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Cervical spine

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14 papers 0 to 25 followers
David Dreizin, Michael Letzing, Clint W Sliker, Falgun H Chokshi, Uttam Bodanapally, Stuart E Mirvis, Robert M Quencer, Felipe Munera
A number of new developments in cervical spine imaging have transpired since the introduction of 64-section computed tomographic (CT) scanners in 2004. An increasing body of evidence favors the use of multidetector CT as a stand-alone screening test for excluding cervical injuries in polytrauma patients with obtundation. A new grading scale that is based on CT and magnetic resonance (MR) imaging findings, the cervical spine Subaxial Injury Classification and Scoring (SLIC) system, is gaining acceptance among spine surgeons...
November 2014: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Jetan H Badhiwala, Chung K Lai, Waleed Alhazzani, Forough Farrokhyar, Farshad Nassiri, Maureen Meade, Alireza Mansouri, Niv Sne, Mohammed Aref, Naresh Murty, Christopher Witiw, Sheila Singh, Blake Yarascavitch, Kesava Reddy, Saleh A Almenawer
BACKGROUND: Cervical spine clearance protocols are controversial for unconscious patients after blunt traumatic injury and negative findings on computed tomography (CT). PURPOSE: To review evidence about the utility of different cervical spine clearance protocols in excluding significant cervical spine injury after negative CT results in obtunded adults with blunt traumatic injury. DATA SOURCES: MEDLINE, EMBASE, CINAHL, Google Scholar, and the Cochrane Library were searched from January 2000 through November 2014...
March 17, 2015: Annals of Internal Medicine
Ryan D Muchow, Kelly R Egan, Walter W Peppler, Paul A Anderson
BACKGROUND: The trend of increasing cervical spine multidirectional computed tomography (MDCT) imaging of pediatric trauma patients is characteristic of the overall dramatic increase in computed tomography utilization in the United States. The purpose of this study is to compare the amount of radiation a pediatric trauma patient absorbs to the thyroid from plain radiographs and MDCT of the cervical spine and to express risk by calculation of theoretical thyroid cancer induction. METHODS: A retrospective evaluation of pediatric trauma patients admitted from October 1, 2004, to October 31, 2009, was performed at an academic, Level I trauma center...
February 2012: Journal of Trauma and Acute Care Surgery
Keiko Hikino, Loren G Yamamoto
BACKGROUND: The purpose of this study was to compare the benefit of neck computed tomography (CT) of identifying important cervical spine injuries (CSIs) with its harm of radiation exposure and cancer risk. METHODS: A PubMed search for published studies relating to CSI in trauma, cervical spine imaging, CT, and cancer risk was conducted. Article abstracts were reviewed, and selected published studies relating to the study objective were retrieved. RESULTS: Of 100,000 trauma patients, neck CT scans were obtained in 3,767 to 26,785 patients...
January 2015: Journal of Trauma and Acute Care Surgery
N V Todd, D Skinner, J Wilson-MacDonald
We assessed the frequency and causes of neurological deterioration in 59 patients with spinal cord injury on whom reports were prepared for clinical negligence litigation. In those who deteriorated neurologically we assessed the causes of the change in neurology and whether that neurological deterioration was potentially preventable. In all 27 patients (46%) changed neurologically, 20 patients (74% of those who deteriorated) had no primary neurological deficit. Of those who deteriorated, 13 (48%) became Frankel A...
April 2015: Bone & Joint Journal
Ala'a O Oteir, Karen Smith, Johannes U Stoelwinder, James Middleton, Paul A Jennings
BACKGROUND: Spinal cord injuries occur worldwide; often being life-threatening with devastating long term impacts on functioning, independence, health, and quality of life. OBJECTIVES: Systematic review of the literature to determine the efficacy of cervical spinal immobilisation (vs no immobilisation) in patients with suspected cervical spinal cord injury (CSCI); and to provide recommendations for prehospital spinal immobilisation. METHODS: Searches were conducted of the Cochrane library, CINAHL, EMBASE, Pubmed, Scopus, Web of science, Google scholar, and OvidSP (MEDLINE, PsycINFO, and DARE) databases...
April 2015: Injury
Amit Patel, Rasheed Zakaria, Rafid Al-Mahfoudh, Simon Clark, Chris Barrett, Zaid Sarsam, Robin Pillay, Tim Drummond Pigott, Martin J Wilby
BACKGROUND: The optimal management of odontoid fractures in the elderly population is unclear and management of this group of patients is complicated by multiple co-morbidities. This study aimed to determine the outcomes after conservative management strategies were applied in this patient group. METHODS: We carried out retrospective and prospective analyses of all patients with axial cervical spine injuries, at a single centre. We included patients aged over 60 years with type II and III odontoid fractures...
April 2015: British Journal of Neurosurgery
Ala'a O Oteir, Paul A Jennings, Karen Smith, Johannes Stoelwinder
BACKGROUND: Cervical spinal cord injuries may result in life-threatening situations and long-term disability. Prehospital spinal immobilisation is the standard of care for patients with potential spinal cord injury (SCI). It aims to prepare patients for transport, achieve neutral spinal alignment, and reduce movement and secondary injuries in potentially unstable spines. However, there is a lack of evidence on its clinical benefits and its overall effect on patient outcomes. OBJECTIVES: To identify the reported outcomes following immobilisation of suspected cervical SCI, to compare the effects of spinal immobilisation versus no immobilisation on the reported outcomes, and to provide recommendations for prehospital cervical immobilisation...
June 2014: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
Mark Dixon, Joseph O'Halloran, Niamh M Cummins
BACKGROUND: In most countries, road traffic collisions (RTCs) are the main cause of cervical spine injuries. There are several techniques in use for spinal immobilisation during prehospital extrication; however, the evidence for these is currently poor. OBJECTIVE: The objective of this study is to establish which technique provides the minimal deviation of the cervical spine from the neutral inline position during the extrication of the RTC patient using biomechanical analysis techniques...
September 2014: Emergency Medicine Journal: EMJ
Mark Hauswald
The emergency care of patients who may have spinal injuries has become highly ritualised. There is little scientific support for many of the recommended interventions and there is evidence that at least some methods now used in the field and emergency department are harmful. Since prospective clinical trials are not likely to resolve these issues I propose a reconceptualisation of spinal trauma to allow a more rational approach to treatment. To do this I analyse the basic physics, biomechanics and physiology involved...
September 2013: Emergency Medicine Journal: EMJ
M Holla
BACKGROUND: All trauma patients with a cervical spinal column injury or with a mechanism of injury with the potential to cause cervical spinal injury should be immobilised until a spinal injury is excluded. Immobilisation of the entire patient with a rigid cervical collar, backboard, head blocks with tape or straps is recommended by the Advanced Trauma Life Support guidelines. However there is insufficient evidence to support these guidelines. OBJECTIVE: To analyse the effects on the range of motion of the addition of a rigid collar to head blocks strapped on a backboard...
February 2012: Emergency Medicine Journal: EMJ
Philippe Lauweryns
Conservative treatment still has an important role to play, despite the increasing possibilities of surgical treatment. Treatment starts at the site of trauma. Transportation and immobilisation in braces are discussed. Skeletal skull traction can be used for realignment and reduction, and eventually used in halo-vest treatment. The advantages and disadvantages of these different treatment options are discussed.
March 2010: European Spine Journal
B P Armstrong, H K Simpson, R Crouch, C D Deakin
Prehospital cervical spine (c-spine) immobilisation is common, despite c-spine injury being relatively rare. Unnecessary immobilisation results in a significant burden on limited prehospital and emergency department (ED) resources. This study aimed to determine whether the incidence of unnecessary c-spine immobilisation by ambulance personnel could be safely reduced through the implementation of an evidence-based algorithm. Following a training programme, complete forms on 103 patients were identified during the audit period, of which 69 (67%) patients had their c-spines cleared at scene...
July 2007: Emergency Medicine Journal: EMJ
Phil Miller, Frank Coffey, Anne-Marie Reid, Keith Stevenson
The Canadian c-spine rule (CCR) allows safe, reproducible use of radiography in alert, stable patients with potential c-spine injury in the emergency setting [Stiell, I., Clement, C., McKnight, R., Brison, R., Schull, M., Lowe, B., Worthington, J., Eisenhauer, M., Cass, D., Greenberg, G., MacPhail, I., Dreyer, J., Lee, J., Bandiera, G., Reardon, M., Holroyd, B., Lesiuk, H., G. Wells, 2003. The Canadian c-spine rule versus the nexus low-risk criteria in patients with trauma. The New England journal of medicine 349 (26), 2510-2518; Stiell, I...
July 2006: Accident and Emergency Nursing
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