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Cervical Spine Fracture

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

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

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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. 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

5. 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

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

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

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2017 Medicine

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

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.

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2017 Surgical neurology international

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

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

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2018 International journal of spine surgery

9. Cervical spine fractures in osteopetrosis: a case report and review of the literature (PubMed)

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

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2018 Journal of biomedical research

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

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

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2018 Geriatric orthopaedic surgery & rehabilitation

11. Outcomes of Unstable Subaxial Cervical Spine Fractures Managed by Posteroanterior Stabilization and Fusion (PubMed)

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

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2018 Asian spine journal

12. 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

13. Unilateral vertebral artery injury in a patient with displaced upper cervical spine fractures: the treatment for one case of vertebral artery embolism. (PubMed)

Unilateral vertebral artery injury in a patient with displaced upper cervical spine fractures: the treatment for one case of vertebral artery embolism. To report a novel treatment method for vertebral artery injury. Vertebral artery injuries may be caused during trauma by fracture and excessive motion with subluxation from C2 to C6 in spite of vertebral artery deeply seated and normally well protected inside the transverse foramen. Optimal medical management of the occluded vertebral artery has (...) yet to be determined.We report on a severely displaced C2-C3 fracture that was found to have a vertebral artery injury. Medical records and imaging were reviewed.A 50-year-old lady was hit by steel tube without loss of consciousness, but complaining of severe cervical and bilateral periscapular pain. Physical examination identified a neurologically intact patient with frontotemporal ecchymosis and posterior cervical tenderness. MRA and DSA showed an occluded left vertebral artery. After 3 days

2017 European Spine Journal

14. Application of ultrasound-guided C5 nerve root block using polydeoxyribonucleotide in traumatic C5 nerve root injury caused by fracture of the articular process of the cervical spine: A case report. (PubMed)

Application of ultrasound-guided C5 nerve root block using polydeoxyribonucleotide in traumatic C5 nerve root injury caused by fracture of the articular process of the cervical spine: A case report. Cervical nerve root injury is one of the complications of traumatic cervical spine fracture. Although one of the most effective treatments to reduce inflammation in nerve root injuries is the use of corticosteroids or nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids and NSAIDs can (...) process fracture with an ultrasound-guided cervical nerve root block (NRB) using PDRN.A 54-year-old female patient with motor weakness of the left upper extremity and tingling sensation in the left neck and shoulder. DIAGNOSES:: traumatic C5 nerve root injury due to a fracture of the left articular process in the C4 spine.Ultrasound-guided C5 NRB using PDRN.Her motor weakness and sensory symptoms of the left upper extremity were significantly improved after treatment using an ultrasound-guided C5 NRB

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2017 Medicine

15. 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. (PubMed)

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. 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.Our aim was to determine factors that contribute to horizontal and angular displacement of dens (...) . Horizontal displacement was only dependent on C6-C7 inclination angle and anteroposterior sagittal balance.Disc space inclination angles of the lower cervical spine and the cervical sagittal balance most contribute to the magnitude of angular and horizontal displacement of the dens after fracture.Copyright © 2017. Published by Elsevier Inc.

2017 The Spine Journal

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

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

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2017 Medicine

17. The NEXUS criteria are insufficient to exclude cervical spine fractures in older blunt trauma patients. (PubMed)

The NEXUS criteria are insufficient to exclude cervical spine fractures in older blunt trauma patients. The National Emergency X-Radiography Utilization Study (NEXUS) criteria are used to assess the need for imaging to evaluate cervical spine integrity after injury. The aim of this study was to assess the sensitivity of the NEXUS criteria in older blunt trauma patients.Patients aged 65 years or older presenting between 1st July 2010 and 30th June 2014 and diagnosed with cervical spine fractures (...) were identified from the institutional trauma registry. Clinical examination findings were extracted from electronic medical records. Data on the NEXUS criteria were collected and sensitivity of the rule to exclude a fracture was calculated.Over the study period 231,018 patients presented to The Alfred Emergency & Trauma Centre, of whom 14,340 met the institutional trauma registry inclusion criteria and 4035 were aged ≥65years old. Among these, 468 patients were diagnosed with cervical spine

2017 Injury

18. 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

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

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.

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

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

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.

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2017 The Journal of the Canadian Chiropractic Association

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