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Spine immobilization

Eugene Kim, Byung-Gun Kim, Young-Jin Lim, Young-Tae Jeon, Jung-Won Hwang, Seo-Yun Lee, Hee-Pyoung Park
BACKGROUND: Positioning of a lightwand in the midline of the oral cavity can be challenging in patients with cervical immobilization. Direct laryngoscopy may permit the lightwand tip to more easily access the glottic opening. We tested our hypothesis that a laryngoscope-assisted lightwand technique allows more successful endotracheal intubation than does a conventional lightwand approach. METHODS: A total of 162 patients requiring cervical immobilization during intubation for cervical spine surgery were allocated randomly to 2 groups...
October 11, 2016: Anesthesia and Analgesia
Jung-In Ko, Sang Ook Ha, Min Seok Koo, Miyoung Kwon, Jieun Kim, Jin Jeon, So Hee Park, Sangwoo Shim, Youjin Chang, Taejin Park
OBJECTIVE: Airway management in patients with suspected cervical spine injury is classified as a "difficult airway." The best device for managing difficult airways is not known. Therefore, we conducted an intubation study simulating patients with cervical spine injury using three devices: a conventional Macintosh laryngoscope, a video laryngoscope (GlideScope), and a fiberoptic bronchoscope (MAF-TM). Success rates, intubation time, and complication rates were compared. METHODS: Nine physician experts in airway management participated in this study...
December 2015: Clin Exp Emerg Med
Alan Cowley, Ashley Hague, Neal Durge
Techniques for extricating vehicle occupants after road-traffic collisions have evolved largely through fear of worsening a cervical spine injury, rather than being evidence-based. Recent research has looked at the safety of allowing the alert patient to self-extricate, rather than being assisted with equipment such as long spinal boards and semirigid cervical collars. This review aims to elucidate whether it is safe to allow an alert, ambulant patient to self-extricate from a vehicle with minimal or no cervical spine immobilization...
September 29, 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
Ali Babashahi, Morteza Taheri
Spinal kyphotic deformity after spinal laminectomy or laminoplasty is more common in pediatric patients than adults. Laminectomy can lead to decreased cartilage growth, anterior wedging and posterior spinal muscle insufficiency which can result in kyphotic deformity. Herein we outline a case report of a child presenting with kyphotic deformity after receiving a spinal laminectomy to treat a penetrating spinal trauma. The 8-year-old male presented with penetrating spinal trauma following a gunshot wound and subsequently underwent L1 laminectomy and thecal sac decompression to remove the foreign body...
March 2016: J Spine Surg
Prashanth J Rao, Kevin Phan, Ralph J Mobbs, David Wilson, Jonathon Ball
BACKGROUND: Immobilization of the cervical spine is a cornerstone of spinal injury management. In the context of suspected cervical spine injury, patients are immobilized in a 'neutral position' based on the head and trunk resting on a flat surface. It is hypothesized that the increased thoracic kyphosis and loss of cervical lordosis seen in elderly patients may require alternative cervical immobilization, compared with the 'neutral position'. METHODS: To investigate this, an audit of pan-scan CT performed on consecutive major trauma patients aged over 65 years was carried out over a 6-month period...
March 2016: J Spine Surg
Leila Louise Benhassen, Thomas Balslev, Lise Gammelgaard, Lena Hagelskjær Kristensen, Bjarne Møller-Madsen
Intervertebral discitis is a rare disorder which is easily missed. It presents with non-specific symptoms such as irritability, abdominal pain, decreased appetite and limping. The infection parameters can be normal, and blood cultures are often negative. The pathogenesis is not established but infectious, and inflammatory aetiologies have been suggested. Diagnostic golden standard is magnetic resonance imaging. The treatment is immobilization, anti-inflammatory drugs and often antibiotics. Early treatment is important to reduce the risk of complications such as nerve damage and spine fusion...
September 19, 2016: Ugeskrift for Laeger
Kevin J DiSilvestro, Adam J Santoro, Fotios P Tjoumakaris, Eric A Levicoff, Kevin B Freedman
BACKGROUND: Patients often ask their doctors when they can safely return to driving after orthopaedic injuries and procedures, but the data regarding this topic are diverse and sometimes conflicting. Some studies provide observer-reported outcome measures, such as brake response time or simulators, to estimate when patients can safely resume driving after surgery, and patient survey data describing when patients report a return to driving, but they do not all agree. We performed a systematic review and quality appraisal for available data regarding when patients are safe to resume driving after common orthopaedic surgeries and injuries affecting the ability to drive...
August 4, 2016: Clinical Orthopaedics and related Research
Krzysztof Malinowski
The rescuer often has to deal with patients who have suffered trauma to the bone , including heads, spine, lower and upper limbs. Serious injuries or multiorgan grudges are a frequent result of communicative cases, and a fast but accurate examination is a condition of the success of a rescue operation, putting the preliminary diagnosis and implementing real rescue activities. Delays in a rescue operation or the lack appropriate the equipment is threatening the patient with the permanent disability or even a loss of life...
2016: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
S Weckbach, B Lutz, J V Wölfle-Roos, H Reichel
Spinal infections are relatively rare entities but the incidence is significantly increasing due to the rapidly growing numbers of interventions on the spine. Primary infections of intervertebral discs (spondylodiscitis) and vertebral bodies (spondylitis) are distinguished from secondary postinterventional infections. Treatment relies primarily on either conservative or surgical management. In the absence of indications for surgery, a conservative approach is indicated when the patient is neurologically intact and the bony destruction is minimal...
October 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Vahe M Zohrabian, Adam E Flanders
The goal of imaging in spine trauma is to gauge the extent of bony, vascular, and neurologic compromise. Neurologic and mechanical stability are key pieces of information that must be efficiently communicated to the referring clinician. From immobilization and steroid therapy, to vascular repair and emergent surgical intervention, clinical outcomes of spine-injured patients depend on timely and well-chosen imaging studies. Multidetector computed tomography (CT) has essentially replaced radiography in clearance of the spine and is the gold standard in evaluation of the bony spinal column...
2016: Handbook of Clinical Neurology
Hans-Joachim Wilke, Dominik Kaiser, David Volkheimer, Carsten Hackenbroch, Klaus Püschel, Michael Rauschmann
PURPOSE: For the stabilization of the thoracolumbar spine area, various stabilization techniques have been developed in recent decades. The aim of these techniques is to immobilize the treated segment to repositioning or correct the spine and guaranty long-term stability to achieve a reliable fusion. The aim of this study was to simulate in an in vitro experiment the postoperative long-term situation in elderly osteoporotic patients to compare two different stabilization principles; a pedicle screw system and a lamina hook system...
September 2016: European Spine Journal
Z Guo, M Yao, J Wang, K Sun, Z Ji
Objective: This work aims to investigate the efficacy of debridement for paediatric thoracolumbar spinal tuberculosis (TB) by using the anterior approach and the allogeneic bone graft. Methods: The lesions of 16 children diagnosed with thoracolumbar spinal TB were exposed via the anterior approach. The pleura and peritoneum, granulation tissue, pus and dead bones of the TB, and the intervertebral disc with pathological changes and necrosis were completely eliminated...
December 10, 2015: West Indian Medical Journal
Yi-Kan Cheng, Lei Zeng, Shu-Biao Ye, Jian Zheng, Lin Zhang, Peng Sun, Xiao-Bo Jiang, Wen-Zhao Sun, Tao Xu, Lei Chen
OBJECTIVE: To report a novel approach for craniospinal irradiation (CSI) using a supine isocentric technique. METHODS: Patients were treated in the supine position using CT simulation. Half-beam-blocked lateral cranial fields and superior spinal fields have the same isocentre, and their beam divergences match. Tangential irradiation provides a non-divergent junction for the other two full-beam spinal fields. Shielding for cranial fields was generated, and dose distribution was calculated using a three-dimensional planning system...
September 2016: British Journal of Radiology
Katarzyna Kępczyńska, Małgorzata Zajda, Zbigniew Lewandowski, Jerzy Przedlacki, Beata Zakrzewska-Pniewska
BACKGROUND: Vitamin D (VD), an important factor for bone health immobilization and immune regulation, has been shown to have low serum concentration in multiple sclerosis (MS) patients. Those patients have also multiple fracture risk factors, including progressive immobilization and long-term glucocorticoids treatment. The aim of the study was to analyze bone health (osteopenia or osteoporosis prevalence) and VD serum concentration in MS patients as well as the influence of disease activity and treatment on bone health...
July 2016: Neurologia i Neurochirurgia Polska
J Pogorzelski, S Braun, A B Imhoff, K Beitzel
OBJECTIVE: Treatment of posterior shoulder instability with increased retroversion of the glenoid using open-wedge osteotomy of the glenoid neck stabilized with an autologous bone block. INDICATIONS: Symptomatic, atraumatic posterior shoulder instability with increased retroversion (>20°) of the glenoid and previously failed conservative or surgical treatment. CONTRAINDICATIONS: General contraindications against surgery. Relative contraindications: osteoporosis, nicotine abuse, or suspected patient noncompliance...
June 29, 2016: Operative Orthopädie und Traumatologie
M Kreinest, S Goller, G Rauch, B Gliwitzky, C Frank, S Matschke, C G Wölfl, M Münzberg
BACKGROUND: The application of cervical collars is a standard procedure in emergency care of trauma patients. It is often observed that the application of cervical collars is performed incorrectly, which may lead to reduced immobilization of the cervical spine. OBJECTIVES: The objective of this study was to analyze the practical skills of professional emergency care providers concerning the application of cervical collars. MATERIALS AND METHODS: Emergency care professionals (n = 104) were asked to apply a cervical collar to a training doll...
June 29, 2016: Der Unfallchirurg
Christian von Rüden, Peter Augat
This manuscript will provide an overview of how the age and osteoporosis related changes in mechanical properties of bone affect the stability of osteosynthesis constructs, both from a mechanical as well as from a clinical perspective. The manuscript will also address some of the principles of fracture fixation for osteoporotic fractures and discuss applications of osteoporotic fracture fixation at sites typically affected by fragility fractures, namely the distal radius, the proximal humerus, the femur and the spine...
June 2016: Injury
H W Ham, L Schoonhoven, M J Schuurmans, L P H Leenen
Of all patients in a hospital environment, trauma patients may be particularly at risk for developing (device-related) pressure ulcers (PUs), because of their traumatic injuries, immobility, and exposure to immobilizing and medical devices. Studies on device-related PUs are scarce. With this study, the incidence and characteristics of PUs and the proportion of PUs that are related to devices in adult trauma patients with suspected spinal injury were described. From January-December 2013, 254 trauma patients were visited every 2 days for skin assessment...
2016: Nederlands Tijdschrift Voor Geneeskunde
Mark N Pernik, Hudson H Seidel, Ryan E Blalock, Andrew R Burgess, MaryBeth Horodyski, Glenn R Rechtine, Mark L Prasarn
BACKGROUND: Most emergency transport protocols in the United States currently call for the use of a spine board (SB) to help immobilize the trauma patient. However, there are concerns that their use is associated with a risk of pressure ulcer development. An alternative device, the vacuum mattress splint (VMS) has been shown by previous investigations to be a viable alternative to the SB, but no single study has explicated the tissue-interface pressure in depth. METHODS: To determine if the VMS will exert less pressure on areas of the body susceptible to pressure ulcers than a SB we enrolled healthy subjects to lie on the devices in random order while pressure measurements were recorded...
August 2016: Injury
Z Wang, L N Zhu, L Zhou, B Yi
OBJECTIVE: To evaluate the feasibility of integrating 3D photos and cone-beam computed tomography (CBCT) images and to assess the degree of error that may occur during the above process, and to analyze soft and hard tissue changes after orthognathic surgery using this new method. METHODS: Ten patients with maxillofacial deformities were chosen. For each patient, CBCT scans and stereophotographic images were taken before and 3 months after surgery. 3D photos were superimposed onto the CBCT skin images using relatively immobile areas of the face as a reference...
June 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
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