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Cervical Spine Fracture

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2. Spinal and Epidural Anesthesia in Patients With Recent Stable Fractures of Vertebral Column. (Abstract)

surgery in the presence of coexisting recent spine injury (defined as spine injury within 1 month) to assess the occurrence of postoperative deterioration of spinal cord function or occurrence of new spinal cord dysfunction.The hospital records of patients with recent stable traumatic fractures of the vertebral column who underwent lower limb orthopedic surgery under CNB from January 2010 to December 2013 were reviewed. Data collected included age, sex, level of fracture, number of vertebrae injured (...) Spinal and Epidural Anesthesia in Patients With Recent Stable Fractures of Vertebral Column. The use of central neuraxial block (CNB) in patients with spinal injuries with or without spinal cord injury continues to be a contentious issue due to paucity of evidence supporting or refuting its use. There are only a few case reports reporting the use of the technique in these patients. We performed a retrospective record review of patients who underwent neuraxial blockade for lower limb orthopedic

2015 Journal of neurosurgical anesthesiology

3. Outcomes of the conservative and surgical treatment of spinal trauma in elderly patients: a systematic literature review (part I: cervical subaxial fractures part II: thoracic and lumbar fractures)

Outcomes of the conservative and surgical treatment of spinal trauma in elderly patients: a systematic literature review (part I: cervical subaxial fractures part II: thoracic and lumbar fractures) Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears

2020 PROSPERO

4. Is Focused MRI Adequate for Treatment Decision-Making in Acute Traumatic Thoracic and Lumbar Spine Fractures seen on Whole spine CT? (Abstract)

and lumbar spine within 10 days. Exclusion criteria were patients with >4 fractured levels, pathologic fractures, isolated transverse, and/or spinous process fractures, prior vertebral augmentation, and prior thoracic or lumbar spine instrumentation. Patients with neurologic deficits or cervical spine fractures were also included. MRIs were reviewed independently by one spine surgeon and one musculoskeletal fellowship-trained emergency radiologist for posterior ligamentous complex (PLC) integrity (...) Is Focused MRI Adequate for Treatment Decision-Making in Acute Traumatic Thoracic and Lumbar Spine Fractures seen on Whole spine CT? To assess whether a focused magnetic resonance imaging (MRI) limited to the region of known acute traumatic thoracic or lumbar fracture(s) would miss any clinically significant injuries that would change patient management.A multicenter retrospective clinical study.Adult patients with acute traumatic thoracic and/or lumbar spine fracture(s).Pathology identified

2018 The Spine Journal

5. Analysis of the Literature on Cervical Spine Fractures in Ankylosing Spinal Disorders Full Text available with Trip Pro

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

6. Cervical spine fracture through a cervical disc replacement Full Text available with Trip Pro

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

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

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

8. Cervical Spine Fractures: Who Really Needs CT Angiography? (Abstract)

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

9. Frequency of cervical spine injuries in patients with midface fractures. (Abstract)

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

10. Paediatric Trauma: Stabilisation of the Cervical Spine

and alternative guidelines nor should they be used as the basis for a ‘test of clinical negligence’. There is increasing concern that semi-rigid collars may cause more harm than good by: - Distracting a cervical spine fracture or dislocation if applied incorrectly (e.g. wrong size) - Distressing the child, causing them to move their injured spine more rather than less. - Causing neck stiffness and pain, which then makes it harder to ‘clear’ the spine clinically, leading to unnecessary investigations (...) blocks, carefully consider the risks / benefits of trauma anaesthesia and immobilisation versus allowing the child to find a position of comfort. If a cervical spine injury is confirmed by imaging (or suspected despite normal radiographs or CT), ongoing immobilisation can be achieved using an appropriately sized rigid collar, applied by a trained clinician and prescribed by a Registrar or Consultant in Spinal Surgery / Neurosurgery. In summary: ? The use of semi-rigid collars in children

2020 Royal College of Emergency Medicine

11. Evaluation of the Thoracic and Lumbar Spine in Blunt Trauma

was involved in a motor vehicle collision. he was the unrestrained driver in a car that hydroplaned on the highway and collided with the concrete barrier. His car spun around and was struck on the driver’s side before coming to rest in the median. The driver had LOC and ended up in the passenger side of the car. His only complaint is a headache and chest pain. He arrives awake, alert, with abrasions and contusions to his upper face. he has no midline cervical, thoracic, or lumbar spine tenderness and he (...) is neurologically intact. Your next patient is Ms. P, a 47-year-old female with no significant past history who slipped on the wet stairs outside her apartment building. She ended up falling down four stairs, landing primarily on her buttocks. She complains of coccygeal and left hip pain, but denies back or neck pain. She has no midline tenderness in her cervical or thoracic spine, but does have tenderness in the midline lumbar spine, around L2/3. She is neurologically intact. You consider your imaging options

2019 Washington University Emergency Medicine Journal Club

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

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. Age and Other Risk Factors Influencing Long-Term Mortality in Patients With Traumatic Cervical Spine Fracture Full Text available with Trip Pro

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

14. Outcomes of Unstable Subaxial Cervical Spine Fractures Managed by Posteroanterior Stabilization and Fusion Full Text available with Trip Pro

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 (...) , and magnetic resonance imaging of the cervical spine for fracture classification based on the mechanism of injury with status of disc herniation and posterior tension band disruption. All patients were managed by immediate reduction, posterior and anterior stabilization, and fusion in a single session of anesthesia. Data of all patients were analyzed with respect to pre- and postoperative neurological status based on American Spinal Injury Association grading, Visual Analog Scale score, the observation

2018 Asian spine journal

15. Anterior Fixation of Floating Facet Fractures in the Cervical Spine: A Prospective Case Series and Biomechanical Analysis Full Text available with Trip Pro

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

16. Cervical spine fractures in osteopetrosis: a case report and review of the literature Full Text available with Trip Pro

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 (...) , and special considerations that must be explored when determining operative versus non-operative management of spinal injury in osteopetrosis. A PubMed query was performed for English articles in the literature published up to June 2016, and used the following search terms alone and in combination: "osteopetrosis", "spine", "fractures", "osteoclasts", and "operative management". Within four months after initial injury, treatment with halo vest allowed for adequate healing. The patient was asymptomatic

2018 Journal of biomedical research

17. Measuring outcomes following fractures of the cervical spine: protocol for a systematic review

Measuring outcomes following fractures of the cervical spine: protocol for a systematic review Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files or external

2020 PROSPERO

18. Anterior cervical distraction and screw elevating-pulling reduction for traumatic cervical spine fractures and dislocations: A retrospective analysis of 86 cases. Full Text available with Trip Pro

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 (...) 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

2017 Medicine

19. Impact of resident involvement on cervical and lumbar spine surgery outcomes. (Abstract)

Impact of resident involvement on cervical and lumbar spine surgery outcomes. Resident involvement in the operating room is a vital component of their medical education. Conflicting and limited research exists regarding the effects of surgical resident participation on spine surgery patient outcomes.To determine the effect of resident involvement on surgery duration, length of hospital stay and 30-day postoperative complication rates in common spinal surgery using the American College (...) of Surgeons' National Surgical Quality Improvement Program (ACS-NSQIP) database.Multicenter retrospective cohort study.A total of 1,441 patients met the inclusion criteria: 1,142 patients had surgeries with an attending physician alone and 299 patients had surgeries with trainee involvement. All anterior cervical or posterior lumbar surgery patients were identified. Patients who had missing trainee involvement information, surgery for cancer, preoperative infection or dirty wound classification, spine

2019 The Spine Journal

20. True oblique axis fracture associated with congenital anomalies of the upper cervical spine: Case report of an unusual fracture pattern Full Text available with Trip Pro

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

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