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Cervical Spine Fracture

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181. A delayed diagnosis of bilateral facet dislocation of the cervical spine: a case report (PubMed)

A delayed diagnosis of bilateral facet dislocation of the cervical spine: a case report To review the case of a patient suffering from bilateral facet dislocation of the cervical spine.A 53-year-old male was involved in a car accident and was transported to the hospital. Cervical radiographs were taken at the emergency department and interpreted as normal. Four days later, he consulted a chiropractor where radiographs of the cervical spine were repeated. The examination revealed bilateral (...) cervical facet joint dislocation at C5-C6 as well as a fracture involving the spinous process and laminae of C6.The patient was referred to the hospital and underwent surgery.Patients involved in motor vehicle accidents often consult chiropractors for neck pain treatment. A high index of suspicion due to significant history and physical examination findings should guide the clinician in determining the need for reviewing the initial radiographs (if taken and available) or request repeat studies

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2014 The Journal of the Canadian Chiropractic Association

182. [The clinical outcome after occipitocervical fusion due to metastases of the upper cervical spine: a consecutive case series and a systematic review of the literature]. (PubMed)

[The clinical outcome after occipitocervical fusion due to metastases of the upper cervical spine: a consecutive case series and a systematic review of the literature]. Increasing incidences of osseous metastatic malignancies and higher life expectancy in patients are resulting in a raise of occipitocervical metastases. Those patients with infaust prognosis have a significantly reduced quality of life. In Germany, between 800 and 1680 new cases per year are expected. Treatment algorithms (...) include the evaluation of the general condition, the operability of visceral metastases, the tumor localization, the sensitivity to chemo-/radiotherapy, the fracture risk and the extent of neurological deficits and myelopathies.A systematic review on clinical studies or case series in posterior occipitocervical fusions due to metastases to the craniocervical transition yielded nine publications with 48 patients without neurological deficit. The mean survival time in the given follow-up was 6.44 months

2014 Zeitschrift für Orthopädie und Unfallchirurgie

183. Interventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications

of the respondents (98%) followed ASRA guidelines for anticoagulants but not for antiplatelet agents. Two-thirds of the participants (67%) had separate protocols regarding aspirin [acetylsalicylic acid (ASA)] or nonsteroidal anti-inflammatory drugs (NSAIDs). Moreover, 55% stopped ASA before spinal cord stimulation (SCS) trials and implants, and 32% stopped ASA before epidural steroid injections (ESIs). However, 17% admitted that they used different protocols for cervical spine injections as compared with lumbar (...) ). The amount of epidural fat in the posterior epidural space is directly related to age and body weight. Epidural fat decreases with age. The amount of epidural fat according to spinal location increases with caudal progression, being absent in the cervical spine and highest in the lumbosacral spinal region. Epidural lipomatosis (ie, excessive hypertrophy and abnormal accumulation of epidural fat) may also be seen with long-term exogenous steroid use, obesity, and ESIs. The size of the epidural space also

2015 American Society of Regional Anesthesia and Pain Medicine

184. A potentially missed cervical (C2) spine fracture (PubMed)

A potentially missed cervical (C2) spine fracture The authors present a case report of a potentially missed C2 fracture whose signs and symptoms did not warrant radiograph imaging according to both the National Emergency X-Radiography Utilization Study and Canadian C-spine Rules. The patient had a significant injury while rear-ending a stationary vehicle at 20 mph, and the correct diagnosis was only made based on approaching him with a high index of suspicion. He was successfully treated

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2011 BMJ case reports

185. Do contemporary temporal bone fracture classification systems reflect concurrent intracranial and cervical spine injuries? (PubMed)

Do contemporary temporal bone fracture classification systems reflect concurrent intracranial and cervical spine injuries? Temporal bone fractures (TBFs) are a frequent manifestation of head trauma. We investigated the prevalence of concurrent intracranial injuries (ICIs) and cervical spine injuries (CSIs) in a series of patients with TBFs and attempted to identify significant associations between current TBF classification systems and either ICI or CSI.Retrospective case series with chart (...) review.The records of all patients ≥18 years of age diagnosed with a basilar skull fracture, including TBF, at a level I trauma center from 2004 to 2009 were reviewed. Patient demographics, mechanism of injury, and Glasgow Coma Scale (GCS) scores were collected. Imaging studies were reviewed to classify TBF using the traditional longitudinal-transverse-mixed and otic capsule-sparing versus -involving systems and identify concurrent ICI and CSI.Of 1,279 patients, 202 (15.8%) met inclusion criteria

2011 Laryngoscope

186. Fracture and contralateral dislocation of the twin facet joints of the lower cervical spine. (PubMed)

Fracture and contralateral dislocation of the twin facet joints of the lower cervical spine. The combination of a facet fracture and a contralateral facet dislocation at the same intervertebral level of the cervical spine (a fracture and contralateral dislocation of the twin facet joints) has not been described in detail. The aims of this study are to report a series of 11 patients with this injury, to clarify the clinical features and to discuss its pathomechanism.Among 251 patients with lower (...) cervical spine fractures and/or dislocations surgically treated, 11 (9 males and 2 females, averaged age, 52 years) had this kind of injury. Medical charts and medical images were reviewed retrospectively.Injury levels were C4-5, C5-6 and C6-7 in 1, 4 and 6 patients, respectively. A fracture was found at the superior facet in 6, and at the inferior facet in 5. The anterior displacement of the vertebral body ranged from 7 to 19 mm. The unilateral horizontal facet appearance on an anteroposterior

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2011 European Spine Journal

187. Mortality in elderly patients with hyperostotic disease of the cervical spine after fracture: an age- and sex-matched study. (PubMed)

Mortality in elderly patients with hyperostotic disease of the cervical spine after fracture: an age- and sex-matched study. Several reports indicate that patients with ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (DISH) have increased mortality after cervical spine fractures. However, outcomes of the fractured hyperostotic cervical spine are incompletely described, and there are limited data regarding the covariable effects of patient age and medical comorbidities (...) on mortality.To determine mortality associated with cervical fractures in patients with hyperostotic disease.Retrospective case-control study.Forty-three patients identified through a registry as having fractures of the cervical spine in the setting of hyperostotic disease. These patients were matched to 43 controls who did not carry the diagnosis of hyperostotic disease.Mortality at 3 months and 1, 2, and 3 years after fracture.An institutional database was used to identify all cervical fractures sustained

2011 The Spine Journal

188. Epidemiology of cervical spine fractures in the US military. (PubMed)

Epidemiology of cervical spine fractures in the US military. The epidemiology of cervical spine fractures and associated spinal cord injury (SCI) has not previously been estimated within the American population.To determine the incidence of cervical spine fractures and associated SCI and identify potential risk factors for these injuries in a large multicultural military population.Query of a prospectively collected military database.The 13,813,333 military servicemembers serving in the US (...) Armed Forces between 2000 and 2009.The Defense Medical Epidemiology Database (DMED) was queried to identify all servicemembers diagnosed with cervical spine fractures with and without SCI during the time period under investigation. Data were used to determine the incidence of cervical spine fractures and SCI as well as identify risk factors for their development.The DMED was queried for the years 2000 to 2009 using the International Classification of Diseases, Ninth Revision, Clinical Modification

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2011 The Spine Journal

189. Type II Odontoid Fractures of the Cervical Spine: Do Treatment Type and Medical Co-morbidities Affect Mortality in Elderly Patients? (PubMed)

Type II Odontoid Fractures of the Cervical Spine: Do Treatment Type and Medical Co-morbidities Affect Mortality in Elderly Patients? Retrospective cohort study.To determine the influence of age, comorbidities, and treatment type on mortality in elderly patients with acute Type II odontoid fractures.Prior studies have documented increased morbidity and mortality among geriatric patients sustaining odontoid fractures. However, there is limited data regarding the effect of patient age, medical (...) comorbidities, and treatment selection on mortality after Type II odontoid (C2) fractures in the elderly.An institutional registry was used to identify all Type II odontoid fractures sustained by patients aged 65 and older from 1991 to 2006. Demographic information, date of injury, associated injuries, treatment type, and comorbidities were abstracted from medical records. Mortality was ascertained using the National Death Index. Risks of mortality and their associated 95% confidence intervals (CIs) were

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2011 Spine

190. Swallowing dysfunction in trauma patients with cervical spine fractures treated with halo-vest fixation. (PubMed)

Swallowing dysfunction in trauma patients with cervical spine fractures treated with halo-vest fixation. ACKGROUND:: Cervical spine fractures are common in traumatically injured patients. The halo-vest brace is a common treatment used for these fractures. We hypothesize that the use of halo-vest fixation is associated with a high incidence of dysphagia in trauma patients.All trauma patients at our Level I Trauma Center from August 2005 to August 2007 were analyzed retrospectively via the trauma (...) registry (N=3,702). Included were adult patients with cervical spine fractures treated with halo-vests and evaluated formally by speech-language pathologists for dysphagia and aspiration. Patients were categorized into mild, moderate, and severe dysphagia.Of the 3,702 patients, 369 (10%) had cervical spine fractures from blunt trauma and 56 met inclusion criteria. Of these, 19 (34%) had no evidence of swallowing dysfunction and the remaining 37 (66%) had evidence of dysphagia. Thirteen (23%) exhibited

2011 Journal of Trauma

191. Artifact Simulating Fracture on Cervical Spine Computed Tomography (PubMed)

Artifact Simulating Fracture on Cervical Spine Computed Tomography We present the case of a 31-year-old trauma patient with computed tomography concerning significant C3-C4 subluxation. The abnormality is due to an artifact with which emergency physicians should be aware.

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2011 Western Journal of Emergency Medicine

192. Stress (Fatigue/Insufficiency) Fracture, Including Sacrum, Excluding Other Vertebrae

rami, and pubic bone. Radiographs should be the initial imaging modality in patients with low back and/or pelvic pain. Anterior-posterior (AP) and lateral lumbar spine and AP pelvis radiographs are usually obtained. Because of overlying bowel gas, fecal material, vascular calcifications, sacral curvature, and/or copious soft tissue, the sensitivity of radiographs is low [55]. Radiographs may be more likely to be negative initially in older or osteoporotic patients with insufficiency fractures (...) , pelvis or hip or sacrum. Pregnant patient. Pregnancy-related osteoporosis is rare and its pathogenesis is unclear [60]. Patients are predisposed to develop insufficiency fractures in the spine, pelvis, femoral neck, wrist, or clavicle. Decreased serum calcium levels may occur during pregnancy [20] because of decreased levels of 1,25-dihydroxyvitamin D 3 , decreased calcitonin levels, and the effects of cytokines on bone remodeling. Insufficiency fractures of the sacrum secondary to postmenopausal

2016 American College of Radiology

193. The Effect of Directional Specific Thoracic Spine Mobilization on Cervical Spine Pain

The Effect of Directional Specific Thoracic Spine Mobilization on Cervical Spine Pain The Effect of Directional Specific Thoracic Spine Mobilization on Cervical Spine Pain - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before (...) adding more. The Effect of Directional Specific Thoracic Spine Mobilization on Cervical Spine Pain The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT01917071 Recruitment Status : Completed First Posted : August 6, 2013 Last Update Posted : July 28, 2015 Sponsor: Chatham University Information provided

2013 Clinical Trials

194. Fracture of the anterior arch of atlas after minor trauma of the immature spine postlaminectomy. (PubMed)

Fracture of the anterior arch of atlas after minor trauma of the immature spine postlaminectomy. Torticollis is a common complaint in the pediatric emergency department. Here, we report what we believe to be the first example in a young child of a fracture of the anterior arch of the atlas associated with an acquired, postsurgical defect of the posterior arch. A brief review of pediatric cervical spine injuries and fractures is presented. Atlas laminectomy may predispose patients to isolated (...) atlas fractures even with minor trauma. Those fractures, however, are stable and treated by hard cervical orthosis.

2014 Pediatric Emergency Care

195. Conservative management of type II and III odontoid fractures in the elderly at a regional spine centre: A prospective and retrospective cohort study. (PubMed)

patients with axial cervical spine injuries, at a single centre. We included patients aged over 60 years with type II and III odontoid fractures. Information was gathered on demographics, ASA grading-associated injuries and complications. The outcome measures were rates and type of union, pain and neurological functions, specifically ambulation.Fifty-seven adult patients with a median age of 78 years (range 60-92 years) were included. There were 42 type II and 15 type III odontoid fractures. Three (...) Conservative management of type II and III odontoid fractures in the elderly at a regional spine centre: A prospective and retrospective cohort study. 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.We carried out retrospective and prospective analyses of all

2014 British Journal of Neurosurgery

196. Traumatic C1-2 posterolateral dislocation with dens fracture, injury of the transverse atlantal ligament, and unilateral facet fracture with subluxation of C6-7: A case report. (PubMed)

Traumatic C1-2 posterolateral dislocation with dens fracture, injury of the transverse atlantal ligament, and unilateral facet fracture with subluxation of C6-7: A case report. Traumatic C1-2 dislocation associated with contiguous or noncontiguous cervical spine injury is rare. Moreover, there have been no reports describing traumatic C1-2 dislocation associated with multiple contiguous and noncontiguous cervical injuries.The authors present a case of a 20-year-old male with painful limitation (...) of motion of the neck. This complex cervical injury occurred due to hyperextension of the head in a rotated position. The patient complained of neck pain that radiated to the left shoulder and arm, but he did not exhibit any neurological abnormalities.The diagnosis of the patients was traumatic C1-2 posterolateral dislocation associated with type II dens fracture (Anderson and D'Alonzo classification), type II injury of the transverse atlantal ligament (Dickman classification), and unilateral facet

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2017 Medicine

197. Cervical Spine Injuries in Sports (Diagnosis)

the yield strength of the vertebrae, a fracture and possible dislocation with cord injury can occur. [ , ] One of the most challenging roles of the team physician involves addressing C-spine injuries in contact sports. It is essential that he or she be well versed in the prevention, evaluation, stabilization, and treatment of these injuries. [ ] A high index of suspicion and an understanding of cervical alignment and architecture, as well as comprehension of the mechanics exerted during a sporting event (...) the spine Because most burners are self-limited, the most important treatment obligation of the team physician is to rule out an unstable cervical injury. The key to assessment is that patients with burners have full pain-free neck range of motion (ROM). If neck motion is decreased or painful, withdraw the athlete from play and obtain cervical radiographs to rule out fracture/dislocation. If symptoms persist for 3-4 weeks following injury, perform electromyography (EMG) to evaluate upper-trunk function

2014 eMedicine Surgery

198. Cervical Spine Injuries in Sports (Follow-up)

the yield strength of the vertebrae, a fracture and possible dislocation with cord injury can occur. [ , ] One of the most challenging roles of the team physician involves addressing C-spine injuries in contact sports. It is essential that he or she be well versed in the prevention, evaluation, stabilization, and treatment of these injuries. [ ] A high index of suspicion and an understanding of cervical alignment and architecture, as well as comprehension of the mechanics exerted during a sporting event (...) the spine Because most burners are self-limited, the most important treatment obligation of the team physician is to rule out an unstable cervical injury. The key to assessment is that patients with burners have full pain-free neck range of motion (ROM). If neck motion is decreased or painful, withdraw the athlete from play and obtain cervical radiographs to rule out fracture/dislocation. If symptoms persist for 3-4 weeks following injury, perform electromyography (EMG) to evaluate upper-trunk function

2014 eMedicine Surgery

199. Cervical Spine Acute Bony Injuries (Diagnosis)

= processing > Cervical Spine Acute Bony Injuries in Sports Medicine Updated: Feb 03, 2017 Author: George L Hertner, MD; Chief Editor: Sherwin SW Ho, MD Share Email Print Feedback Close Sections Sections Cervical Spine Acute Bony Injuries in Sports Medicine Overview Background Cervical spine lead to substantial morbidity and mortality. Neck injury in athletes can quickly end or change the future of an athlete. Failure to properly recognize and provide early care in cervical spine fracture cases may lead (...) of the incidence of cervical spine injury and approach to cervical spine clearance in U.S. trauma centers. J Trauma . 1999 Oct. 47(4):684-90. . Khosla R. An occult cervical spine fracture. Phys Sportsmed . Dec 1997. 25(12):69. . . Wiesenfarth J, Briner W Jr. Neck injuries: urgent decisions and actions. Phys Sportsmed . Jan 1996. 24(1):35. . . Boden BP, Tacchetti RL, Cantu RC, Knowles SB, Mueller FO. Catastrophic cervical spine injuries in high school and college football players. Am J Sports Med . 2006 Aug. 34

2014 eMedicine.com

200. Cervical Spine Sprain/Strain Injuries (Diagnosis)

energy of collisions by dissipation through the normal lordotic curve of the cervical spine, the paravertebral musculature, and the intervertebral discs. However, when the neck is flexed about 30°, the forces applied to the top of the head are directed to a straight-segmented column because the normal lordotic curve is flattened. The cervical spine is then less able to dissipate the exerted forces in this situation, leading to fracture(s) and possible spinal cord injury. This proposed mechanism (...) , Anderson DG. Cervical sprains, disc herniations, minor fractures, and other cervical injuries in the athlete. Clin Sports Med . 2003 Jul. 22(3):513-21. . Tall RL, DeVault W. Spinal injury in sport: epidemiologic considerations. Clin Sports Med . 1993 Jul. 12(3):441-8. . Bogduk N. The anatomy and pathophysiology of neck pain. Phys Med Rehabil Clin N Am . 2003 Aug. 14(3):455-72, v. . Panjabi MM, Vasavada A, White AA III. Cervical spine biomechanics. Semin Spine Surg . 1993 Mar. 5(1):10-6. Holsgrove TP

2014 eMedicine.com

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