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Cervical Spine Fracture

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2. Cervical spine fracture through a cervical disc replacement (Full text)

Cervical spine fracture through a cervical disc replacement We report a rare case of cervical spine trauma through a cervical disc replacement and adjacent multilevel disc fusions. Cervical disc replacement (CDR) is a viable option for the surgical treatment of degenerative disc disease however long term follow up data regarding this operative technique is poor specifically relating to traumatic complications. We know of no previous reports of bilateral cervical pedicle fractures occurring (...) adjacent to CDR and anterior cervical spine instrumentation.A 46 year-old with a history of C6C7 CDR and C4-6 anterior cervical decompression and fusion was an unrestrained driver involved in a road traffic accident and suffered bilateral C7 pedicle fractures and a right C6C7 facet joint fracture-subluxation without neurological deficit. Reduction and fixation via a posterior approach achieved a satisfactory alignment and the patient made an uneventful recovery.A significant force coupled with cervical

2018 International journal of surgery case reports

3. Predicting survival in older patients treated for cervical spine fractures: development of a clinical survival score. (PubMed)

Predicting survival in older patients treated for cervical spine fractures: development of a clinical survival score. Emerging literature has identified the importance of pretreatment health and functional status as influential in the prognostication of survival. A comprehensive, accessible, predictive model for survival following cervical spine fracture has yet to be developed.To develop an accessible and intuitive predictive model for survival in individuals aged 50 and older treated (...) [OR] 7.35; 95% confidence interval [CI] 3.77, 14.32), 2 (OR 8.43; 95% CI 4.66, 15.25), 1 (OR 17.47; 95% CI 9.81, 31.11), and 0 (OR 26.58; 95% CI 13.87, 50.92). Score performance was unchanged in bootstrap testing and sensitivity analyses.We have developed a useful prognostic utility capable of informing survival in individuals age 50 and older, following cervical spine fractures. The score can be applied to adjust patient expectations, anticipate outcomes, and as an adjunct to decision-making

2019 The Spine Journal

4. Frequency of cervical spine injuries in patients with midface fractures. (PubMed)

Frequency of cervical spine injuries in patients with midface fractures. The aim of this retrospective cohort study was to determine the frequency and risk factors for cervical spine injury (CSI) in patients with midface fractures. Patients ≥18 years of age entered in the Massachusetts General Hospital Trauma Registry from 2007 to 2017 were identified. Those with a midface fracture, computed tomography and/or magnetic resonance imaging of the cervical spine, and complete medical records were (...) included. There were 23,394 patients in the registry; 3950 (16.9%) had craniomaxillofacial fractures and 1822 (7.8%) had a CSI. Craniomaxillofacial fractures included fractures of the midface (n=2803, 71.0%), mandible (n=873, 22.1%), and midface plus mandible (n=274, 6.9%). The overall frequency of CSI in patients with midface fractures was 11.4% (350/3077). Patients with midface fractures had a higher risk for CSI compared to patients without a midface fracture (odds ratio 2.4, 95% confidence interval

2019 International Journal of Oral and Maxillofacial Surgery

5. Cervical Spine Fractures: Who Really Needs CT Angiography? (PubMed)

Cervical Spine Fractures: Who Really Needs CT Angiography? Retrospective cohort study OBJECTIVE.: Compare a novel two-step algorithm for indicating a computed tomography angiography (CTA) in the setting of a cervical spine fracture with established gold standard criteria SUMMARY OF BACKGROUND DATA.: As CTA permits the rapid detection of blunt cerebrovascular injuries (BCVI), screening criteria for its use have broadened. However, more recent work warns of the potential for the overdiagnosis (...) of BCVI, which must be considered with the adoption of broad criteria.A novel two-step metric for indicating CTA screening was compared with the American College of Surgeons guidelines and the expanded Denver Criteria using patients who presented with cervical spine fractures to a tertiary level 1 trauma center from 1/1/2012 to 1/1/2016. The ability for each metric to identify BCVI and posterior circulation strokes that occurred during this period was assessed.A total of 721 patients with cervical

2019 Spine

6. Cervical spine fractures in osteopetrosis: a case report and review of the literature (Full text)

Cervical spine fractures in osteopetrosis: a case report and review of the literature While management of appendicular fractures has been well described in the setting of osteopetrosis, there is limited information on managing fractures of the axial spine. Here we present an osteopetrotic patient with multiple traumatic multiple, comminuted, unstable cervical spinal fractures managed with non-operative stabilization, and provide a review of the pathophysiology, genetic characteristics (...) with cervical spine dynamic radiographs confirming stability at four months. On four-year follow up examination, the patient remained without neck pain, and CT scan demonstrated partially sclerotic fracture lines with appropriate anatomical alignment. In conclusion, external halo stabilization may be an effective option for treatment of multiple unstable acute traumatic cervical spine fractures in patients with osteopetrosis. Given the challenge of surgical stabilization in osteopetrosis, further research

2018 Journal of biomedical research

7. Age and Other Risk Factors Influencing Long-Term Mortality in Patients With Traumatic Cervical Spine Fracture (Full text)

Age and Other Risk Factors Influencing Long-Term Mortality in Patients With Traumatic Cervical Spine Fracture To identify clinical or demographic variables that influence long-term mortality, as well as in-hospital mortality, with a particular focus on the effects of age.Cervical spine fractures with or without spinal cord injury (SCI) disproportionately impact the elderly who constitute an increasing percentage of the US population.We analyzed data collected for 10 years at a state-designated (...) level I trauma center to identify variables that influenced in-hospital and long-term mortality among elderly patients with traumatic cervical spine fracture with or without SCI. Acute in-hospital mortality was determined from hospital records and long-term mortality within the study period (2003-2013) was determined from the National Death Index. Univariate and multivariate regression analyses were used to identify factors influencing survival.Data from patients (N = 632) with cervical spine

2018 Geriatric orthopaedic surgery & rehabilitation

8. Outcomes of Unstable Subaxial Cervical Spine Fractures Managed by Posteroanterior Stabilization and Fusion (Full text)

Outcomes of Unstable Subaxial Cervical Spine Fractures Managed by Posteroanterior Stabilization and Fusion Retrospective study.To evaluate clinical and radiological outcomes of unstable subaxial cervical spine injuries managed by both posterior tension band column stabilization and anterior decompression, stabilization, and fusion.Unstable subaxial cervical spine injuries often involve disruption of the anterior column and posterior tension band osteoligamentous complex. Such injuries need (...) immediate surgical intervention. Different methods of reduction and surgical approaches have been published in the literature, with lack of consensus on a uniform or standardized method. Controversy still exists regarding stabilization of unstable cervical fractures by anterior or posterior approach alone or combined approaches.We retrospectively evaluated 24 patients with post-traumatic unstable subaxial cervical spine injuries with their preoperative clinical details, X-ray, computed tomography

2018 Asian spine journal

9. Anterior Fixation of Floating Facet Fractures in the Cervical Spine: A Prospective Case Series and Biomechanical Analysis (Full text)

Anterior Fixation of Floating Facet Fractures in the Cervical Spine: A Prospective Case Series and Biomechanical Analysis Unilateral fractures involving complete separation of the lateral mass from the vertebra and lamina (floating lateral mass fractures) are a unique subset of cervical spine fractures. These injuries are at significant risk for displacement without operative fixation. Posterior fixation has proven to facilitate adequate fusion. However, there are few data supporting (...) the clinical success of single-level anterior fixation.Biomechanical evaluation of floating lateral mass fractures and a consecutive case series of patients with rotationally unstable floating lateral mass fractures treated with anterior fixation using an integrated cage-screw device with anterior plating (ICSD) was performed. The study comprised 7 fresh human cadaver cervical spines (C2-C7), and 11 patients with floating lateral mass fractures. Segmental flexibility testing evaluating axial rotation

2018 International journal of spine surgery

10. The Clinical Implications of Adding CT Angiography in the Evaluation of Cervical Spine Fractures: A Propensity-Matched Analysis. (PubMed)

The Clinical Implications of Adding CT Angiography in the Evaluation of Cervical Spine Fractures: A Propensity-Matched Analysis. Advanced-imaging screening for asymptomatic blunt cerebrovascular injury is controversial. Vertebral artery injury (VAI) is most commonly associated with cervical spine fracture, and many guidelines advocate indiscriminate screening for all cervical spine fractures. The purpose of this study was to determine whether the addition of computed tomographic angiography (...) (CTA) results in a change in management for patients with cervical spine fractures.Adult patients treated for acute cervical spine fractures after blunt trauma during the period of 2000 to 2015 were retrospectively identified. Patients who sustained a penetrating trauma or who had a history of neoplasm or prior cervical spine surgery were excluded. The following variables were recorded: age, biologic sex, race, medical comorbidities, Injury Severity Score (ISS), mechanism of injury, whether CTA

2018 The Journal of Bone and Joint Surgery. American Volume

11. Anterior cervical distraction and screw elevating-pulling reduction for traumatic cervical spine fractures and dislocations: A retrospective analysis of 86 cases. (Full text)

Anterior cervical distraction and screw elevating-pulling reduction for traumatic cervical spine fractures and dislocations: A retrospective analysis of 86 cases. Treatment of cervical fracture and dislocation by improving the anterior cervical technique.Anterior cervical approach has been extensively used in treating cervical spine fractures and dislocations. However, when this approach is used in the treatment of locked facet joints, an unsatisfactory intraoperative reduction and prying (...) reduction increases the risk of secondary spinal cord injury. Thus, herein, the cervical anterior approach was improved. With distractor and screw elevation therapy during surgery, the restoration rate is increased, and secondary injury to the spinal cord is avoided.To discuss the feasibility of the surgical method of treating traumatic cervical spine fractures and dislocations and the clinical application.This retrospective study included the duration of patients' hospitalization from January 2005

2017 Medicine

12. True oblique axis fracture associated with congenital anomalies of the upper cervical spine: Case report of an unusual fracture pattern (Full text)

True oblique axis fracture associated with congenital anomalies of the upper cervical spine: Case report of an unusual fracture pattern Acute traumatic axis fractures are common cervical spine injuries often caused by road accidents or falls. They are usually classified into three different types, namely, odontoid fractures, Hangman's fractures, and miscellaneous fractures. Congenital malformations of the craniovertebral junction (CVJ), although typically asymptomatic, may result in neural (...) , and ultimately the fracture was fused.True oblique fractures of the axis are rare, as in the case presented, and may occasionally occur in conjunction with KFS of the upper cervical spine.

2017 Surgical neurology international

13. The Effects of Perioperative Corticosteroids on Dysphagia Following Surgical Procedures Involving the Anterior Cervical Spine: A Prospective, Randomized, Controlled, Double-Blinded Clinical Trial (PubMed)

The Effects of Perioperative Corticosteroids on Dysphagia Following Surgical Procedures Involving the Anterior Cervical Spine: A Prospective, Randomized, Controlled, Double-Blinded Clinical Trial Dysphagia is one of the most common complications of surgical procedures in the anterior cervical spine, and can persist up to 2 years postoperatively. Corticosteroids are relatively safe and inexpensive for treating various inflammatory conditions. Perioperative corticosteroid administration (...) for anterior cervical spine procedures may effectively minimize postoperative dysphagia, potentially leading to better outcomes, decreased readmission rates, and improved patient satisfaction. The purpose of this study was to determine the efficacy of perioperative corticosteroids in decreasing the severity and duration of dysphagia following single-level and multilevel anterior cervical spine procedures.Seventy-four patients undergoing elective anterior cervical surgical procedures for degenerative

2019 EvidenceUpdates

14. Single-Session Combined Anterior-Posterior Approach for Treatment of Ankylosing Spondylitis with Obvious Displaced Lower Cervical Spine Fractures and Dislocations (Full text)

Single-Session Combined Anterior-Posterior Approach for Treatment of Ankylosing Spondylitis with Obvious Displaced Lower Cervical Spine Fractures and Dislocations For patients with AS and lower cervical spine fractures, surgical methods have mainly included the single anterior approach, single posterior approach, and combined anterior-posterior approach. However, various surgical procedures were utilized because the fractures have not been clearly classified according to presence (...) of displacement in these previous studies. Consequently, controversies have been raised regarding the selection of the surgical procedure. This study retrospective analysis was conducted in 12 patients with AS and lower cervical spine fractures and dislocations and explored single-session combined anterior-posterior approach for the treatment of AS with obvious displaced lower cervical spine fractures and dislocations which has demonstrated advantages such as good stabilization, satisfied fracture healing

2017 BioMed research international

15. Analysis of the Literature on Cervical Spine Fractures in Ankylosing Spinal Disorders (Full text)

Analysis of the Literature on Cervical Spine Fractures in Ankylosing Spinal Disorders Narrative literature review.The numbers of low-energy cervical fractures seen in patients suffering from ankylosing spondylitis (also known as Bechterew disease) or diffuse idiopathic skeletal hyperostosis (also known as Forestier disease) have greatly increased over recent decades. These fractures tend to be particularly overlooked, leading to delayed diagnosis and secondary neurological deterioration (...) . The aim of the present evaluation was to summarize current knowledge on cervical fractures in patients with ankylosing spinal disorders (ASDs).The literature was analyzed through an extensive PubMed search focusing on cervical fractures, especially with delayed diagnosis.In ASDs, it was mainly the cervical spine that was found to be affected by fractures. Fifty percent of ASD patients had neurological deficits at admission, with a high probability of secondary deterioration due to an initially missed

2017 Global spine journal

16. The role of pre-reduction MRI in the management of complex cervical spine fracture-dislocations: an ongoing controversy? (Full text)

The role of pre-reduction MRI in the management of complex cervical spine fracture-dislocations: an ongoing controversy? Cervical spine fracture-dislocations in neurologically intact patients represent a surgical challenge due to the risk of inflicting iatrogenic spinal cord compression by closed reduction maneuvers. The use of MRI for early advanced imaging in these injuries remains controversially debated.A 54-year old man sustained a fall over the handlebars of his racing bicycle (...) . The helmeted patient sustained a fall on his head which resulted in a hyperflexion injury of the neck. He was neurologically intact on presentation. Initial CT imaging revealed a complex multisegmental cervical spine injury with a left-sided C6/C7 perched facet, a right sided C7/T1 fracture-dislocation, and a right-sided C6 and C7 traumatic laminotomy. The initial management consisted of temporary external Halo fixator application without closed reduction maneuver, to mitigate the risk of a delayed spinal

2017 Patient safety in surgery

17. Kinematics of the Cervical Spine Following Unilateral Facet Fracture: An in-vitro Cadaver Study. (PubMed)

Kinematics of the Cervical Spine Following Unilateral Facet Fracture: An in-vitro Cadaver Study. Biomechanical study utilizing human cadaveric cervical spines.To quantitatively assess the effects on intervertebral motion of isolated unilateral cervical facet fracture, and after disruption of the intervertebral disc at the same level.Clinical evidence has indirectly suggested that cervical facet fractures involving 40% of the height of the lateral mass can cause instability of the involved (...) segment. No study to date has demonstrated the kinematic effects of such an injury in a cadaveric model of the cervical spine.Nine six-segment cervical spines were defrosted and fixated to a spine motion simulator capable to apply unconstrained bending moments in the three anatomical planes. The spines were subjected to a maximum torque of 2 N · m in flexion, extension, left and right lateral bending, and of 4 N · m in left and right axial rotation. Each spine was tested in the intact configuration

2017 Spine

18. Clinical Efficacy of Anterior Partial Corpectomy and Titanium Mesh Fusion and Internal Fixation for Treatment of Old Fracture Dislocation of the Lower Cervical Spine (Full text)

Clinical Efficacy of Anterior Partial Corpectomy and Titanium Mesh Fusion and Internal Fixation for Treatment of Old Fracture Dislocation of the Lower Cervical Spine BACKGROUND The aim of this study was to analyze the clinical features and to evaluate the efficacy of anterior partial corpectomy and titanium mesh fusion and internal fixation of old fracture dislocation of the lower cervical spine. MATERIAL AND METHODS We retrospectively analyzed the clinical data of 52 patients with old lower (...) restoration can be achieved by using anterior partial corpectomy and titanium mesh fusion and internal fixation to treat old fracture dislocation of the lower cervical spine. For cases with locked facet joints or posterior structures invading the vertebral canal, the combined anterior and posterior approaches should be performed, when necessary, to achieve better results.

2017 Medical science monitor : international medical journal of experimental and clinical research

19. Pathological burst fracture in the cervical spine with negative red flags: a 12-year follow-up (Full text)

Pathological burst fracture in the cervical spine with negative red flags: a 12-year follow-up In 2004, a 61-year-old male presented to a chiropractic clinic complaining of neck pain after hearing a 'crunch' when getting out of bed that morning. The initial history intake and physical examination identified no red flags or indications for the patient's pain, with the exception of traction being pain-provoking. Conventional radiographs were ordered, which identified a pathological burst fracture (...) of the fourth cervical vertebra. This Imaging Case Review (ICR) is to provide clinicians with a follow-up to the patient's care and current state.

2017 The Journal of the Canadian Chiropractic Association

20. One-stage surgical treatment of cervical spine fracture-dislocation in patients with ankylosing spondylitis via the combined anterior-posterior approach. (Full text)

One-stage surgical treatment of cervical spine fracture-dislocation in patients with ankylosing spondylitis via the combined anterior-posterior approach. 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 (...) and 2 of moderate dependence preoperation. In no cases did severe complications from implanted instrumentation occur.It was high efficacy and safety that the surgical therapy was performed on cervical fracture-dislocation in AS patients by the 1-stage combined anterior-posterior approach. The key of the surgery is the robust stabilization and full decompression of fracture spine at early stage. In addition, if spinal anatomical reduction of fracture segments is difficult to be achieved

2017 Medicine

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