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Pediatric c spine injury

Lynn Babcock, Cody S Olsen, David M Jaffe, Julie C Leonard
OBJECTIVE: The aim of this study was to ascertain potential factors associated with cervical spine injuries in children injured during sports and recreational activities. METHODS: This is a secondary analysis of a multicenter retrospective case-control study involving children younger than 16 years who presented to emergency departments after blunt trauma and underwent cervical spine radiography. Cases had cervical spine injury from sports or recreational activities (n = 179)...
September 30, 2016: Pediatric Emergency Care
Julio J Jauregui, Dean C Perfetti, Frank S Cautela, David B Frumberg, Qais Naziri, Carl B Paulino
BACKGROUND: Although rare, spinal injuries associated with abuse can have potentially devastating implications in the pediatric population. We analyzed the association of pediatric spine injury in abused children and determined the anatomic level of the spine affected, while also focusing on patient demographics, length of stay, and total hospital charges compared with spine patients without a diagnosis of abuse. METHODS: A retrospective review of the Kids' Inpatient Database was conducted from 2000 to 2012 to identify pediatric patients (below 18 y) who sustained vertebral column fractures or spinal cord injuries...
September 22, 2016: Journal of Pediatric Orthopedics
Shari Cui, Gennadiy A Busel, Aki S Puryear
BACKGROUND: Pediatric spine trauma often results from high-energy mechanisms. Despite differences in healing potential, comorbidities, and length of remaining life, treatment is frequently based on adult criteria; ligamentous injuries are fused and bony injuries are treated accordingly. In this study, we present short-term results of a select group of adolescent patients treated using percutaneous pedicle screw instrumentation without fusion. METHODS: An IRB-approved retrospective review was performed at a level 1 pediatric trauma center for thoracolumbar spine fractures treated by percutaneous pedicle screw instrumentation...
October 2016: Journal of Pediatric Orthopedics
Sophia A Strike, Hamid Hassanzadeh, Amit Jain, Khaled M Kebaish, Dolores B Njoku, Daniel Becker, Michael C Ain, Paul D Sponseller
STUDY DESIGN: Review of techniques and description of institutional clinical experience. OBJECTIVE: To provide a historical review and description of key neuromonitoring concepts, focusing on neurogenic motor-evoked potentials and descending neurogenic evoked potentials, and to review the authors' experience with neuromonitoring techniques in children and adults undergoing spinal deformity surgery. SUMMARY OF BACKGROUND DATA: The original form of neuromonitoring, the Stagnara wake-up test, remains the "gold standard" for detecting true neurological deficits...
May 27, 2016: Clinical Spine Surgery
R Jacob, M Cox, K Koral, C Greenwell, Y Xi, L Vinson, K Reeder, B Weprin, R Huang, T N Booth
BACKGROUND AND PURPOSE: Cervical MR imaging has demonstrated a utility for detecting soft tissue injury in nonaccidental trauma. The purpose of this study was to identify the incidence and types of cervical spine injury on MR imaging in nonaccidental trauma and to correlate cervical spine injury with parenchymal injury on brain MR imaging and findings on head CT. MATERIALS AND METHODS: A retrospective review of children diagnosed with nonaccidental trauma in a tertiary referral pediatric hospital over 8 years was performed...
May 26, 2016: AJNR. American Journal of Neuroradiology
Jonathan N Sellin, William J Steele, Lauren Simpson, Wei X Huff, Brandon C Lane, Joshua J Chern, Daniel H Fulkerson, Christina M Sayama, Andrew Jea
OBJECTIVE The Thoracolumbar Injury Classification and Severity Score (TLICS) system was developed to streamline injury assessment and guide surgical decision making. To the best of the authors' knowledge, external validation in the pediatric age group has not been undertaken prior to this report. METHODS This study evaluated the use of the TLICS in a large retrospective series of children and adolescents treated at 4 pediatric medical centers (Texas Children's Hospital, Children's Healthcare of Atlanta, Riley Children's Hospital, and Doernbecher Children's Hospital)...
August 2016: Journal of Neurosurgery. Pediatrics
Manuel Ribeiro da Silva, Daniela Linhares, Pedro Cacho Rodrigues, Eurico Lisboa Monteiro, Manuel Santos Carvalho, Pedro Negrão, Rui Peixoto Pinto, Nuno Neves
PURPOSE: This observational study aims to describe pediatric C-spine injuries from a level 1 trauma centre through a period of 19 years. METHODS: Clinical records of pediatric trauma patients admitted to a level 1 trauma centre between 1991 and 2009 were analyzed. Patients were stratified by age into groups A (8 or less) and B (9 to 16), and in lower (C0-C2) and upper (C3-C7) spine injuries. Several variables were studied. RESULTS: Seventy-five cases of C-spine injuries (nine SCIWORA) were identified...
June 2016: International Orthopaedics
Christopher R Connelly, John D Yonge, Lynn E Eastes, Pamela E Bilyeu, Phillip M Kemp Bohan, Martin A Schreiber, Kenneth S Azarow, Jennifer M Watters, Mubeen A Jafri
BACKGROUND: Morbidity and mortality of cervical spine (C-spine) injury in pediatric trauma patients are high, necessitating quick and accurate diagnosis. Best practices emphasize minimizing radiation exposure through decreased reliance on computed tomography (CT), instead using clinical assessment, physical examination, and alternate imaging techniques. We implemented an institutional performance improvement and patient safety (PIPS) program initiative for C-spine clearance in 2010 because of high rates of CT scans among pediatric trauma patients...
August 2016: Journal of Trauma and Acute Care Surgery
Pankaj Kumar Singh, P Sarat Chandra, Gaurang Vaghani, Dattaraj Paramanand Savarkar, Kanwaljeet Garg, Rajender Kumar, Shashant Sharad Kale, Bhawani Shankar Sharma
PURPOSE: Pediatric vertebral hemangiomas (VH) are exceedingly rare benign and highly vascular tumours of the spine. There are no guidelines available for management of these patients in literature. Purpose of this study is to evaluate the role of intraoperative ethanol embolization, surgical decompression, and instrumented fusion in pediatric symptomatic VH with single-level involvement. METHODS: Surgery consisted of intraoperative bilateral pedicular absolute alcohol injection and laminectomy at the level of pathology followed by a short-/long-segment instrumented fusion using pedicle screws and rod...
February 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Pamela M McMahon, Shannon M Alwood, Cristina Zeretzke-Bien, Swathi Chalasani, Scott Herskovitz, Meagan C Blanchard, Yea Ping Lin
In order to minimize the amount of ionizing radiation to which young trauma patients are subjected, a cervical spine clearance project was implemented. The aim was to increase the number of pediatric trauma patients clinically cleared and decrease the number of such patients undergoing cervical spine CT imaging when they met clinical clearance criteria. To accomplish the goals, a brief education program about the epidemiology of pediatric cervical spine injuries, radiation exposure risks, and safe and effective means available for cervical spine clearance to pediatric trauma providers was delivered...
September 2015: Radiology Management
John I Shin, Nathan J Lee, Samuel K Cho
STUDY DESIGN: A retrospective administrative database analysis. OBJECTIVE: The aim of this study was to investigate the incidence and characteristics of pediatric cervical spine injury (PCSI) utilizing the Kids' Inpatient Database (KID). SUMMARY OF BACKGROUND DATA: PCSI is debilitating, but comprehensive analyses have been difficult due to its rarity. There have been a few database studies on PCSI; however, the studies employed databases that suffer from selection bias...
February 2016: Spine
John C Quinn, Nitesh V Patel, Rachana Tyagi
We present a novel salvage technique for pediatric subaxial cervical spine fusion in which lateral mass screw fixation was not possible due to anatomic constraints. The case presentation details a 4-year-old patient with C5-C6 flexion/distraction injury with bilateral jumped facets. Posterior cervical fixation was attempted; however, lateral mass fracture occurred during placement of screws. Using a wire-screw construct, an attempt was made to provide stable fixation. The patient was followed post-operatively for assessment of outcomes...
March 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
R Arun Babu, Arimappamagan Arivazhagan, B Indira Devi, Dhananjaya I Bhat, Somanna Sampath, B A Chandramouli
Cervical spine injuries occur infrequently in children but are associated with significant disability and mortality. A retrospective analysis was performed of 84 consecutive pediatric spine injuries treated at our institute from January 2002 to December 2011. The mean age was 14.7 years. There were 18 patients (21%) in group A (0-12 years) and 66 patients (79%) in group B (13-18 years). Overall, injury was more common in boys (ratio of 6:1). Trivial fall was the predominant cause in group A and fall from height in group B...
2016: Pediatric Neurosurgery
Patrick T Reeves, David N Herndon, Jessica D Tanksley, Kristofer Jennings, Gordon L Klein, Ronald P Mlcak, Robert P Clayton, Nancy N Crites, Joshua P Hays, Clark Andersen, Jong O Lee, Walter Meyer, Oscar E Suman, Celeste C Finnerty
Administration of oxandrolone, a nonaromatizable testosterone analog, to children for 12 months following severe burn injury has been shown to improve height, increase bone mineral content (BMC), reduce cardiac work, and augment muscle strength. Surprisingly, the increase in BMC persists well beyond the period of oxandrolone administration. This study was undertaken to determine if administration of oxandrolone for 2 years yields greater effects on long-term BMC and bone mineral density (BMD). Patients between 0 and 18 years of age with ≥30% of total body surface area burned were consented to an IRB-approved protocol and randomized to receive either placebo (n = 84) or 0...
April 2016: Shock
A Eran, D M Yousem, I Izbudak
BACKGROUND AND PURPOSE: Odontoid lateral mass interval asymmetry can be within the normal spectrum or the result of traumatic atlantoaxial injury. We sought to set radiographic guidelines for further investigation of odontoid lateral mass interval asymmetry in cervical spine CT studies of pediatric trauma patients. MATERIALS AND METHODS: Fourteen children with C1-2 ligamentous injury or atlantoaxial rotational fixation/subluxation were retrospectively identified...
January 2016: AJNR. American Journal of Neuroradiology
David Qualls, Jeffrey R Leonard, Martin Keller, Jose Pineda, Julie C Leonard
BACKGROUND: Evaluation of children for cervical spine injuries (CSIs) after blunt trauma is complicated, particularly if the patient is unresponsive because of severe traumatic brain injury. Plain radiography and computed tomography (CT) are commonly used, but CT combined with magnetic resonance imaging (MRI) is still considered the gold standard in CSI detection. However, MRI is expensive and can delay cervical clearance. The purpose of this study is to determine the added benefit of MRI as an adjunct to CT in the clearance of children with severe head trauma...
June 2015: Journal of Trauma and Acute Care Surgery
Simon C Mears, Hardin A Pantle, Edward S Bessman, Scott D Lifchez
Access to musculoskeletal consultation in the emergency department (ED) is a nationwide problem. In addition, consultation from a subspecialist may be delayed or may not be available, which can slow down the ED flow and reduce patient satisfaction. The purpose of this study was to review the 1-year results of a change in the authors' institutional practice to reduce subspecialty consultation for select musculoskeletal problems while still ensuring adequate patient follow-up in orthopedic or plastic surgery clinics for patients not seen by these services in the ED...
May 2015: Orthopedics
Neriman Özkan, Karsten Wrede, Ardeshir Ardeshiri, Zeynep Sariaslan, Klaus Peter Stein, Phillip Dammann, Oliver Müller, Adrian Ringelstein, Ulrich Sure, I Erol Sandalcioglu
PURPOSE: Spinal injuries are rarely seen in pediatric patients and therapeutic options are still poorly defined. The present study is aimed to present our experience with a rather large series of children and young adults suffering from traumatic spinal injury. PATIENTS AND METHODS: Between 1990 and 2010, 75 consecutive pediatric patients with spinal injuries were treated in our institution. Mean age was 15 years, ranging from 3 months to 21 years. Radiological findings, treatment strategies, and clinical outcome were evaluated retrospectively and compared with literature...
July 2015: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Justin J Ernat, Jeffrey B Knox, Robert L Wimberly, Anthony I Riccio
INTRODUCTION: While the use of vehicular restraints has reduced the morbidity and mortality of children involved in motor vehicle collisions (MVC), to our knowledge, no study has examined the relationship between restraint type and patterns of pediatric spinal injuries. The purpose of this study is to evaluate this association and review the spinal injuries sustained in children involved in MVC. METHODS: We completed an IRB-approved, retrospective chart review of all patients below 10 years of age presenting to a level 1 pediatric trauma hospital with spine injuries sustained in MVC from 2003 to 2011...
September 2016: Journal of Pediatric Orthopedics
Koichi Sairyo, Akihiro Nagamachi, Tetsuya Matsuura, Kosaku Higashino, Toshinori Sakai, Naoto Suzue, Daisuke Hamada, Yoichiro Takata, Tomohiro Goto, Toshihiko Nishisho, Yuichiro Goda, Takahiko Tsutsui, Ichiro Tonogai, Ryo Miyagi, Mitsunobu Abe, Masatoshi Morimoto, Kazuaki Mineta, Tetsuya Kimura, Akihiro Nitta, Tadahiro Higuchi, Shingo Hama, Subash C Jha, Rui Takahashi, Shoji Fukuta
Spondylolysis is a stress fracture of the pars interarticularis, which in some cases progresses to spondylolisthesis (forward slippage of the vertebral body). This slip progression is prevalent in children and occurs very rarely after spinal maturation. The pathomechanism and predilection for children remains controversial despite considerable clinical and basic research into the disorder over the last three decades. Here we review the pathomechanism of spondylolytic spondylolisthesis in children and adolescents, and specifically the Tokushima theory of growth plate slippage developed from our extensive research findings...
2015: Journal of Medical Investigation: JMI
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