew K Chan, Ethan A Winkler, Sanjay S Dhall
INTRODUCTION: Managing neurogenic shock following acute traumatic spinal cord injury (SCI) is challenging. Current guidelines target mean arterial pressure (MAP) above 85-90 mmHg to maintain cord perfusion and reduce ischemia/secondary injury. While early vasopressor utilization has been associated with improved outcomes, recent updates regarding indications of specific vasopressors for refinement of existing guidelines are needed. EVIDENCE ACQUISITION: A comprehensive search was conducted using the National Library of Medicine PubMed database between 01/2010 and 01/2017 targeting vasopressor use in the setting of neurogenic/spinal shock and/or hypotension following acute SCI in adult patients...
March 1, 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/28250641/traumatic-high-grade-spondylolisthesis-at-c7-t1-with-no-neurological-deficits-case-series-literature-review-and-biomechanical-implications
#8
Ha Son Nguyen, Hesham Soliman, Shekar Kurpad
Traumatic high-grade spondylolisthesis in subaxial cervical spine is frequently associated with acute spinal cord injury and quadriparesis. There have been rare cases where such pathology demonstrates minimal to no neurological deficits. Assessment of the underlying biomechanics may provide insight into the mechanism of injury and associated neurological preservation. Patient 1 is a 63-year-old female presenting after a motor vehicle collision with significant right arm pain without neurological deficits. Imaging demonstrated C7/T1 spondyloptosis, associated with a locked facet on the left at C6/7 and a locked facet on the right at C7/T1, with a fracture of the left C7 pedicle and right C7 lamina...
January 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/28250638/odontoidectomy-through-posterior-midline-approach-followed-by-same-sitting-occipitocervical-fixation-a-cadaveric-study
#9
Ehab Mohamed Eissa, Mohamed Mohi Eldin
OBJECT: Atlantoaxial instability with irreducible odontoid process is one of the challenges in spine surgery. These lesions are commonly treated through anterior transoral approach which is followed by posterior atlantoaxial fusion. However, there are still many limitations, especially cerebrospinal fluid fistula with subsequent life-threatening infection, difficulty in cases with limited opening of mouth due to temporomandibular arthritis or anomalies of naso-oropharynx. Türe et al...
January 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/28247075/cervical-facet-dislocations-in-the-adolescent-population-a-report-of-21-cases-at-a-level-1-trauma-center-from-2004-to-2014
#10
Alireza K Anissipour, Julie Agel, Carlo Bellabarba, Richard J Bransford
PURPOSE: The purpose of this study was to present a series of adolescent patients with cervical facet dislocations to identify the mechanism of injury, severity of neurological injury and rate of neurological recovery. METHODS: Between 2004 and 2014, a retrospective review at a level I trauma center identified patients with unilateral or bilateral dislocated facet(s). Demographic data, initial neurological exams, surgical data, radiographic findings, and follow-up records were reviewed...
February 28, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28192259/impact-of-intraoperative-monitoring-during-elective-complex-spinal-fusions-%C3%A2-4-levels-on-30-day-complication-and-readmission-rates-a-single-institutional-study-of-643-adult-spinal-deformity-patients
#11
Aladine A Elsamadicy, Owoicho Adogwa, Emily Lydon, Gireesh Reddy, Rayan Kaakati, Amanda Sergesketter, Oren N Gottfried, Isaac O Karikari
OBJECTIVE: The aim of this study is to determine if there are differences in 30-day postoperative complication and readmission rates between spinal deformity patients undergoing complex spinal fusion with and without intraoperative monitoring. METHODS: The medical records of 643 adult spine deformity patients undergoing elective complex spinal fusion (≥4 levels) at a major academic institution from 2005 to 2015 were reviewed. We identified 122 (19%) cases that involved intraoperative monitoring (IOM) including EMG, SSEP, and/or TcMEP and 521 (81%) that did not (IOM: n=122; No-IOM: n=521)...
February 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28190553/cervical-spine-imaging-for-young-children-with-inflicted-trauma-expanding-the-injury-pattern
#12
Joanne Baerg, Arul Thirumoorthi, Rosemary Vannix, Asma Taha, Amy Young, Alexander Zouros
AIM: The purpose of this study was to document the incidence and pattern of cervical spine (c-spine) injuries in children below 36months with inflicted trauma. METHODS: An IRB approved, prospective cohort study was performed between July 2011 and January 2016. Inclusion criteria were: age below 36months, loss of consciousness after inflicted trauma, and one initial head computed tomography finding: a subdural, intraventricular, intraparenchymal, subarachnoid hemorrhage, diffuse axonal injury, hypoxic injury, or cerebral edema...
January 30, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28187806/diagnosis-and-management-of-spinal-cord-emergencies
#13
E P Flanagan, S J Pittock
Most spinal cord injury is seen with trauma. Nontraumatic spinal cord emergencies are discussed in this chapter. These myelopathies are rare but potentially devastating neurologic disorders. In some situations prior comorbidity (e.g., advanced cancer) provides a clue, but in others (e.g., autoimmune myelopathies) it may come with little warning. Neurologic examination helps distinguish spinal cord emergencies from peripheral nervous system emergencies (e.g., Guillain-Barré), although some features overlap...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28187803/management-of-acute-traumatic-spinal-cord-injuries
#14
C D Shank, B C Walters, M N Hadley
Acute traumatic spinal cord injury (SCI) is a devastating disease process affecting tens of thousands of people across the USA each year. Despite the increase in primary prevention measures, such as educational programs, motor vehicle speed limits, automobile running lights, and safety technology that includes automobile passive restraint systems and airbags, SCIs continue to carry substantial permanent morbidity and mortality. Medical measures implemented following the initial injury are designed to limit secondary insult to the spinal cord and to stabilize the spinal column in an attempt to decrease devastating sequelae...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28186470/image-guidance-based-on-mri-for-spinal-interstitial-laser-thermotherapy-technical-aspects-and-accuracy
#15
Claudio E Tatsui, Clarissa N G Nascimento, Dima Suki, Behrang Amini, Jing Li, Amol J Ghia, Jonathan G Thomas, R Jason Stafford, Laurence D Rhines, Juan P Cata, Ashok J Kumar, Ganesh Rao
OBJECTIVE Image guidance for spinal procedures is based on 3D-fluoroscopy or CT, which provide poor visualization of soft tissues, including the spinal cord. To overcome this limitation, the authors developed a method to register intraoperative MRI (iMRI) of the spine into a neuronavigation system, allowing excellent visualization of the spinal cord. This novel technique improved the accuracy in the deployment of laser interstitial thermal therapy probes for the treatment of metastatic spinal cord compression...
February 10, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28168635/imaging-of-post-surgical-treatment-and-of-related-complications-in-spinal-trauma
#16
REVIEW
F Caranci, G Leone, L Ugga, E Cesarano, R Capasso, S Schipani, A Bianco, P Fonio, F Briganti, L Brunese
Spinal trauma is a devastating event with a high morbidity and mortality. The rationale of imaging is to diagnose the traumatic abnormalities and characterize the type of injury, to estimate the severity of the lesions, to evaluate the potential spinal instability. In case of spinal instability, the goals of operative treatment are decompression of the spinal cord canal and stabilization of the disrupted vertebral column. Particularly, diagnostic imaging, mainly by CT and MR, has a main role in the post-treatment evaluation...
February 6, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28152039/individualized-3d-printing-navigation-template-for-pedicle-screw-fixation-in-upper-cervical-spine
#17
Fei Guo, Jianhao Dai, Junxiang Zhang, Yichuan Ma, Guanghui Zhu, Junjie Shen, Guoqi Niu
PURPOSE: Pedicle screw fixation in the upper cervical spine is a difficult and high-risk procedure. The screw is difficult to place rapidly and accurately, and can lead to serious injury of spinal cord or vertebral artery. The aim of this study was to design an individualized 3D printing navigation template for pedicle screw fixation in the upper cervical spine. METHODS: Using CT thin slices data, we employed computer software to design the navigation template for pedicle screw fixation in the upper cervical spine (atlas and axis)...
2017: PloS One
https://www.readbyqxmd.com/read/28150118/clinical-outcomes-following-spinal-fracture-in-patients-with-ankylosing-spondylitis
#18
M Nugent, M J Berney, S Morris
BACKGROUND: Ankylosing spondylitis is a seronegative rheumatoid condition mainly affecting the axial skeleton. It leads to progressive deformity and stiffening of the spine with an increased risk of vertebral fractures and significant neurological deficits compared to the general population. AIM: This study aimed to evaluate the outcomes of patients with ankylosing spondylitis who sustained acute vertebral fractures over a 10-year period. METHODS: A retrospective review of patient records and radiographic images was performed...
February 1, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28134070/earthquake-related-orthopedic-injuries-in-adult-population-a-systematic-review
#19
Michelangelo Bortolin, Ilaria Morelli, Amalia Voskanyan, Nina R Joyce, Gregory R Ciottone
Introduction Earthquake-related trauma results in crush injuries and bony- and soft-tissue trauma. There are no systematic reviews analyzing the typical injury patterns and treatments in "Mega-Mass-Casualty" earthquakes. The characterization of an injury pattern specific to disaster type, be it natural or manmade, is imperative to build an effective disaster preparedness and response system. METHODS: The systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)...
January 30, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28125935/atraumatic-spine-distraction-induces-metabolic-distress-in-spinal-motor-neurons
#20
Jennifer Elizabeth Bell, Jennifer L Seifert, Eileen Nicole Shimizu, Daniel J Sucato, Mario Romero-Ortega
Correction forces during spine deformity surgery including distraction, impart significant stresses to the spinal cord, which may result in permanent injury. Intraoperative neuromonitoring (IONM) is commonly used by surgeons to recognize possible damage to the spinal cord in cases of evident traumatic or vascular damage to the spinal cord. However, mild insult to the spinal cord, which does not result in obvious trauma or electrophysiological changes, present a major clinical challenge as the mechanisms of this type of spinal cord injury (SCI) remain largely unknown, and thus preventive strategies are lacking...
January 26, 2017: Journal of Neurotrauma
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