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Cervical spine injuries

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https://www.readbyqxmd.com/read/28723840/cervical-spine-evaluation-and-clearance-in-the-intoxicated-patient-a-prospective-western-trauma-association-multi-institutional-trial-and-survey
#1
Matthew J Martin, Lisa D Bush, Kenji Inaba, Saskya Byerly, Martin Schreiber, Kimberly A Peck, Galinos Barmparas, Jay Menaker, Joshua P Hazelton, Raul Coimbra, Martin D Zielinski, Carlos V R Brown, Chad G Ball, Jill R Cherry-Bukowiec, Clay Cothren Burlew, Julie Dunn, C Todd Minshall, Matthew M Carrick, Gina M Berg, Demetrios Demetriades, William Long
INTRODUCTION: Intoxication often prevents clinical clearance of the cervical spine (Csp) after trauma leading to prolonged immobilization even with a normal CT scan. We evaluated the accuracy of CT at detecting clinically significant Csp injury, and surveyed participants on related opinions and practice. METHODS: A prospective multicenter study (2013-2015) at 17 centers. All adult blunt trauma patients underwent structured clinical examination and imaging including a Csp CT, with follow-up thru discharge...
July 19, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28721000/roentgenographic-and-computerized-tomography-based-morphometric-analysis-of-cervical-spinal-canal-diameters-to-establish-normative-measurements-in-an-indian-population
#2
Kapil A Pawar, Arya S Mishra, Gokul Bandagi, Sudhir K Srivastava
Compressive cervical myelopathy secondary to degenerative changes in the cervical spine is a common cause of neurologic morbidity in the elderly. Identification of canal stenosis and addressing it surgically in addition to the obvious compressive lesions is essential to obtain satisfactory results. We attempt to define the saggital and transverse diameters in a normal adult population presenting at our centre with head injuries. We found that the values were lower than those reported in comparable studies for a western population, and also that the dimensions in women are significantly lower than in men...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28720989/trapezius-perforator-flap-for-reconstruction-of-a-posterior-cervical-defect
#3
Ricardo Nascimento, Joana Costa, Ricardo Horta, Álvaro Silva
The use of free flaps is considered the "gold standard" for reconstruction of head and neck defects. Locoregional flaps allows a better aesthetic result compared to free flaps, whenever there's an external skin defect. However the use of free flaps is not always adequate in the presence of preoperative comorbidities or previous surgeries. Since the description of the trapezius myocutaneous flap in the 1980's, many authors have published the results of the applicability of this flap in head and neck salvage reconstructive surgery...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28720987/management-of-post-traumatic-neglected-cervical-facet-dislocation
#4
Vinay Prabhat, Tankeshwar Boruah, Hitesh Lal, Ramesh Kumar, Ashish Dagar, Harekrushna Sahu
BACKGROUND: Post-traumatic unilateral or bilateral sub-axial cervical spine dislocations with locked facets are quite common. In developing countries like India, many patients with cervical injuries report late due to many reasons like rural backgrounds, lack of infrastructures and skilled surgeons, unawareness, poor socioeconomic status, lack of transportation to the specialized center with proper facility, etc. Early management is essential to maximize better neurological outcome. Delayed or neglected presentation makes treatment more challenging...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28720693/catastrophic-cervical-spinal-injury-in-an-amateur-college-wrestler
#5
Jayakrishnan Kelamangalathu Narayana Kurup, Ravitheja Jampani, Simanchal P Mohanty
A young amateur wrestler presented with a burst fracture of the seventh cervical vertebra with complete paraplegia. He was treated with surgery for spine stabilisation and was actively rehabilitated. Adolescents and teenagers are indulging in high-contact sports like wrestling, without proper training and technical know-how, which can lead to severe injuries and possibly, permanent handicap or death. Trainers, assistants and institutions should be well equipped to diagnose and provide initial care of people with a spinal injury to prevent a partial injury from progressing to complete injury...
July 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28713667/absent-congenital-cervical-pedicle-nearly-misdiagnosed-as-a-facet-dislocation-a-case-report
#6
Scott Safir, Jonathan Rasouli, Jeremy Steinberger, Branko Skovrlj, Amish Doshi, Konstantinos Margetis, Saadi Ghatan
BACKGROUND: Cervical spinal injury encompasses up to 1.5% of all pediatric injuries. Children, and more specifically infants, are a difficult subset of patients to obtain neurological exam in the setting of trauma, thus necessitating the use of cervical X-rays, CT scans, and MRI imaging. CASE DESCRIPTION: A healthy, 15-month-old boy had an unwitnessed fall down a flight of stairs and received a CT scan of the head and cervical spine in the emergency department due to cephalohematoma and mechanism of injury...
September 2017: Interdisciplinary Neurosurgery: Advanced Techniques and Case Management
https://www.readbyqxmd.com/read/28712898/iatrogenic-vertebral-artery-injury-during-anterior-cervical-spine-surgery-a-systematic-review
#7
REVIEW
Qing Guan, Long Chen, Ye Long, Zhou Xiang
BACKGROUND: Iatrogenic vertebral artery injury (VAI) during anterior cervical surgery is rare but potentially catastrophic. METHOD: The causes, presentation, diagnosis, management, prognosis, and prevention of VAI were reviewed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. English-language studies and case reports published from 1980 to 2017 were retrieved. Data on diagnosis, surgical procedures and approach, site and cause of VAI, management, outcomes, and VA status were extracted...
July 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28710046/image-guidance-to-aid-pedicle-screw-fixation-of-a-lumbar-fracture-dislocation-injury-in-a-toddler
#8
John K Houten, Jonathan Nahkla, Shashank Ghandi
BACKGROUND: Pedicle screw fixation of the lumbar spine in children less than two years of age is particularly challenging, as successful cannulation of the small pedicle dimensions require a high level of precision and there are no implants specifically designed for the infantile spine. Image-guided navigation is commonly used in adult spinal surgery and may be particularly helpful for placement of spinal screws where the bony anatomy is small and/or anatomically complex as in the upper cervical area...
July 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28710045/management-of-pediatric-atlantoaxial-rotatory-subluxation-with-a-simple-hand-made-cervical-traction-device-doing-more-with-less
#9
Mohammad Sadegh Masoudi, Nima Derakhshan, Fariborz Ghaffarpasand, Tayebeh Sadeghpoor
Atlanto-axial (C1- C2) joint is accountable for up to two third of total axial craniocervical rotation. Its major role in pivotal rotation of cervical spine makes it more vulnerable to a certain type of injury known as atlanto-axial rotatory subluxation (AARS). Management of AARS is based on the Fielding classification which includes closed reduction and immobilization and cervical fusion in unstable cases. There are several cervical traction devices including the Gardner-Wells tongs and halter traction device...
July 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28709833/anterior-reduction-and-fusion-for-treatment-of-massive-tear-drop-fracture-of-axis-combining-with-inferior-endplate-serious-traversed-lesion-a-retrospective-study
#10
Tao Jiang, Hong Yin, Xian-Jun Ren, Tong-Wei Chu, Wei-Dong Wang, Chang-Qing Li
BACKGROUND: Tear drop fracture of axis represents a very small percentage of injuries of the cervical spine, but there is controversy about the treatment method for tear drop fracture of axis, especially when a large avulsed fragment is significant displacement, which combined with the inferior endplate serious traversed lesion of axis. OBJECTIVE: To evaluate the clinical outcome of anterior reduction, graft fusion of C2-3 and plate fixation in the management of massive tear drop fracture of axis combining with inferior endplate serious traversed lesion of axis...
July 11, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28705774/asia-a-sensory-and-motor-complete-is-not-different-than-asia-b-sensory-incomplete-motor-complete-in-gunshot-related-spinal-cord-injury
#11
Eric McCoy, Nima Eftekhary, Kenneth Nwosu, Dudley Fukunaga, Charles Liu, Kevin Rolfe
Background Context We receive a large number of spinal cord injury (SCI) patients due to penetrating gunshot wounds (GSW) at our national rehabilitation center. Though many patients are labeled American Spinal Injury Association (ASIA) B sensory incomplete due to sensory sparing, especially deep anal pressure, with purported prognostic value, we have not observed a clinical difference from ASIA A completes. We hypothesized that sensory sparing, if meaningful, should reduce the occurrence of pressure ulcers...
July 10, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28700454/posterior-only-hemivertebra-resection-for-congenital-cervicothoracic-scoliosis-correcting-neck-tilt-and-balancing-the-shoulders
#12
Zhonghui Chen, Yong Qiu, Zezhang Zhu, Song Li, Xi Chen, Liang Xu, Xu Sun
STUDY DESIGN: A retrospective study. OBJECTIVE: To evaluate radiographic and cosmetic outcomes following posterior-only cervicothoracic hemivertebra resection and instrumentation. SUMMARY OF BACKGROUND DATA: Cervicothoracic hemivertebra is a rare congenital deformity. It locates between the mobile cervical spine and the fixed thoracic spine, leading to rapid curve progression, shoulder imbalance, fixed torticollis and facial asymmetry. METHODS: This study reviewed a consecutive series of 18 patients with cervicothoracic hemivertebra...
July 11, 2017: Spine
https://www.readbyqxmd.com/read/28694597/management-of-cervical-monoradiculopathy-due-to-prolapsed-intervertebral-disc-an-institutional-experience
#13
Amresh S Bhaganagare, S A Nagesh, B G Shrihari, Vikas Naik, M N Nagarjun, Balaji S Pai
BACKGROUND: Cervical radiculopathy is the common clinical entity, often caused by "wear and tear" changes that occur in the spine. In the younger population, cervical radiculopathy is a result of a disc herniation or an acute injury causing foraminal impingement of an exiting nerve, whereas in the older individuals, it is due to foraminal narrowing from osteophyte formation, decreased disc height, and degenerative changes of the uncovertebral joints anteriorly and of the facet joints posteriorly...
April 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/28694217/the-magnitude-of-angular-and-translational-displacement-of-dens-fractures-is-dependent-on-the-sagittal-alignment-of-the-cervical-spine-rather-than-the-force-of-injury
#14
Sabina R Blizzard, Bala Krishnamoorthy, Matthew Shinseki, Marcel Betsch, Jung Yoo
BACKGROUND CONTEXT: Although it is generally believed that the magnitude of dens fracture displacement is proportional to the amount of force applied to the cervical spine during injury, the factors responsible for displacement have not been studied. PURPOSE: Our aim was to determine factors which contribute to horizontal and angular displacement of dens fractures. STUDY DESIGN/SETTING: We conducted a retrospective review of adult patients who were admitted to our level one trauma center between 1/1/2008 and 12/31/2013...
July 7, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28692625/a-new-craniothoracic-mattress-for-immobilization-of-the-cervical-spine-in-critical-care-patients
#15
Micha Holla, Mitchel Driessen, Thomas G E Eggen, Robin A Daanen, Allard J F Hosman, Nico Verdonschot, Gerjon Hannink
Current immobilization techniques of the cervical spine are associated with complications including pressure ulcers, discomfort, and elevated intracranial pressures with limited access to the thorax and airway. In this study, a newly developed craniothoracic immobilizer (Pharaoh mattress) for critical care patients with cervical injury was tested for its restriction of cervical movement, peak interface pressures, comfort, and radiolucency, and compared with headblocks strapped to a spineboard. Cervical movement was measured by roentgen stereophotogrammetric analysis in 5 fresh frozen cadavers...
July 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28684013/cervical-spine-alignment-in-helmeted-skiers-and-snowboarders-with-suspected-head-and-neck-injuries-comparison-of-lateral-c-spine-radiographs-before-and-after-helmet-removal-and-implications-for-ski-patrol-transport
#16
Jared Murray, David A Rust
OBJECTIVE: Current protocols for spine immobilization of the injured skier/snowboarder have not been scientifically validated. Observing changes in spine alignment during common rescue scenarios will help strengthen recommendations for rescue guidelines. METHODS: Twenty-eight healthy volunteers (18 men, 10 women) age 47±17 (range 20-73) (mean ±SD with range) underwent a mock rescue in which candidate patrollers completing an Outdoor Emergency Care course performed spine immobilization and back boarding in 3 scenarios: 1) Ski helmet on, no c-collar; 2) helmet on, with c-collar; and 3) helmet removed, with c-collar...
July 3, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28682906/one-stage-surgical-treatment-of-cervical-spine-fracture-dislocation-in-patients-with-ankylosing-spondylitis-via-the-combined-anterior-posterior-approach
#17
Axiang He, Dong Xie, Xiaomin Cai, Bo Qu, Qin Kong, Chenhui Xu, Lili Yang, Xiongsheng Chen, Lianshun Jia
The aim of the article is to investigate the efficacy and safety of 1-stage surgical therapy via combined anterior-posterior approach on cervical spine fracture in patients with ankylosing spondylitis (AS).We retrospectively analyzed profiles of 12 AS patients with severe fracture-dislocation of cervical spine received 1-stage combined anterior-posterior surgery in our hospital from October, 2013, to October, 2015, including clinical characteristics, follow-up data, and imaging records. We compared the parameters before and after surgery on the basis of neurological function, bone fusion, Cobb angles of operation segment, Barthel index (BI) score, and incidence rate of complications...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28678026/transoral-closed-reduction-of-fixed-atlanto-axial-rotatory-subluxation-aars-in-childhood-and-adolescence
#18
Dezsoe Jeszenszky, Tamas Fekete, Frank Kleinstück, Daniel Haschtmann, Markus Loibl
Atlanto-axial rotatory-subluxation (AARS) is the most common pediatric cervical spine injury. Patients usually present with contralateral rotation and inclination of the upper cervical spine after minor trauma, or associated with an infection of the upper respiratory tract. According to the authors, initial management of patients with acute and chronic AARS type I-II should comprise closed reduction and immobilization with a cervical collar or a Halo-Body-Jacket. Surgical options of open reduction or C1/2 fusion should be restricted to irreducible or recurrent subluxations...
July 3, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28673831/risk-factors-for-laryngeal-penetration-aspiration-in-patients-with-acute-traumatic-cervical-spinal-cord-injury
#19
Tiina Ihalainen, Irina Rinta-Kiikka, Teemu M Luoto, Tuomo Thesleff, Mika Helminen, Anna-Maija Korpijaakko-Huuhka, Antti Ronkainen
BACKGROUND CONTEXT: Laryngeal penetration-aspiration, entry of material into the airways, is considered the most severe subtype of dysphagia and common among patients with acute cervical spinal cord injury. PURPOSE: The aim of this study was to investigate risk factors for penetration-aspiration in patients with acute traumatic cervical spinal cord injury (TCSCI). STUDY DESIGN: A prospective cohort study. PATIENT SAMPLE: Thirty-seven patients with TCSCI...
June 30, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28673827/the-impact-of-spine-stability-on-cervical-spinal-cord-injury-with-respect-to-demographics-management-and-outcome-a-prospective-cohort-from-a-national-sci-registry
#20
Jérôme Paquet, Carly S Rivers, Dilinuer Kuerban, Joel Finkelstein, Jin W Tee, Vanessa K Noonan, Brian K Kwon, R John Hurlbert, Sean Christie, Eve C Tsai, Henry Ahn, Brian Drew, Christopher S Bailey, Daryl R Fourney, Najmedden Attabib, Michael G Johnson, Michael G Fehlings, Stefan Parent, Marcel F Dvorak
BACKGROUND CONTEXT: Emergent surgery for patients with a traumatic spinal cord injury (SCI) is seen as the gold standard in acute management. However, optimal treatment for those with the clinical diagnosis of central cord syndrome (CCS) is less clear and classic definitions of CCS do not identify a unique population of patients. PURPOSE: To test the authors' hypothesis that spine stability can identify a unique group of patients with regards to demographics, management, and outcomes, which classic CCS definitions do not...
June 30, 2017: Spine Journal: Official Journal of the North American Spine Society
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