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Spine immobilization

Kivanc Atesok, Nobuhiro Tanaka, Andrew O'Brien, Yohan Robinson, Dachling Pang, Donald Deinlein, Sakthivel Rajaram Manoharan, Jason Pittman, Steven Theiss
"Spinal Cord Injury without Radiographic Abnormality" (SCIWORA) is a term that denotes objective clinical signs of posttraumatic spinal cord injury without evidence of fracture or malalignment on plain radiographs and computed tomography (CT) of the spine. SCIWORA is most commonly seen in children with a predilection for the cervical spinal cord due to the increased mobility of the cervical spine, the inherent ligamentous laxity, and the large head-to-body ratio during childhood. However, SCIWORA can also be seen in adults and, in rare cases, the thoracolumbar spinal cord can be affected too...
2018: Advances in Orthopedics
Michael J Moses, Jared C Tishelman, Saqib Hasan, Peter L Zhou, Ioanna Zevgaras, Justin S Smith, Aaron J Buckland, Yong Kim, Afshin Razi, Themistocles S Protopsaltis
STUDY DESIGN: Cross-Sectional Study. OBJECTIVE: The goal of this study is to investigate how surgeons differ in collar and narcotic use, as well as return to driving recommendations following cervical spine surgeries and the associated medico-legal ramifications of these conditions. SUMMARY OF BACKGROUND DATA: Restoration of quality of life is one of the main goals of cervical spine surgery. Patients frequently inquire when they may safely resume driving after cervical spine surgery...
March 9, 2018: Spine
J Juanos Cabanas, H Jennart, G Leclercq, D Zorman
Acromioclavicular dislocation is a frequent pathology commonly encountered in traumatology. Therefore, its management is generally standardized, guided by clinical and radiological evaluation. This can range from conservative treatment by limb immobilization and functional rehabilitation, to surgical treatment by using minimally invasive techniques. We present the particular case of a 74-year-old patient with an acromioclavicular dislocation associated with a non-displaced fracture of the coracoid process as well as of the spine of the scapula...
2018: Revue Médicale de Bruxelles
Taylor E Purvis, Rafael De la Garza-Ramos, Nancy Abu-Bonsrah, C Rory Goodwin, Mari L Groves, Michael C Ain, Daniel M Sciubba
OBJECTIVE: To compare in-hospital complication rates in pediatric patients with atlantoaxial and subaxial injuries undergoing either external fixation or surgical fusion. PATIENTS AND METHODS: Baseline and outcome data were obtained from the 2002-2011 Nationwide Inpatient Sample (NIS) for patients under the age of 18 with a diagnosis of cervical spine fracture without spinal cord injury or cervical spine subluxation. Patients who underwent external immobilization or internal fixation were included for analysis...
February 5, 2018: Clinical Neurology and Neurosurgery
XiangYu Xu, SongBo Han, Liang Jiang, ShaoMin Yang, XiaoGuang Liu, HuiShu Yuan, Feng Wei, FengLiang Wu, Lei Dang, Hua Zhou, Hua Zhang, ZhongJun Liu
BACKGROUND CONTEXT: Langerhans cell histiocytosis (LCH) of the spine is a relatively rare condition with unknown etiology. The diagnosis and treatment protocols for spine LCH remain controversial. PURPOSE: In this study, we evaluated the efficacy and safety of our proposed diagnosis and treatment protocol introduced in 2009. STUDY DESIGN: This is a retrospective study. PATIENT SAMPLE: One hundred and ten patients with spine LCH who had been diagnosed and treated in our hospital from October 1997 to November 2015 were included in this study...
March 2, 2018: Spine Journal: Official Journal of the North American Spine Society
William M Rambo
INTRODUCTION: Septic infection of a lumbar intervertebral disc is a serious disorder which is often difficult to diagnose and appropriately treat because of the rarity of the disease, the varied presentation of symptoms, and the frequency of low-back pain within the overall population. Its etiology can be pyogenic, granulomatous, fungal, or parasitic; its incidence is rising due to increased patient susceptibility and improved diagnostic tools. Conservative treatments involve antibiotics, physical therapy, and/or immobilization...
February 10, 2018: International Journal of Surgery Case Reports
Erik E Swartz, W Steven Tucker, Matthew Nowak, Jason Roberto, Amy Hollingworth, Laura C Decoster, Thomas W Trimarco, Jason P Mihalik
OBJECTIVE: This study aims to evaluate the efficacy of two different spinal immobilization techniques on cervical spine movement in a simulated prehospital ground transport setting. METHODS: A counterbalanced crossover design was used to evaluate two different spinal immobilization techniques in a standardized environment. Twenty healthy male volunteers (age = 20.9 ± 2.2 yr) underwent ambulance transport from a simulated scene to a simulated emergency department setting in two separate conditions: utilizing traditional spinal immobilization (TSI) and spinal motion restriction (SMR)...
February 16, 2018: Prehospital Emergency Care
Brian M Clemency, Christopher T Tanski, Jennifer Gibson Chambers, Michael O'Brien, Andrew S Knapp, Alexander J Clark, Patrick McGoff, Johanna Innes, Heather A Lindstrom, David Hostler
BACKGROUND: Backboards have been shown to cause pain in uninjured patients. This may alter physical exam findings, leading emergency department (ED) providers to suspect a spinal injury when none exists resulting in additional imaging of the thoracolumbar spine. New York had previously employed a "Spinal Immobilization" protocol that included compulsory backboard application for all patients with suspected spinal injuries. In 2015, New York instituted a new "Spinal Motion Restriction" protocol that made backboard use optional for these patients...
February 15, 2018: Prehospital Emergency Care
Linda Underbrink, Alice Twink Dalton, Jan Leonard, Pamela W Bourg, Abigail Blackmore, Holly Valverde, Thomas Candlin, Lisa M Caputo, Christopher Duran, Sherrie Peckham, Jeff Beckman, Brandon Daruna, Krista Furie, Debra Hopgood
OBJECTIVE: The impact of immobilization techniques on older adult trauma patients with spinal injury has rarely been studied. Our advisory group implemented a change in the immobilization protocol used by emergency medical services (EMS) professionals across a region encompassing 9 trauma centers and 24 EMS agencies in a Rocky Mountain state using a decentralized process on July 1, 2014. We sought to determine whether implementing the protocol would alter immobilization methods and affect patient outcomes among adults ≥60 years with a cervical spine injury...
February 6, 2018: Prehospital Emergency Care
Jinlin Jiang, Zhengjun Shan, Xiaorong Wang, Yuxuan Zhu, Junying Zhou
The nonsteroidal ecdysone mimic 1,2-dibenzoyl-1-tert-butylhydrazine (RH-5849), a novel insect growth regulator, is mainly registered for use in rice fields. So far, its toxicity and ecological risks towards aquatic cladoceran invertebrates remain unclear. In this study, RH-5849 was evaluated for its acute and 21-day chronic toxicity towards Daphnia magna. The viability, morphology, growth, and reproduction of D. magna were observed to establish a concentration-toxicity relationship associated with the RH-5849 exposure...
February 2, 2018: Environmental Science and Pollution Research International
Mary P Zhu, Lindsay A Tetreault, Fatimah Sorefan-Mangou, Philip Garwood, Jefferson R Wilson
BACKGROUND CONTEXT: Bracing is often used after spinal surgery to immobilize the spine, improve fusion, and relieve pain. However, controversy exists regarding the efficacy, necessity and safety of various bracing techniques in the post-surgical setting. PURPOSE: In this systematic review, we aimed to compare the effectiveness, safety and cost-effectiveness of postoperative bracing versus no postoperative bracing following spinal surgery in patients with several common operative spinal pathologies...
January 17, 2018: Spine Journal: Official Journal of the North American Spine Society
Marc O'Donnell, William F Lavelle, Mike H Sun
Spondylolysis is frequently seen in adolescents, typically at the L5 vertebral level. While there may be a congenital predisposition for spondylolysis, it has long been suggested that the defect results from a fatigue or stress fracture of the pars interarticularis. Spondylolisthesis may result from a bilateral spondylolytic defect and is frequently asymptomatic. There is a paucity of literature on infant and toddler spondylolysis, as the focus is primarily on school-aged children, typically those over ten years of age...
December 2017: Journal of Spine Surgery (Hong Kong)
Brian E Etier, Grant E Norte, Megan M Gleason, Dustin L Richter, Kelli F Pugh, Keith B Thomson, Lindsay V Slater, Joe M Hart, Stephen F Brockmeier, David R Diduch
Background: The National Athletic Trainers' Association (NATA) advocates for cervical spine immobilization on a rigid board or vacuum splint and for removal of athletic equipment before transfer to an emergency medical facility. Purpose: To (1) compare triplanar cervical spine motion using motion capture between a traditional rigid spine board and a full-body vacuum splint in equipped and unequipped athletes, (2) assess cervical spine motion during the removal of a football helmet and shoulder pads, and (3) evaluate the effect of body mass on cervical spine motion...
December 2017: Orthopaedic Journal of Sports Medicine
Raquel Gordillo Martin, Pedro E Alcaráz, Laura Juguera Rodriguez, Antonio Nieto Fernandez-Pacheco, Elena Marín-Cascales, Tomás T Freitas, Manuel Pardo Rios
More than 7.5 million people in the world are affected by spinal cord injury (SCI). In this study, we aimed to analyze the effect of training in advanced trauma life support (ATLS) on the kinematics of the spine when performing different mobilization and immobilization techniques on patients with suspected SCI. A quasi-experimental study, clinical simulation, was carried out to determine the effect of training in ATLS on 32 students enrolled in the Master's program of Emergency and Special Care Nursing. The evaluation was performed through 2 maneuvers: placing of the scoop stretcher (SS) and spinal board (SB), with an actor who simulated a clinical situation of suspected spinal injury...
December 2017: Medicine (Baltimore)
Catherine G Velopulos, Hasan M Shihab, Lawrence Lottenberg, Marcie Feinman, Ali Raja, Jeffrey Salomone, Elliott R Haut
BACKGROUND: Spine immobilization in trauma has remained an integral part of most emergency medical services (EMS) protocols despite a lack of evidence for efficacy and concern for associated complications, especially in penetrating trauma patients. We reviewed the published evidence on the topic of prehospital spine immobilization or spinal motion restriction in adult patients with penetrating trauma to structure a Practice Management Guideline. METHODS: We conducted a Cochrane style systematic review and meta-analysis, and applied GRADE methodology to construct recommendations...
December 28, 2017: Journal of Trauma and Acute Care Surgery
Carolyn E Carr, Rajkumar Ganugula, Ronald Shikiya, Ana Maria Soto, Luis A Marky
Oligonucleotide-directed triple helix formation has been recognized as a potential tool for targeting genes with high specificity. Cystosine methylation in the 5' position is both ubiquitous and a stable regulatory modification, which could potentially stabilize triple helix formation. In this work, we have used a combination of calorimetric and spectroscopic techniques to study the intramolecular unfolding of four triplexes and two duplexes. We used the following triplex control sequence, named Control Tri, d(AGAGAC5TCTCTC5TCTCT), where C5 are loops of five cytosines...
December 22, 2017: Biochimie
Atsushi Tanida, Shinji Tanishima, Tokumitsu Mihara, Aya Narita, Yoshihiro Maegaki, Hideki Nagashima
CASE: A 16-year-old girl with Pompe disease underwent surgery for scoliosis. She had been able to walk without any assistance, and kept her balance by swinging her waist. Therefore, we performed posterior selective spinal correction and fusion to avoid any adverse effects on walking ability that could occur with immobilization of the lumbosacral spine. After surgery, she was highly satisfied with her ability to perform the activities of daily living. CONCLUSION: For nonambulatory patients with scoliosis and Pompe disease, long fusion from the upper thoracic spine to the pelvis is generally required...
January 2017: JBJS Case Connector
Nitin Agarwal, Robert F Heary, Prateek Agarwal
OBJECTIVE Pedicle screw fixation is a technique widely used to treat conditions ranging from spine deformity to fracture stabilization. Pedicle screws have been used traditionally in the lumbar spine; however, they are now being used with increasing frequency in the thoracic spine as a more favorable alternative to hooks, wires, or cables. Although safety concerns, such as the incidence of adjacent-segment disease (ASD) after cervical and lumbar fusions, have been reported, such issues in the thoracic spine have yet to be addressed thoroughly...
December 15, 2017: Journal of Neurosurgery. Spine
Sandra Larson, Andrew U Delnat, Jill Moore
INTRODUCTION: Five million patients in America are placed in spinal immobilization annually, with only 1% to 2% of these patients suffering from an unstable cervical spine injury. Prehospital agencies are employing selective and limited immobilization practices, but there is concern that this practice misses cervical spine injuries and therefore possibly predisposes patients to worsening injuries. METHODS: A systematic review was conducted that examined literature from the last 5 years that reviewed cervical spine immobilization application and/or clearance in alert trauma patients...
December 1, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
Gautam Zaveri, Gurdip Das
Sub-axial cervical spine injuries are commonly seen in patients with blunt trauma. They may be associated with spinal cord injury resulting in tetraplegia and severe permanent disability. Immobilization of the neck, maintenance of blood pressure and oxygenation, rapid clinical and radiological assessment of all injuries, and realignment of the spinal column are the key steps in the emergency management of these injuries. The role of intravenous methylprednisolone administration in acute spinal cord injuries remains controversial...
November 2017: Indian Journal of Orthopaedics
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