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Cervical spine injuries

Christian B Theodotou, George M Ghobrial, Andrew L Middleton, Michael Y Wang, Allan D Levi
BACKGROUND: Cervical facet dislocations are among the most common traumatic spinal injuries. Posterior, anterior, and combined surgical approaches have been described and are widely debated. OBJECTIVE: To demonstrate efficacy in anterior-only surgical management for subaxial cervical facet dislocations. METHODS: A consistent surgical algorithm for cervical facet dislocation was applied over a 19-yr period and analyzed retrospectively in adults with acute unilateral or bilateral facet dislocation of the subaxial cervical spine...
March 14, 2018: Neurosurgery
Yad Ram Yadav, Shailendra Ratre, Vijay Parihar, Amitesh Dubey, Mashoo N Dubey
Symptomatic ventral cervical cord compressions have been treated by anterior discectomy with fusion, anterior corpectomy and fusion, discectomy with an artificial disc, and minimally invasive techniques. There are complications associated with the fusion procedure, especially when a long segment fusion is undertaken. Partial removal of the vertebral body without fusion could help in avoiding fusion and its associated complications. We are describing the detailed surgical technique, indications, limitations, and early results of endoscopic partially corpectomy...
March 2018: Neurology India
Kyriakos Paraskeva, Dimitrios Giakoumettis, Ioannis Nikas, George Georgoulis, George Sfakianos, Marios S Themistocleous
INTRODUCTION: Neck pain and torticollis are common symptoms in the pediatric population that rarely requires further investigation. However, in case symptoms persist, then a more meticulously approach should be considered. Underlying conditions such as infections, neck injury, autoimmune disorders or even cervical spine cancer should be excluded from diagnosis. Cervical spine cancer is a rare neurosurgical entity in the pediatric population and even rarer is atlantoaxial Ewing's sarcoma...
March 3, 2018: Neurologia i Neurochirurgia Polska
Roger W Nightingale, Cameron R Bass, Barry S Myers
BACKGROUND: Cervical bilateral facet dislocations are among the most devastating spine injuries in terms of likelihood of severe neurological sequelae. More than half of patients with tetraparesis had sustained some form of bilateral facet fracture dislocation. They can occur at any level of the sub-axial cervical spine, but predominate between C5 and C7. The mechanism of these injuries has long been thought to be forceful flexion of the chin towards the chest. This "hyperflexion" hypothesis comports well with intuition and it has become dogma in the clinical literature...
March 8, 2018: Clinical Biomechanics
Xiao Wu, Ajay Malhotra, Bertie Geng, Vivek B Kalra, Khalid Abbed, Howard P Forman, Pina Sanelli
Importance: Magnetic resonance imaging (MRI) continues to be performed for cervical clearance of obtunded blunt trauma, despite poor evidence regarding its utility after a normal computed tomographic (CT) finding. Objective: To evaluate the utility and cost-effectiveness of MRI vs no follow-up after a normal cervical CT finding in patients with obtunded blunt trauma. Design, Setting and Participants: This cost-effectiveness analysis evaluated an average patient aged 40 years with blunt trauma from an institutional practice...
March 14, 2018: JAMA Surgery
Xinwei Shao, Jican Zeng, Yuchun Chen, Lixian Wu, Xinjia Wang
OBJECTIVE: To analyze the mechanism of the halo vest-assisted Z-shape elevating-pulling reduction technique for cervical unilateral locked facets, and confirm the safety of the spinal cord under the epidural pressure that occurs during the reduction process. METHODS: Eleven osteoligamentous whole coronal and cervical spine specimens were established as skull-neck-thorax models of cervical unilateral locked facets at the C5/6 level. The halo vest-assisted Z-shape elevating-pulling reduction technique was then applied to reduce the locked facets...
March 14, 2018: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
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
Ji-Hui Zhang, Liu-Jun Zhao
Instability of the cervical spine disease requires surgery to restore stability. In the past, surgical methods were divided into two kinds of anterior and posterior. But each has its own disadvantages:anterior vertebral screw has a higher failure rate, sometimes need a second operation; and posterior pedicle screw, lateral mass screw and facet joint screw may make greater trauma, lead to longer hospitalization. For general instable cervical spine disease, according to the location of the disease, only with the anterior or posterior approach can achieve a stable effect...
January 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Hai-Hao Wu, Tao Tang, Qing-Jiang Pang, Xin-Hua Yuan, Chun-Guang Zhou
OBJECTIVE: To compare the stability of subaxial cervical anterior transpedicular screw(ATPS) fixation and three traditional fixations for three-column injury. METHODS: Six specimens of cervical spine were prepared. After measurememt of the range of motion(ROM) in intact state, the specimens were made into three-column injury models. The models were reconstructed with an anterior cervical cage, and stabilized by ATPS, anterior plate(AP), anterior plate + lateral mass screw(AP+LMS) and posterior transpedicular screw(PTPS)...
January 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Daniel Novick, Raina Wallace, Jody C DiGiacomo, Anand Kumar, Steven Lev, L D George Angus
BACKGROUND: The newest CT scanners provide resolution comparable to MRIs leading many to question when and whether cervical spine MRIs are warranted. METHODS: An 8 year retrospective review identified 241 patients who underwent CT scan and MRI of the cervical spine. The initial clinical examination, cervical spine CT scan, and cervical spine MRI were compared to identify cervical spine injuries that would have been missed had the MRI not been performed. RESULTS: The CT scans were normal in 153 patients, and abnormal in 88...
March 6, 2018: American Journal of Surgery
Figen Govsa, Mehmet Asim Ozer, Huseyin Biceroglu, Asli Beril Karakas, Sedat Cagli, Cenk Eraslan, Ahmet Kemal Alagoz
BACKGROUND: Transarticular screw fixation has fatal complications such as vertebral artery (VA), carotid artery and spinal cord injuries. The landmarks for deciding the entry point for C1 lateral mass screws were clarified by using life-size three dimensional (3D) patient specific spine models. METHODS: This study included a total of 10 patients with C1 fractures. Dual CT scan data from C1 pre and post screwing of them were modified into 3D patient specific life-size cervical spine models...
March 3, 2018: World Neurosurgery
Paul S Page, Zhikui Wei, Nathaniel P Brooks
OBJECTIVE Motorcycle helmets have been shown to decrease the incidence and severity of traumatic brain injury due to motorcycle crashes. Despite this proven efficacy, some previous reports and speculation suggest that helmet use is associated with a higher likelihood of cervical spine injury (CSI). In this study, the authors examine 1061 cases of motorcycle crash victims who were treated during a 5-year period at a Level 1 trauma center to investigate the association of helmet use with the incidence and severity of CSI...
March 6, 2018: Journal of Neurosurgery. Spine
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
Jing Wang, Adam E M Eltorai, J Mason DePasse, Wesley Durand, Daniel Reid, Alan H Daniels
BACKGROUND: Cervical spine injuries are a common cause of morbidity and mortality, but optimal treatment is debated. Prior studies showed substantial variation in treatment. We examined treatment variation in arthrodesis and halo/tong placement in cervical spine injury patients. METHODS: We used the Healthcare Cost and Utilization Project National Inpatient Sample, 2000-2011. Patients were identified based on International Classification of Diseases, 9th Revision diagnosis codes...
February 28, 2018: World Neurosurgery
De-Chao Miao, Can Qi, Feng Wang, Kuan Lu, Yong Shen
BACKGROUND Cervical facet dislocation is the anterior displacement of one cervical vertebral body on another. The aim of this study was to evaluate the clinical efficacy of skull traction through an anterior cervical approach in the treatment of severe lower cervical facet dislocation without vertebral body fracture. MATERIAL AND METHODS Forty subjects with severe lower cervical facet dislocation, without vertebral body fracture, were treated between February 2010 and December 2013. Road traffic accident was the primary cause of injury...
March 3, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Joham Choque-Velasquez, Roberto Colasanti, Julio C Resendiz-Nieves, Kléber E Gonzáles-Echevarría, Rahul Raj, Behnam Rezai Jahromi, Felix Goehre, Ann-Christine Lindroos, Juha Hernesniemi
OBJECTIVE: Nowadays, the sitting position has lost favor among neurosurgeons partly due to assumptions of increased complications, such as venous air embolisms (VAEs) and hemodynamic disturbances. Moreover, it may oblige the surgeon to a tiring posture. Herein, we describe our protocol for the "praying (steeper sitting) position" for pineal region surgery, a variant which may reduce some of the risks of the sitting position while providing a more ergonomic surgical position...
February 27, 2018: World Neurosurgery
Yutaka Igarashi, Takahiro Kanaya, Shoji Yokobori, Takeshi Tsukamoto, Hiroyuki Yokota
PURPOSE: Cerebrovascular ischaemia is a rare but serious complication of damage to the carotid or vertebral arteries in the neck caused by blunt injury to the neck. Screening for blunt cerebrovascular injury should be performed in patients with certain signs or symptoms and risk factors. We described a case of traumatic bilateral vertebral artery injury (VAI) including unilateral vertebral arterial occlusion that resolved 3 months post-injury with antiplatelet and direct oral anticoagulant therapy...
March 1, 2018: European Spine Journal
T D Woo, G Tony, A Charran, R Lalam, J Singh, P N M Tyrrell, V N Cassar-Pullicino
BACKGROUND: The ring apophyses of the cervical spine have a variable appearance that changes with age. The times at which they appear and fuse at each level are not fixed. In this study, we aim to detail normal ranges of appearance of these ossification centers for each age group. MATERIALS AND METHODS: One hundred and eighty patients under the age of 21 attending the Royal Stoke University Hospital for cervical spine radiographs were retrospectively identified...
March 1, 2018: Skeletal Radiology
Dong-Ho Lee, Jae Hwan Cho, Choon Sung Lee, Chang Ju Hwang, Sung Hoon Choi, Chul Gie Hong
BACKGROUND CONTEXT: Conventional anterior decompression surgery for cervical myelopathy, including anterior corpectomy and fusion, is technically demanding and known to be associated with a higher incidence of surgery-related complications, including cerebrospinal fluid (CSF) leakage, neurologic deterioration, and graft failure compared with posterior surgery. PURPOSE: We introduce a novel anterior decompression technique (vertebral body sliding osteotomy; VBSO) for cervical myelopathy caused by ossification of posterior longitudinal ligament (OPLL) and evaluate the efficacy and safety of this procedure...
February 26, 2018: Spine Journal: Official Journal of the North American Spine Society
A Taha, S L M Bakker
In patients with pre-existent cervical spinal canal stenosis, minimal trauma, leading to neck hyperextension, can cause a significant increase of spinal cord compression. However, spinal cord injury is generally associated with major trauma and is usually not expected in patients with minor trauma. The resulting symptoms are diverse, making it even more difficult to diagnose. To illustrate the variety in symptoms at presentation, we describe two male patients aged 66 and 69. Rapid diagnosis is important as acute neurosurgical intervention may be indicated...
2018: Nederlands Tijdschrift Voor Geneeskunde
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