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https://www.readbyqxmd.com/read/28426562/asymptomatic-cervical-spine-fractures-current-guidelines-can-fail-older-patients
#1
Christopher D Healey, Sarah K Spilman, Bradley D King, Joseph E Sherrill, Carlos A Pelaez
BACKGROUND: Older adults represent a growing proportion of trauma patients treated in the United States, and cervical spine (c-spine) fracture is an injury that is increasingly common in this population. Neck pain is a major component of current clinical clearance guidelines, but some older adults with c-spine fractures report no neck pain after injury. The objective of this study was to investigate the frequency at which c-spine fractures were unassociated with neck pain in an aging population...
April 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28411008/cone-beam-computed-tomography-incidental-findings-of-the-cervical-spine-and-clivus-retrospective-analysis-and-review-of-the-literature
#2
Noura A Alsufyani
OBJECTIVE: The aim of this study was to analyze and describe incidental findings in the cervical spine (C-spine) and the clivus encountered in cone beam computed tomography (CBCT) imaging. The wide range of possible anatomic variants and pathoses is discussed in the context of the medical and dental literature to clarify their radiographic appearance and clinical implications as a guide for the oral and maxillofacial radiologist. STUDY DESIGN: A retrospective analysis of radiographic reports was conducted based on CBCT images from 2 oral and maxillofacial imaging centers...
March 19, 2017: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/28391603/embedded-clinical-decision-support-in-electronic-health-record-decreases-use-of-high-cost-imaging-in-the-emergency-department-embed-study
#3
Kelly Bookman, David West, Adit Ginde, Jennifer Wiler, Robert McIntyre, Andrew Hammes, Nichole Carlson, David Steinbruner, Matthew Solley, Richard Zane
OBJECTIVE: Evaluate the impact of evidence-based clinical decision support tools integrated directly into provider workflow in the electronic health record on utilization of CT brain, c-spine and pulmonary embolism (PE). METHODS: Validated, well accepted scoring tools for head injury, c-spine injury and pulmonary embolism were embedded into the electronic health record in a manner minimally disruptive to provider workflow. This was a longitudinal, before/after study in 5 emergency departments in a healthcare system with a common electronic health record...
April 9, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28256741/osteoporosis-is-the-most-important-risk-factor-for-odontoid-fractures-in-the-elderly
#4
Johannes Kaesmacher, Claudia Schweizer, Alexander Valentinitsch, Thomas Baum, Anna Rienmüller, Bernhard Meyer, Jan S Kirschke, Yu-Mi Ryang
Traumatic odontoid fractures (TOFs) have been described as the most common injury affecting the C-spine in the elderly. Previous studies have identified degenerative changes and bone loss as important predisposing factors. However, their interaction and respective age-adjusted impact needs further clarification. We conducted a retrospective analysis of 5303 patients (aged ≥60 years) admitted to a level I trauma center between January 2008 and January 2016 who underwent CT imaging of the C-spine. Ninety-two patients with TOF and 80 patients with other cervical spine fractures (OCSF) were identified and a respective 3:1 age- and sex-matched control group without fractures after trauma was built...
March 3, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28251880/choosing-wisely-canada%C3%A2-five-tests-procedures-and-treatments-to-question-in-emergency-medicine
#5
Amy H Y Cheng, Sam Campbell, Lucas B Chartier, Tom Goddard, Kirk Magee, Jill McEwen, Atul K Kapur, Brian R Holroyd, Suneel Upadhye, Stephanie Couperthwaite, Brian H Rowe
OBJECTIVES: Choosing Wisely Canada (CWC) is an initiative to encourage patient-physician discussions about the appropriate, evidence based use of medical tests, procedures and treatments. We present the Canadian Association of Emergency Physicians' (CAEP) top five list of recommendations, and the process undertaken to generate them. METHODS: The CAEP Expert Working Group (EWG) generated a candidate list of 52 tests, procedures, and treatments in emergency medicine whose value to care was questioned...
March 2, 2017: CJEM
https://www.readbyqxmd.com/read/28242065/the-impact-of-helmet-use-on-outcomes-after-a-motorcycle-crash
#6
Desmond Khor, Kenji Inaba, Alberto Aiolfi, Samantha Delapena, Elizabeth Benjamin, Kazuhide Matsushima, Aaron M Strumwasser, Demetrios Demetriades
BACKGROUND: Helmet use in a motorcycle collision has been shown to reduce head injury and death. Its protective effect on the cervical spine (C-spine), however, remains unclear. The objective of this study was to explore the relationship between helmet use and C-spine injuries. METHOD: Retrospective National Trauma Data Bank (NTDB) study. All motorcycle collisions between 2007 and 2014 involving either a driver or passenger were included. Data collected included demographics, vital signs, Abbreviated Injury Scale (AIS), Injury Severity Score (ISS) and specific injuries...
February 20, 2017: Injury
https://www.readbyqxmd.com/read/28190553/cervical-spine-imaging-for-young-children-with-inflicted-trauma-expanding-the-injury-pattern
#7
Joanne Baerg, Arul Thirumoorthi, Rosemary Vannix, Asma Taha, Amy Young, Alexander Zouros
AIM: The purpose of this study was to document the incidence and pattern of cervical spine (c-spine) injuries in children below 36months with inflicted trauma. METHODS: An IRB approved, prospective cohort study was performed between July 2011 and January 2016. Inclusion criteria were: age below 36months, loss of consciousness after inflicted trauma, and one initial head computed tomography finding: a subdural, intraventricular, intraparenchymal, subarachnoid hemorrhage, diffuse axonal injury, hypoxic injury, or cerebral edema...
January 30, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28073868/delayed-diagnosis-of-fractured-anterior-arch-of-the-atlas-in-a-young-child
#8
Sergio B Sesia, Friederike Prüfer, Michael Walther, Daniel Studer
A 2-year-old girl fell off a bunk bed onto a parquet floor. She immediately reported neck pain and presented with muscle spasm and limited motion of the cervical spine (C-spine). Plain X-rays of the C-spine showed no osseous lesion. Owing to persisting pain and limited motion in the neck, MRI of the C-spine was obtained which revealed intact ligaments and cervical spinal cord, as well as soft tissue swelling in front of the anterior arch of the atlas. Subsequent CT of the C-spine confirmed a complete, undisplaced fracture of the anterior arch of the atlas (Gehweiler type I fracture)...
January 10, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28047444/mo-fg-campus-jep3-02-a-novel-setup-approach-to-improve-c-spine-curvature-reproducibility-for-head-and-neck-radiotherapy-using-optical-surface-imaging-with-two-regions-of-interest
#9
K Ryan, M Gil, C Della Biancia, G Li
PURPOSE: To develop a novel approach to improve cervical spine (c-spine) curvature reproducibility for head and neck (HN) patients using optical surface imaging (OSI) with two regions of interests (ROIs). METHODS: The OSI-guided, two-step setup procedure requires two ROIs: ROI-1 of the shoulders and ROI-2 of the face. The neck can be stretched or squeezed in superior-inferior (SI) direction using a specially-designed sliding head support. We hypothesize that when these two ROIs are aligned, the c-spine should fall into a naturally reproducible position under same setup conditions...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/27893647/cervical-spine-mri-in-patients-with-negative-ct-a-prospective-multicenter-study-of-the-research-consortium-of-new-england-centers-for-trauma-reconect
#10
Adrian A Maung, Dirk C Johnson, Kimberly Barre, Thomas Peponis, Tomaz Mesar, George C Velmahos, Daniel McGrail, George Kasotakis, Ronald I Gross, Michael S Rosenblatt, Kristen C Sihler, Robert J Winchell, Walter Cholewczynski, Kathryn L Butler, Stephen R Odom, Kimberly A Davis
BACKGROUND: Although cervical spine CT (CSCT) accurately detects bony injuries, it may not identify all soft tissue injuries. Although some clinicians rely exclusively on a negative CT to remove spine precautions in unevaluable patients or patients with cervicalgia, others use MRI for that purpose. The objective of this study was to determine the rates of abnormal MRI after a negative CSCT. METHODS: Blunt trauma patients who either were unevaluable or had persistent midline cervicalgia and underwent an MRI of the C-spine after a negative CSCT were enrolled prospectively in eight Level I and II New England trauma centers...
February 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27884333/c-spine-injury-and-mandibular-fractures-lifesaver-broken-in-two-spots
#11
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/27842904/yield-of-computed-tomography-of-the-cervical-spine-in-cases-of-simple-assault
#12
Matthew L Uriell, Jason W Allen, Brendan P Lovasik, Marc D Benayoun, Robert M Spandorfer, Chad A Holder
BACKGROUND: Computed tomography (CT) of the cervical spine (C-spine) is routinely ordered for low-impact, non-penetrating or "simple" assault at our institution and others. Common clinical decision tools for C-spine imaging in the setting of trauma include the National Emergency X-Radiography Utilization Study (NEXUS) and the Canadian Cervical Spine Rule for Radiography (CCR). While NEXUS and CCR have served to decrease the amount of unnecessary imaging of the C-spine, overutilization of CT is still of concern...
January 2017: Injury
https://www.readbyqxmd.com/read/27619021/incidental-radiographic-findings-of-thyroglossal-duct-cysts-prevalence-and-management
#13
Michael T Yim, Huy D Tran, Binoy M Chandy
OBJECTIVES/HYPOTHESIS: To determine the epidemiology of incidental thyroglossal duct cysts (TGDC) discovered on imaging studies obtained in the head and neck area in children and to discuss subsequent management. METHODS: A retrospective chart review was performed at Texas Children's Hospital of all computed tomography (CT) and magnetic resonance (MR) imaging studies obtained in the head and neck region between July 2011 and July 2014. Images obtained for the purpose of evaluating a neck or lingual mass were excluded from the study, as were patients with previously known TGDCs...
October 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27484077/eastbourne-miami-j-protocol-a-pilot-study-for-the-care-of-cervical-injuries-in-the-community
#14
B Hylton, S Lidder, A Armitage, S James
UNLABELLED: PURPOSE OF THE STUDY The aim of this pilot study was to develop The Eastbourne Miami-J Protocol for care of cervical injuries within the community. Led by orthopaedic senior practitioners, a multidisciplinary approach was developed to provide education and collar care for patients on a weekly basis. MATERIALS AND METHODS A total of 51 patients (17 male and 33 female), mean age 74 years (21 to 95) with CT confirmed cervical injuries during November 2010 and May 2014 followed the Eastbourne Miami-J Protocol...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/27454805/utility-of-computed-tomographic-imaging-of-the-cervical-spine-in-trauma-evaluation-of-ground-level-fall
#15
Marc D Benayoun, Jason W Allen, Brendan P Lovasik, Matthew L Uriell, Robert M Spandorfer, Chad A Holder
BACKGROUND: Computed tomography (CT) of the cervical spine (C-spine) is routinely ordered for low-risk mechanisms of injury, including ground-level fall. Two commonly used clinical decision rules (CDRs) to guide C-spine imaging in trauma are the National Emergency X-Radiography Utilization Study (NEXUS) and the Canadian Cervical Spine Rule for Radiography (CCR). METHODS: Retrospective cross-sectional study of 3,753 consecutive adult patients presenting to an urban Level I emergency department who received C-spine CT scans were obtained over a 6-month period...
August 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27438681/cervical-spinal-clearance-a-prospective-western-trauma-association-multi-institutional-trial
#16
Kenji Inaba, Saskya Byerly, Lisa D Bush, Matthew J Martin, David T Martin, Kimberly A Peck, Galinos Barmparas, Matthew J Bradley, Joshua P Hazelton, Raul Coimbra, Asad J Choudhry, Carlos V R Brown, Chad G Ball, Jill R Cherry-Bukowiec, Clay Cothren Burlew, Bellal Joseph, Julie Dunn, Christian T Minshall, Matthew M Carrick, Gina M Berg, Demetrios Demetriades
BACKGROUND: For blunt trauma patients who have failed the NEXUS (National Emergency X-Radiography Utilization Study) low-risk criteria, the adequacy of computed tomography (CT) as the definitive imaging modality for clearance remains controversial. The purpose of this study was to prospectively evaluate the accuracy of CT for the detection of clinically significant cervical spine (C-spine) injury. METHODS: This was a prospective multicenter observational study (September 2013 to March 2015) at 18 North American trauma centers...
December 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27338214/efficacy-and-safety-of-one-stage-selective-discectomy-combined-with-expansive-hemilaminectomy-in-treatment-of-cervical-spondylotic-myelopathy
#17
Guoyun Bu, Feng Shuang, Gang Liu, Ye Wu, Shuxun Hou, Dongfeng Ren, Weilin Shang
OBJECTIVES: We designed a novel surgical strategy named one-stage selective discectomy combined with expansive hemilaminectomy (OSDEHL) which might theoretically reduce the postoperative complications of Cervical Spondylotic Myelopathy (CSM). The objectives of this study is to evaluate its efficacy and safety. METHODS: 62 patients with CSM were enrolled in this study. The procedure includes selective discectomy with fusion at 1 or 2 segments of maximal cord compression and expansive hemilaminectomy on the symptomatic or severe side of the body...
June 20, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27330655/prospective-validation-of-modified-nexus-cervical-spine-injury-criteria-in-low-risk-elderly-fall-patients
#18
John Tran, Donald Jeanmonod, Darin Agresti, Khalief Hamden, Rebecca K Jeanmonod
INTRODUCTION: The National Emergency X-radiography Utilization Study (NEXUS) criteria are used extensively in emergency departments to rule out C-spine injuries (CSI) in the general population. Although the NEXUS validation set included 2,943 elderly patients, multiple case reports and the Canadian C-Spine Rules question the validity of applying NEXUS to geriatric populations. The objective of this study was to validate a modified NEXUS criteria in a low-risk elderly fall population with two changes: a modified definition for distracting injury and the definition of normal mentation...
May 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27270856/defining-the-cervical-spine-clearance-algorithm-a-single-institution-prospective-study-of-more-than-9-000-patients
#19
Therese M Duane, Andrew J Young, Poornima Vanguri, Luke G Wolfe, Judith Katzen, Jinfeng Han, Julie Mayglothling, James F Whelan, Michel B Aboutanos, Rao R Ivatury, Ajai K Malhotra
BACKGROUND: Variability exists in the approach to cervical spine (c-spine) clearance after significant trauma. Using concurrently gathered data on more than 9,000 such patients, the current study develops an evidence-based and readily adoptable algorithm for c-spine clearance aimed at timely removal of collar, optimal use of imaging, and appropriate spine consultations. METHODS: Prospective study of adult blunt trauma team alert (TTA) patients presenting at a Level I trauma center who underwent screening computed tomography (CT) to diagnose/rule out c-spine injury (January 2008 to May 2014)...
September 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27234435/radiological-assessment-of-paediatric-cervical-spine-injury-in-blunt-trauma-the-potential-impact-of-new-nice-guidelines-on-the-use-of-ct
#20
COMPARATIVE STUDY
J Davies, S Cross, J Evanson
AIM: To determine the potential effect of changes to the National Institute for Health and Care Excellence (NICE) guidelines to the use of computed tomography (CT) in the assessment of suspected paediatric cervical spine (c-spine) injury. MATERIAL AND METHODS: A 5 year retrospective study was conducted of c-spine imaging in paediatric (<10 years) patients presenting following blunt trauma at a Level 1 trauma centre in London. All patients under the age of 10 years who underwent any imaging of the c-spine following blunt trauma were included...
September 2016: Clinical Radiology
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