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Pediatric c spine injury

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https://www.readbyqxmd.com/read/28921731/inter-observer-agreement-in-pediatric-cervical-spine-injury-assessment-between-prehospital-and-emergency-department-providers
#1
Lorin R Browne, Hamilton Schwartz, Fahd A Ahmad, Michael Wallendorf, Nathan Kuppermann, E Brooke Lerner, Julie C Leonard
BACKGROUND: Investigators have derived cervical spine injury (CSI) decision support tools from physician observations. There is a need to demonstrate that prehospital emergency medical services (EMS) providers can use these tools to appropriately determine the need for spinal motion restrictions and make field disposition decisions. OBJECTIVE: To determine the inter-observer agreement between EMS and emergency department (ED) providers for CSI risk assessment variables and overall gestalt for CSI in children after blunt trauma...
September 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28665242/changes-in-use-of-cervical-spine-magnetic-resonance-imaging-for-pediatric-patients-with-nonaccidental-trauma
#2
Ahyuda Oh, Michael Sawvel, David Heaner, Amina Bhatia, Andrew Reisner, R Shane Tubbs, Joshua J Chern
OBJECTIVE Past studies have suggested correlations between abusive head trauma and concurrent cervical spine (c-spine) injury. Accordingly, c-spine MRI (cMRI) has been increasingly used in radiographic assessments. This study aimed to determine trends in cMRI use and treatment, and outcomes related to c-spine injury in children with nonaccidental trauma (NAT). METHODS A total of 503 patients with NAT who were treated between 2009 and 2014 at a single pediatric health care system were identified from a prospectively maintained database...
September 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28656384/x-ray-vs-ct-in-identifying-significant-c-spine-injuries-in-the-pediatric-population
#3
Andrew T Hale, Abraham Alvarado, Amita K Bey, Sumit Pruthi, Gregory A Mencio, Christopher M Bonfield, Jeffrey E Martus, Robert P Naftel
PURPOSE: Evaluation of cervical spine injury (CSI) in children requires rapid, yet accurate assessment of damage. Given concerns of radiation exposure, expert consensus advises that computed tomography (CT) should be used sparingly. However, CT can provide superior image resolution and detection of pathology. Herein, we evaluate if X-ray offers equal diagnostic accuracy compared to CT imaging in identifying CSI in children. METHODS: We conducted a retrospective study between October 2000 and March 2012 of pediatric patients evaluated for cervical spine injury at a level 1 trauma center...
June 27, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28554184/vertebral-artery-dissection-in-a-bouncy-castle-injury-case-report-and-literature-review
#4
Valeria Ripa, Timur M Urakov, Sarah C Jernigan
There is an increased rate of injuries associated with activities on bouncy castles. The purpose of this article was to describe the case of a 6-year-old boy who sustained a brain infarct as a consequence of a left posterior inferior cerebellar artery dissection due to improper landing in a bouncy castle and who required a suboccipital craniotomy. The second goal was to outline the literature review regarding cervical trauma related to trampoline or bouncy castle accidents in pediatric populations. Based on the described case and reviewed studies, bouncy castle or any other activity resulting in hyperflexion or hyperextension of the neck should be carefully evaluated for cervical spine fractures and vascular injuries...
2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28550896/pediatric-near-drowning-events-do-they-warrant-trauma-team-activation
#5
Pranit N Chotai, Lisa Manning, Benjamin Eithun, Joshua C Ross, James W Eubanks, Chad Hamner, Ankush Gosain
BACKGROUND: The purpose of this study was to determine the incidence of traumatic injuries, factors associated with mortality, and need for pediatric trauma surgery involvement for drowning and near-drowning events in children. MATERIALS AND METHODS: An institutional review board-approved, retrospective chart review was performed at three American College of Surgeons-verified Pediatric Trauma Centers (2011-2014). Patients with International Classification of Diseases, Ninth Revision, codes or E-codes for fatal-nonfatal drowning, fall into water, accidental drowning, or submersion were included...
May 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28429117/a-comparison-of-mcgrath-mac%C3%A2-and-standard-direct-laryngoscopy-in-simulated-immobilized-cervical-spine-pediatric-intubation-a-manikin-study
#6
Marcin Madziala, Jacek Smereka, Marek Dabrowski, Steve Leung, Kurt Ruetzler, Lukasz Szarpak
Emergency airway management in children is generally considered to be challenging, and endotracheal intubation requires a high level of personal skills and experience. Immobilization of the cervical spine is indicated in all patients with the risk of any cervical spine injury but significantly aggravates endotracheal intubation. The best airway device in this setting has not been established yet, although the use of videolaryngoscopes is generally promising. Seventy-five moderately experienced paramedics of the Emergency Medical Service of Poland performed endotracheal intubations in a pediatric manikin in three airway scenarios: (A) normal airway, (B) manual in-line cervical immobilization, and (C) cervical immobilization using a Patriot cervical extrication collar and using two airway techniques: (1) McGrath videolaryngoscope and (2) Macintosh blade in a randomized sequence...
June 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28141768/atlantoaxial-rotatory-subluxation-in-children
#7
Elizabeth C Powell, Jeffrey R Leonard, Cody S Olsen, David M Jaffe, Jennifer Anders, Julie C Leonard
OBJECTIVES: Pediatric cervical injuries are uncommon. This study was to describe injury circumstances, clinical findings, and management among children diagnosed with atlantoaxial rotatory subluxation (AARS) to aid in its recognition and management. METHODS: Subanalysis of a large case-control study from January 2000 to December 2004 in 17 hospitals in the Pediatric Emergency Care Applied Research Network was performed. Cases were children younger than 16 years with AARS after blunt trauma (n = 55); controls were (a) children with other cervical spine injuries (other CSI, n = 485) and (b) those with normal imaging of the cervical spine (non-CSI, n = 1060)...
February 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27976464/methods-for-collecting-paired-observations-from-emergency-medical-services-and-emergency-department-providers-for-pediatric-cervical-spine-injury-risk-factors
#8
Fahd A Ahmad, Hamilton Schwartz, Lorin R Browne, Sherry Lassa-Claxton, Michael Wallendorf, E Brooke Lerner, Nathan Kuppermann, Julie C Leonard
OBJECTIVES: Cervical spine injuries (CSIs) after blunt trauma in children are rare, but cause substantial morbidity and mortality. Emergency medical services (EMS) and emergency department (ED) providers routinely use spinal precautions and cervical spine imaging, respectively, during the management of children experiencing blunt trauma. These practices lack evidence, and there is concern that they may be harmful. A pediatric CSI risk assessment tool is needed to inform EMS and ED provider decision making...
April 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27918863/ems-providers-beliefs-regarding-spinal-precautions-for-pediatric-trauma-transport
#9
Cindy D Chang, Remle P Crowe, Melissa A Bentley, Alyssa R Janezic, Julie C Leonard
OBJECTIVE: Describe prehospital Emergency Medical Services (EMS) providers' beliefs regarding spinal precautions for pediatric trauma transport. METHODS: We randomly surveyed nationally certified EMS providers. We assessed providers' beliefs about specific precautions, and preferred precautions given a child's age (0-4 or 5-18 years) and presence of specific cervical spine injury (CSI) risk factors. RESULTS: We received 5,400 responses (17%)...
May 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27894431/head-and-cervical-spine-evaluation-for-the-pediatric-surgeon
#10
REVIEW
Mary K Arbuthnot, David P Mooney, Ian C Glenn
This article is designed to guide pediatric surgeons in the evaluation and stabilization of blunt head and cervical spine injuries in pediatric patients. Trauma remains the number one cause of morbidity and mortality among children, and the incidence of head injuries continues to rise. Cervical spine injuries, on the other hand, are unusual but can be devastating if missed. This article highlights the pathophysiology unique to pediatric head and cervical spine trauma as well as keys to clinical and diagnostic evaluation...
February 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/27886884/classification-and-management-of-pediatric-craniocervical-injuries
#11
REVIEW
Hannah E Goldstein, Richard C E Anderson
This article addresses the key features, clinical presentation, patterns of injury, indicated workup, and radiographic findings associated with craniocervical injuries in the pediatric population. It discusses nonsurgical and surgical management of pediatric cervical spine trauma, addressing when each is indicated, and the various techniques available to the pediatric neurosurgeon.
January 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/27884333/c-spine-injury-and-mandibular-fractures-lifesaver-broken-in-two-spots
#12
Michael W Chu, Tahereh Soleimani, Tyler A Evans, Sarah I Fernandez, Leigh Spera, Carrie Klene, Ben L Zarzaur, Sunil S Tholpady
BACKGROUND: Trauma is a leading cause of injury and mortality and may involve mandibular fractures and cervical spine injuries. Manipulation of the spine during trauma protocols and operative treatment has the potential to cause serious spinal cord injuries. The purpose of this study was to identify risk factors associated with cervical spine injury (CSI) in patients with mandibular fractures. METHODS: The National Trauma Databank (2007-2010) was used to identify patients with mandibular fractures...
December 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27749628/cervical-spine-injuries-in-children-associated-with-sports-and-recreational-activities
#13
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
https://www.readbyqxmd.com/read/27662382/spine-injuries-in-child-abuse
#14
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
https://www.readbyqxmd.com/read/27603096/temporary-percutaneous-pedicle-screw-stabilization-without-fusion-of-adolescent-thoracolumbar-spine-fractures
#15
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
https://www.readbyqxmd.com/read/27231831/intraoperative-neuromonitoring-in-pediatric-and-adult-spine-deformity-surgery
#16
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
https://www.readbyqxmd.com/read/27231224/mr-imaging-of-the-cervical-spine-in-nonaccidental-trauma-a-tertiary-institution-experience
#17
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
https://www.readbyqxmd.com/read/27058457/multicenter-retrospective-evaluation-of-the-validity-of-the-thoracolumbar-injury-classification-and-severity-score-system-in-children
#18
MULTICENTER STUDY
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
https://www.readbyqxmd.com/read/27052667/paediatric-cervical-spine-injures-nineteen-years-experience-of-a-single-centre
#19
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
https://www.readbyqxmd.com/read/27032011/performance-improvement-and-patient-safety-program-guided-quality-improvement-initiatives-can-significantly-reduce-computed-tomography-imaging-in-pediatric-trauma-patients
#20
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
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