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Cervical Spine Fracture

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181. Traumatic combined vertical atlanto-occipital and atlanto-axial dislocations with 2-part fracture of the atlas: Two case reports. Full Text available with Trip Pro

comatose after a fall.Traumatic combined vertical AOD and AAD with 2-part fractures of the atlas was diagnosed using plain radiography, 2-dimensional computed tomography, and/or magnetic resonance imaging of the cervical spine.The first patient received immediate intubation and cardiopulmonary resuscitation in the emergency room. The second patient also received immediate intubation in the emergency room. After her vitals stabilized, she underwent occipitocervical fusion with instrumentation.The first (...) patient died 2 days after the accident. The second patient remained quadriplegic in a ventilatory-dependent state at 1 year after surgery. She continues to receive comprehensive rehabilitation.Immediate respiratory support and surgical stabilization are important for saving lives in this kind of extremely unstable and fatal complex upper cervical spine injury.

2019 Medicine

182. Spinal Fractures in Older Adult Patients Admitted After Low-Level Falls: 10-Year Incidence and Outcomes. (Abstract)

, and outcomes.Spinal fractures occurred in 18% of 4,202 older adult patients admitted following trauma over this 10-year time period, in the following distribution: 43% cervical spine, 5.7% thoracic, 4.9% lumbar spine, 36% sacrococcygeal, and 9.6% multiple spinal regions. As compared to non-spinal fracture patients, more spinal fracture patients went to acute/subacute rehabilitation (47% vs 34%, P < .001) and fewer were discharged home (21% vs 35%, P < .001). In-hospital mortality rate in spinal and non-spinal (...) fracture patients was similar (8.5% vs 9.3%, P = .5).Low-level falls often resulted in a spinal fracture at a variety of levels. Vigilance in evaluation of the entire spine in this population is suggested.© 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

2016 Journal of the American Geriatrics Society

183. Surgical management of spinal fractures and neurological involvement in patients with myeloma. (Abstract)

Surgical management of spinal fractures and neurological involvement in patients with myeloma. Multiple Myeloma (MM) typically involves the spine and causes bone pain, pathological fractures and spinal cord compression with possible consequent neurological deficits. This retrospective study reports the results of surgery on a selected population of patients who underwent surgery for symptomatic spinal myeloma.A total of 26 patients who underwent surgery for spinal myeloma with neurological (...) involvement were studied retrospectively. Neurological evaluation was performed according to the Frankel grade. Characteristics of this population, reconstructive techniques and surgery-related complications were reviewed.The tumours involved the thoracic spine in 13 patients, the lumbar spine in 10 patients, and the cervical spine in three patients. The most common approach was a posterior-only approach (70%), followed by a staged, combined approach (20%), and an anterior-only approach (10%). The mean

2016 Injury

184. Vertebral body fracture after anterior cervical discectomy and fusion with zero-profile anchored cages in adjacent levels: a cautionary tale. (Abstract)

in adjacent levels on the cervical spine led to a fracture of the vertebral body between the cages at the 1-month follow-up, with anterior avulsion of the part of the vertebral body where the blades from the two cages converged. According to the systematic literature review which included 409 patients from 10 different clinical series (with a total cumulative follow-up of approximately 535 patients-year), there were only two reported hardware-related complications after ACDF with zero-profile anchored (...) Vertebral body fracture after anterior cervical discectomy and fusion with zero-profile anchored cages in adjacent levels: a cautionary tale. Zero-profile (also called self-locking, anchored or stand-alone cages) have been recently proposed as an interesting alternative for anterior cervical discectomy and fusion (ACDF), as they are supposed to reduce the rates of post-operative cage extrusion without necessarily incurring in the additional surgical time and increased rates of dysphagia

2016 European Spine Journal

185. Cervical fracture from chronic steroid usage presenting as a stroke: A case report Full Text available with Trip Pro

in care that lead to an exacerbated hemiparesis over the following week.We present a patient with an occult cervical spine fracture with extension of the neck, caused by reduced bone density from a chronic steroid regimen. Nine days after the initial onset of her neurological symptoms, the patient presented to the ED with the complaint of left sided weakness and right-sided sensory loss. She was determined to have a left- sided Brown Séquard syndrome, which resolved following anterior cervical (...) Cervical fracture from chronic steroid usage presenting as a stroke: A case report Misdiagnosis of Brown-Séquard-like presentations can delay treatment; potentially endangering the positive outcomes a patient might otherwise have had. Stroke mimics can be perceived as signaling the end of urgent investigation and care once stroke is ruled out; however, stroke mimics themselves can require prompt care. Herein, we discuss an extremely rare case where stroke was ruled out, resulting in a lapse

2016 International journal of surgery case reports

186. Chronic hypertrophic nonunion of the Type II odontoid fracture causing cervical myelopathy: Case report and review of literature Full Text available with Trip Pro

with rapidly progressive cervical myelopathy (from normal to moderate myelopathy modified Japanese Orthopedic Association [mJOA] 13) over 3 months. Her history was positive for a Type II odontoid fracture managed conservatively and lost to follow-up for 25 years. Spinal imaging studies revealed hypertrophic nonunion and craniocervical kyphotic deformity with significant subaxial stenosis and segmental kyphosis. The patient underwent anterior transoral decompression, followed by posterior occipitothoracic (...) Chronic hypertrophic nonunion of the Type II odontoid fracture causing cervical myelopathy: Case report and review of literature Complications of nonunited Type II odontoid fractures can range from neck pain to progressive neurological deficit from cervical myelopathy. Rarely, the hypertrophic nonunion requires both anterior transoral decompression and posterior decompression with instrumented fusion. We present a case and review literature around this entity.A 68-year-old female presented

2016 Surgical neurology international

187. Cervical Fracture/Subluxation in a Patient with a Prior C2-Sacrum Fusion: Case Report and Review of Literature Full Text available with Trip Pro

Cervical Fracture/Subluxation in a Patient with a Prior C2-Sacrum Fusion: Case Report and Review of Literature Traumatic injury to an adjacent segment of a previously fused spine is a rare complication of scoliosis surgery. The adjacent spinal segments may be more vulnerable to traumatic fracture or dislocation due to increased strain. We present a patient with prior C2 to sacrum fusion who suffered a C2 fracture/dislocation after falling. A 52-year-old female with a previous C2 to the sacrum (...) fusion for idiopathic scoliosis presented with severe and progressively worsening neck pain after multiple falls. Imaging showed anterior displacement of the C2 vertebral body, fracture of C2, and anterior subluxation of the C1-2 complex on C3. The patient underwent posterior occiput to cervical fusion and reduction of the C1-C2 complex. Our case describes a potential complication of long-segment fusion. Adjacent segments may be more prone to fracture-dislocation because of increased intradiscal

2016 Cureus

188. Multiple Cerebral Infarctions due to Unilateral Traumatic Vertebral Artery Dissection after Cervical Fractures Full Text available with Trip Pro

showed left lateral mass fractures on C2, C5, and C6, involving the transverse foramen. Cervical spine magnetic resonance imaging (MRI) revealed loss of signal void on the left vertebral artery. Neck CT angiography showed left VAD starting at the C5 level. Brain MRI revealed acute, multiple cerebral infarctions involving the pons, midbrain, thalamus, corpus callosum, and parietal and frontal lobes on diffusion weighted images. The patient was treated conservatively at the intensive care unit (...) Multiple Cerebral Infarctions due to Unilateral Traumatic Vertebral Artery Dissection after Cervical Fractures We report a case of multiple symptomatic cerebral infarctions from a traumatic vertebral artery dissection (VAD) after cervical fractures. A 73-year-old man was admitted with stuporous mentality and left hemiparesis after a motor-vehicle accident. A brain computed tomography (CT) scan at admission showed a traumatic subarachnoid hemorrhage on the left parietal lobe. A cervical CT scan

2016 Korean Journal of Neurotrauma

189. Missed diagnosis of oesophageal perforation in ankylosing spondylitis cervical fracture: Two case reports and literature review Full Text available with Trip Pro

Missed diagnosis of oesophageal perforation in ankylosing spondylitis cervical fracture: Two case reports and literature review Oesophageal perforation after blunt injury cervical fracture in patients with ankylosing spondylitis (AS) is rarely reported. The early diagnosis of oesophageal perforation is extremely important. We present two cases of patients with AS who sustained cervical fracture dislocation and spinal cord injury. The ossified sharp fragments caused oesophageal perforation (...) , and the delayed diagnoses had serious consequences. Oesophageal perforation should be suspected in patients with AS and cervical fracture if bone fragments are pressing against the oesophagus and a gas shadow is visible around the fracture site on computed tomography imaging. © The Author(s) 2016.

2016 The Journal of international medical research

190. "The Length of Cervical Collar Treatment for Traumatic Sub-axial Fractures"

, 2016 See Sponsor: Oslo University Hospital Information provided by (Responsible Party): Christina Høstmælingen, Oslo University Hospital Study Details Study Description Go to Brief Summary: Most fractures of the cervical spine are considered stable and treated with a rigid cervical collar. However no studies have to date been published addressing the length of treatment. There seems to be a significant dissimilarity between hospitals within and between countries with the length of collar treatment (...) varying from 6 to 12 weeks. At the neurosurgical department at Oslo University Hospital, Ullevål the standard length of treatment for a stable cervical fracture is 12 weeks. This study seeks to establish whether 6 weeks of collar treatment for a specific subtype of stable fractures in the cervical spine is sufficient. Condition or disease Intervention/treatment Phase Collar Treatment of Stable Subaxial Spine Fractures Device: Cervical collar (Miami J collar - Össur) Not Applicable Detailed Description

2016 Clinical Trials

191. Esophageal Perforation in a Cervical Fracture Patient with Progressed Ankylosing Spondylitis: Case Report and Review of the literature. (Abstract)

. Surgical incision was washed by saline and hydrogen peroxide without primary closure. Cervical fracture was treated by long level posterior fixation alone. After surgery, the anterior surgical incision was irrigated with normal saline twice a day and closed 3 weeks later.Esophageal perforation was healed completely and neurologic results were improved significantly after surgery. Union of the fracture and segmental stability of cervical spine was confirmed radiologically at 1-year follow up.Esophageal (...) Esophageal Perforation in a Cervical Fracture Patient with Progressed Ankylosing Spondylitis: Case Report and Review of the literature. Case report and review of relevant literature.To report a rare complication of esophageal perforation in cervical fracture patient with progressive ankylosing spondylitis (AS) and review of relevant literature.Esophageal perforation in cervical fracture is extremely rare. This complication has never been reported in AS patients. Key points in the early

2016 Spine

192. Spinal procedures with specific types of implant in cases of therapy-resistant pain and/or neurological failure

of the evidence should be re-considered in the context of decision making where values and preferences regarding aspects like the balance of benefit and harm, and costs can affect the appraisal of the available evidence and its quality. 9 1. Medical background Spinal surgery, including fusion and dynamic stabilisation, is one of the available treatment options for patients with symptomatic degenerative changes of the lumbar or cervical spine. Degenerative changes of the spine can lead to impingement (...) Surgeons guideline update and a survey on the management of spinal stenosis amongst Dutch surgeons in the same year, there is still considerable uncertainty regarding the indications for fusions and dynamic stabilisation devices 3-8 . This Health Technology Assessment (HTA) report re-evaluates the technologies defined above as treatment options for patients with degenerative changes of the cervical and lumbar spine. 2. Aim The aim of the report is to systematically review the evidence on the clinical

2018 Swiss Federal Office of Public Health HTA

193. Spinal Fracture in Patients with Ankylosing Spondylitis: Cohort Definition, Distribution of Injuries, and Hospital Outcomes. (Abstract)

series. The purpose of this study is to better characterize fractures of the ankylosed spine, including the patient population, locations of fracture, and outcomes in a large, nationally representative sample.All patients with diagnoses of both fracture of the spinal column and ankylosing spondylitis admitted between 2005 and 2011 were identified in the National Inpatient Sample (NIS). Patient demographics, fracture regions, and complications were characterized with descriptive statistics (...) . The associations between injury characteristics and outcomes were assessed using Poisson regression.A total of 939 patients with ankylosing spondylitis admitted with a spinal fracture were identified in NIS. The average age was 68.4 ± 14.7 years, and 85% of patients were male. Cervical fractures were the most common (53.0%), followed by thoracic (41.9%), lumbar (18.2%), and sacral (1.5%). Spinal cord injury was present in 27.5% of cervical fractures, 16.0% of thoracic fractures, and 21.1% of cases overall

2015 Spine

194. The Influence of Insurance Status on the Surgical Treatment of Acute Spinal Fractures. Full Text available with Trip Pro

SCI, and the presence of ligamentous and other associated injuries. It is poorly understood how nonclinical factors, such as insurance status, influence the decision for surgical intervention in patients sustaining spinal trauma.Using NTDB admission years 2008 to 2011, we included patients 18 to 64 years old who sustained a fracture of the cervical or thoracolumbar spine. Patients were excluded if they sustained polytrauma (Injury Severity Score ≥27) or a major injury (Abbreviated Injury Scale (...) The Influence of Insurance Status on the Surgical Treatment of Acute Spinal Fractures. A retrospective, propensity score, multivariate analysis of the National Trauma Data Bank (NTDB) between 2008 and 2011.The aim of this study was to determine the relationship between insurance status and rates of surgery for acute spinal fractures with and without spinal cord injury (SCI).The decision for surgery in patients with spinal fractures is often based on fracture pattern and stability, associated

2015 Spine

195. Surgical stabilisation improves survival of spinal fractures related to ankylosing spondylitis. Full Text available with Trip Pro

with AS (age 66 ± 14 years) had 1131 spinal fractures, of which 534 affected cervical, 352 thoracic, and 245 lumbar vertebrae. Thirteen percent had multiple levels of injuries during the observed period. Surgically treated patients had a greater survival than those treated nonsurgically [hazard ratio (HR) 0.79, P = 0.029]. Spinal cord injury was the major factor contributing to mortality in this cohort (HR 1.55, P < 0.001). The proportion of surgically treated spinal fractures increased linearly during (...) Surgical stabilisation improves survival of spinal fractures related to ankylosing spondylitis. National registry cohort study.The aim of this study was to investigate the effect of surgical stabilization on survival of spinal fractures related to ankylosing spondylitis (AS).Spinal fractures related to AS are associated with considerable morbidity and mortality. Multiple studies suggest a beneficial effect of surgical stabilization in these patients.In the Swedish patient registry, all patients

2015 Spine

196. High Incidence of Undiagnosed Cervical Myelopathy in Patients with Hip Fracture Compared to Controls. Full Text available with Trip Pro

High Incidence of Undiagnosed Cervical Myelopathy in Patients with Hip Fracture Compared to Controls. To identify the incidence of undiagnosed cervical myelopathy in patients who fall and develop hip fractures compared with age-matched controls.Prospective, case-control study.University level 1 Trauma Center.Consecutive patients who presented with hip fractures after a fall. A total of 159 patients were screened; 66 patients (38 arthroplasty, 28 fracture) were eligible for enrollment (...) in the study. Exclusion criteria included cognitive impairment, known diagnosis of cervical myelopathy, previous cervical spine surgery, inability to comply with examination, or refusal to participate. The control group was age-matched elderly patients who underwent total hip arthroplasty (THA).Patient interview and physical examination for cervical myelopathy.Myelopathy was diagnosed by clinical history elements (Japanese Orthopaedic Association score ≤15) and pathologic reflexes. Comparison

2015 Journal of Orthopaedic Trauma

197. Comparison of fusion rates between rod-based laminar claw hook and posterior cervical screw constructs in Type II odontoid fractures. Full Text available with Trip Pro

hooks for treating odontoid fractures. Unlike laminar clamps from the 1980s, contemporary laminar hook-rod instrumentation systems provide better immobilisation of the cervical spine and allows for building reliable frame-like constructs similar to cervical screw-rod systems.A retrospective review of a series of 167 consecutive odontoid fractures from a single-institution was conducted. 30 cases from the series were treated using posterior atlantoaxial fusion, 12 using C1/C2 posterior screws (...) Comparison of fusion rates between rod-based laminar claw hook and posterior cervical screw constructs in Type II odontoid fractures. This study was aimed (i) to compare the fusion rates of rod-based laminar claw hook constructs to that of posterior C1/C2 screw constructs in odontoid fractures, and (ii) to evaluate any complications associated with claw hook/rod constructs. To our knowledge, no study in contemporary literature has presented the effects of using modern rod-based laminar claw

2015 Injury

198. Morphological changes in the human cervical intervertebral disc post trauma: response to fracture-type and degeneration grade over time. (Abstract)

and cell-death over a time period of up to 1 year caused by mechanical and structural factors.116 anterior portions of IVDs of the cervical spine were studied histologically by light microscopy and ultrastructurally by transmission electron microscopy (TEM). The group was investigated with regard to three main parameters: fracture mechanism (compressive vs. tensile/shear loads), degeneration grade (low vs. high) and endplate fracture (with vs. without). Disc architecture (e.g. ruptures) was studied (...) Morphological changes in the human cervical intervertebral disc post trauma: response to fracture-type and degeneration grade over time. In the first 24 h post-intervertebral disc (IVD) trauma, up to 75 % cell death has been reported. In addition, burst fractures cause post-traumatic disc degeneration by elevated pro-apoptotic and pro-inflammatory gene transcription. Moreover, some patients have pre-trauma degenerative disc disease. The aim of the study was to assess histological changes

2015 European Spine Journal

199. Cervical plate fracture: a rare complication Full Text available with Trip Pro

Cervical plate fracture: a rare complication In traumatic and degenerative diseases cervical fusion with anterior cervical plate are commonly used. The increase in the use of cervical plate segment level is also increased risk of developing complications. This case report shows that the increase in the use of cervical plate segment level and also the complications in cervical spinal instrumentation, short-segment cervical plate rare case reported to be broken.

2015 The Pan African medical journal

200. Complete fracture of the lamina of the sixth cervical vertebra with hemiplegia: a case report. (Abstract)

Complete fracture of the lamina of the sixth cervical vertebra with hemiplegia: a case report. We report the rare case of a 27-year-old man who presented a right sided complete hemiplegia after a neck trauma due to a road traffic accident.Computed tomography revealed a complete fracture of the C6 lamina including a partial fracture of the right articular process with complete rotation of the fragment into the spinal canal with a major compression of the right side of the cord. The patient (...) , in the literature, to describe a complete laminar fracture at the cervical spine level with hemiplegia. Early surgical intervention probably provides the better neurological outcome.

2015 European Spine Journal

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