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Cervical Spine Fracture

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41. Cervical Spine Fracture Presenting as an Orthostatic Headache Secondary to Cerebral Spinal Fluid Leak. (Abstract)

Cervical Spine Fracture Presenting as an Orthostatic Headache Secondary to Cerebral Spinal Fluid Leak. Head injuries are a common chief complaint encountered in the emergency department (ED). A cerebrospinal fluid (CSF) leak resulting from such injuries is uncommon, but has potentially debilitating consequences if undiagnosed.A 34-year-old male patient presented to the ED with complaints of an orthostatic headache after a bicycle accident that occurred 5 days prior to presentation. He presented (...) imaging to rule out such a leak. He was found, on magnetic resonance imaging, to have epidural CSF collections consistent with the suspected leak. In addition to immobilization for the cervical spine fracture, he was treated for orthostatic headaches conservatively with good outcomes. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Although this syndrome is still considered rare compared to other posttraumatic injuries, there is a growing body of evidence suggesting it may be underdiagnosed

2015 Journal of Emergency Medicine

42. Vertebral Column Resection (VCR) in Congenital Kyphoscoliosis (CKS)

: Preoperative Details : Every patient is examined for 1- Shoulder balance 2- Pelvic balance 3- Thoracic hump 4- Neurological examination. Also preoperative whole-spine X-ray anteroposterior and lateral view radiographs in erect position are obtained for accurate preoperative planning. Three-dimensional Multi-Slice Computed Tomography (MSCT) scan is obtained to delineate posterior vertebral column pathoanatomy before surgery. Whole-spine MRI is obtained for declaration of any associated spinal cord (...) : Assiut University Information provided by (Responsible Party): Muhammad Almessry, Assiut University Study Details Study Description Go to Brief Summary: Congenital spinal deformities (CSD) are caused by early embryologic errors in vertebral column formation. Spinal cord malformations are present in approximately one third of patients, even associated cardiac, renal, and genitourinary organ system anomalies in more than half of patients. Functional activity and health-related quality of life (HRQOL

2018 Clinical Trials

43. Spinal collars for stable cervical fracture: a systematic review

Spinal collars for stable cervical fracture: 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. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence: Organisation web address: Timing and effect measures

2018 PROSPERO

44. Can a relatively large spinal cord for the dural sac influence severity of paralysis in elderly patients with cervical spinal cord injury caused by minor trauma? Full Text available with Trip Pro

Can a relatively large spinal cord for the dural sac influence severity of paralysis in elderly patients with cervical spinal cord injury caused by minor trauma? Retrospective reviewThe degree of spinal cord compression and bony spinal canal stenosis are risk factors for the occurrence of spinal cord injury (SCI) without major fracture or dislocation, but they do not affect the severity of neurological symptoms. However, whether a relatively large spinal cord for the dural sac influences (...) the severity of symptoms in SCI cases is unknown.The purpose of this study was to verify the influence of spinal cord size relative to dural sac on the severity of paralysis in elderly patients with cervical SCI caused by minor trauma.Subjects were 50 elderly patients with SCI caused by falls on flat ground. At 72 hours after injury, neurological assessment was performed using the Japanese Orthopaedic Association (JOA) scoring system. Bony canal anteroposterior diameters (APD) at mid C5 vertebral body were

2020 Medicine

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

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

46. Clinical Influence of Cervical Spinal Canal Stenosis on Neurological Outcome after Traumatic Cervical Spinal Cord Injury without Major Fracture or Dislocation Full Text available with Trip Pro

Clinical Influence of Cervical Spinal Canal Stenosis on Neurological Outcome after Traumatic Cervical Spinal Cord Injury without Major Fracture or Dislocation Retrospective case series.To clarify the influence of cervical spinal canal stenosis (CSCS) on neurological functional recovery after traumatic cervical spinal cord injury (CSCI) without major fracture or dislocation.The biomechanical etiology of traumatic CSCI remains under discussion and its relationship with CSCS is one of the most (...) controversial issues in the clinical management of traumatic CSCI.To obtain a relatively uniform background, patients non-surgically treated for an acute C3-4 level CSCI without major fracture or dislocation were selected. We analyzed 58 subjects with traumatic CSCI using T2-weighted mid-sagittal magnetic resonance imaging. The sagittal diameter of the cerebrospinal fluid (CSF) column, degree of canal stenosis, and neurologic outcomes in motor function, including improvement rate, were assessed.There were

2016 Asian spine journal

47. Use of 3D Navigation in Subaxial Cervical Spine Lateral Mass Screw Insertion Full Text available with Trip Pro

intraoperative complications (vertebral artery injury [VAI], nerve root injury [NRI], spinal cord injury [SCI], lateral mass fracture [LMF]) and postoperative complications (screw malposition, screw complications). Methods  Patients who had LMS fixation for their subaxial cervical spine from January 2014 to April 2015 at the Ottawa Hospital were included. A total of 284 subaxial cervical LMS were inserted in 40 consecutive patients. Surgical indications were cervical myelopathy and fractures. The screws (...) Use of 3D Navigation in Subaxial Cervical Spine Lateral Mass Screw Insertion Objective  Cervical spine can be stabilized by different techniques. One of the common techniques used is the lateral mass screws (LMSs), which can be inserted either by freehand techniques or three-dimensional (3D) navigation system. The purpose of this study is to evaluate the difference between the 3D navigation system and the freehand technique for cervical spine LMS placement in terms of complications. Including

2018 Journal of neurological surgery reports

48. Treatment of Axis Ring Fractures: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU) Full Text available with Trip Pro

Treatment of Axis Ring Fractures: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU) Narrative literature review and expert recommendation.To establish treatment recommendations for axis ring fractures based on the knowledge of the experts of the Spine Section of the German Society for Orthopaedics and Trauma.This recommendation summarizes the knowledge of the experts of the Spine Section of the German Society for Orthopaedics and Trauma with regard (...) to the treatment of axis ring fractures based on a narrative literature review.Typical "hangman's fractures" with bilateral separation of the neural arch from C2 and atypical "hangman's fractures" with irregular fracture morphology are described. Computed tomography is the "gold" standard used to detect and analyse these fractures adequately. Furthermore, the detection of vertebral artery integrity is necessary. To classify axis ring fractures, the Levine-Edwards or Josten classification is recommended

2018 Global spine journal

49. Road bike accidents involving cervical fractures presenting as cardiac arrest: a report of two cases. Full Text available with Trip Pro

Road bike accidents involving cervical fractures presenting as cardiac arrest: a report of two cases. We present two cases in which elderly male recreational cyclists suffered from cervical fractures and coinciding injuries of the spinal cord that subsequently led to cardiac arrest.Based on reports from eye witnesses and due to the low impact nature of the crashes, the two patients were initially considered as having cardiac arrest before falling of their bikes.The spinal cord injuries (...) triggering cardiac arrest were acknowledged with delay, as the primary eliciting cause was considered cardiac disease in conjunction with all-out exercise. We suggest that increased focus should be made on possible cervical injuries even following low energy crashes in road cycling.

2019 Scandinavian journal of trauma, resuscitation and emergency medicine

50. A pathological toe fracture as the first presentation of cervical cancer: A case report. Full Text available with Trip Pro

A pathological toe fracture as the first presentation of cervical cancer: A case report. Cervical cancer is one of the most common gynecologic malignancies worldwide, and it spreads mainly through direct extension. Distinct metastases are less common and usually spread to distant lymph nodes, lungs, and bones. Bone metastases from cervical cancer are most commonly observed in the pelvis and spine. Thus, a pathological toe fracture as the initial presentation of cervical cancer is extremely (...) rare.We report a patient with a toe metastasis that first presented with pain caused by a pathological fracture.The patient underwent surgery to remove the right great toe, and the histopathology revealed squamous carcinoma that originated from the cervix.The patient then underwent cervical cancer surgery, chemotherapy, and radiotherapy.A pathological toe fracture as the initial presentation of cervical cancer is extremely rare, but clinicians need to be aware that we should not exclude cancer when

2019 Medicine

51. Cadaveric study of movement in the unstable upper cervical spine during emergency management: tracheal intubation and cervical spine immobilisation-a study protocol for a prospective randomised crossover trial. Full Text available with Trip Pro

cervical spinal cord injury. However, the evidence that previous studies have provided remains unclear, due to lack of a direct measurement technique for dural sac's space during dynamic processes. Our study will use myelography method and a wireless human motion tracker to characterise and compare the change of dural sac's space during tracheal intubations and cervical spine immobilisation in the presence of unstable upper cervical spine injury such as atlanto-occipital dislocation or type II odontoid (...) fracture.Perform laryngoscopy and intubation, video laryngoscope intubation, laryngeal tube insertion, fiberoptic intubation and cervical collar application on cadaveric models of unstable upper cervical spine injury such as atlanto-occipital dislocation or type II odontoid fracture. The change of dural sac's space and the motion of unstable cervical segment are recorded by video fluoroscopy with previously performing myelography, which enables us to directly measure dural sac's space. Simultaneously

2017 BMJ open Controlled trial quality: uncertain

52. Treatment of Injuries to the Subaxial Cervical Spine: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU) Full Text available with Trip Pro

; A4 fractures need vertebral body replacement. In certain cases, additive or pure posterior instrumentation is needed. Usually, lateral mass screws suffice. A navigation system is advised for pedicle screws from C3 to C6.These recommendations provide a framework for the treatment of subaxial cervical spine Injuries. They give advice about diagnostic measures and the therapeutic strategy. (...) are a stable, painless cervical spine and protection against secondary neurologic damage while retaining maximum possible motion and spinal profile. The AOSpine classification for subaxial cervical injuries is recommended. The Canadian C-Spine Rule is recommended to decide on the need for imaging. Computed tomography is the favoured modality. Conventional x-ray is preserved for cases lacking a "dangerous mechanism of injury." Magnetic resonance imaging is recommended in case of unexplained neurologic

2018 Global spine journal

53. Development of a new clinical decision rule for cervical CT to detect cervical spine injury in patients with head or neck trauma. Full Text available with Trip Pro

Development of a new clinical decision rule for cervical CT to detect cervical spine injury in patients with head or neck trauma. Previous cervical spine imaging decision rules have been based on positive findings on plain X-ray and are limited by lack of specificity, age restrictions and complicated algorithms. We previously derived and validated a clinical decision rule (Rule 1) for detecting cervical spine injury (CSI) on CT in a single-centre study. This recommended CT for patients with (1 (...) ) GCS score <14, (2) GCS 14-15 and posterior cervical tenderness or neurological deficit, (3) age ≥60 years and fall down stairs, or (4) age <60 and injured in a motorcycle collision or fallen from height. This study assessed the accuracy and reliability of this rule and refined the rule.We conducted a prospective, dual-centre study at two Japanese EDs between August 2012 and March 2014. Patients with head or neck injury ≥16 years of age were included. Clinical data were collected from medical

2018 Emergency Medicine Journal

54. Intraoperative conversion of artificial cervical disc replacement to anterior cervical discectomy and fusion for iatrogenic fracture: A rare case report. Full Text available with Trip Pro

Intraoperative conversion of artificial cervical disc replacement to anterior cervical discectomy and fusion for iatrogenic fracture: A rare case report. Artificial cervical disc replacement (ACDR) has been reported to be an effective and safe surgical treatment for cervical spondylosis. However, iatrogenic fracture during ACDR surgery has rarely been reported. Considering its infrequency, we report a rare clinical case, with the aim of sharing our experience and exploring when to convert ACDR (...) tomography (CT) scans showed intervertebral fusion in both the C3/4 and C5/6 segments.Surgery was performed to remove the plate and replace C6/7 with an artificial disc, but a transverse cleavage endplate cortical fracture was detected after cutting the blades. Thus, we terminated artificial cervical disc replacement intraoperatively and changed to discectomy and fusion in C6/7.The patient's symptoms were remarkably relieved. Postoperative CT scans showed a transverse cleavage fracture in the backside

2017 Medicine

55. Rib fractures

correlates with increased morbidity and mortality. History and exam presence of risk factors pain dyspnoea signs of impaired oxygenation paradoxical chest wall motion blunt chest trauma physical abuse in children osteoporosis age >45 years athletics primary bone tumours metastatic bone tumours cardiopulmonary resuscitation (CPR) severe cough Diagnostic investigations CXR x-ray pelvis CT chest ultrasound chest angiography CT of head, cervical spine, chest, abdomen, and pelvis skeletal survey (children (...) Rib fractures Rib fractures - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Rib fractures Last reviewed: February 2019 Last updated: April 2018 Summary Common injuries that may be due to blunt force injury, falls, non-accidental injury, aggressive CPR, severe coughing, athletic activities, or metastatic lesions and primary bone tumours. Without evidence of major injury, about 80% of rib fractures in infants

2018 BMJ Best Practice

56. The effectiveness of biodegradable instrumentation in the treatment of spinal fractures. (Abstract)

. Success rates were calculated according to sufficient tissue biocompatibility, solid clinical fusion and propensity for osseointegration.49 articles (24 animal and 25 human studies) were included. In animal experiments, the overall success rate for spinal fusion was 60.3%, while the mean success rate regarding the cervical spine was 51.8% compared to 68.1% for the lumbar spine (p = 0.002). In studies involving control group(s): the mean bioabsorbable implant success rate for spinal fusion was 42 (...) % compared to 57% for conventional implants (p = 0.0016). In the lumbar spine pL-lactide acid (PLLA) had 75.2% success rate compared to poly (L-lactide-co-DL-lactide) (PLDLLA) at 53.4% (p = 0.003). In clinical studies, the overall mean success rate was 89%, while the mean success rate regarding the cervical spine was 92%, as compared to 83.6% for the lumbar spine (p = 0.001). In studies involving control group(s): the mean bioabsorbable implant success rate was 75% compared to a conventional implant mean

2018 Injury

57. Epidemiology of Spinal Fractures in a level one Trauma Center in the Netherlands; a 10 Years Review. (Abstract)

to address the epidemiology of spinal fractures over a large time period in the Netherlands.All patients with a cervical, thoracic or lumbar spine fracture admitted to a level 1 trauma center from 2007 to 2016 were prospective registered and retrospectively analyzed. In addition to patient-, accident- and associated injury characteristics, radiological and surgery data were obtained from the hospital's Electronic Patient File system.Between 2007 and 2016, 1479 patients with a total of 3029 spinal (...) fractures were admitted. 40,8% were female and 59,2% were male, with a mean age of 52,0 years. 4,9% of fractures occurred at a juvenile age (0-18) and 63,6% at the age of 19-64 years. Most fractures occurred in the thoracic spine, followed by the lumbar- and cervical spine. The most common cause of injury was a fall from height, followed by traffic accidents. Spinal cord injury occurred in 8,5% and associated injuries were reported in 73% of the patients. Sixteen percent of the admitted patients were

2018 Spine

58. Management of Severe Lower Cervical Facet Dislocation without Vertebral Body Fracture Using Skull Traction and an Anterior Approach Full Text available with Trip Pro

lower cervical facet dislocation, without vertebral body fracture, were treated between February 2010 and December 2013. Road traffic accident was the primary cause of injury. Patients presented with dislocated segments in C3-C4 (n=4), C4-C5 (n=4), C5-C6 (n=12), and C6-C7 (n=20). Twenty-six patients had unilateral facet dislocation, and 14 patients had bilateral facet dislocation. Spinal injuries were graded according to the American Spinal Injury Association (ASIA) impairment scale and included (...) Management of Severe Lower Cervical Facet Dislocation without Vertebral Body Fracture Using Skull Traction and an Anterior Approach BACKGROUND Cervical facet dislocation is the anterior displacement of one cervical vertebral body on another. The aim of this study was to evaluate the clinical efficacy of skull traction through an anterior cervical approach in the treatment of severe lower cervical facet dislocation without vertebral body fracture. MATERIAL AND METHODS Forty subjects with severe

2018 Medical science monitor : international medical journal of experimental and clinical research

59. Comparison of clinical and radiological outcomes between modified Gallie graft fusion-wiring technique and posterior cervical screw constructs for Type II odontoid fractures. Full Text available with Trip Pro

Comparison of clinical and radiological outcomes between modified Gallie graft fusion-wiring technique and posterior cervical screw constructs for Type II odontoid fractures. The aim of this study was to compare clinical and radiological outcomes between modified Gallie graft fusion-wiring technique and posterior cervical screw constructs for Type II odontoid fractures, and hope to provide references in decision making and surgical planning for both spinal surgeons and surgically treated (...) patients.This is a retrospective study. By retrieving the medical records from January 2005 to July 2015 in our hospital, 53 Type II odontoid fracture patients were reviewed. According to the instrumentation type, patients were divided into 2 groups: Wiring group and Screw group. Three categorized factors were analyzed statistically: patient characteristics: age, body mass index, preoperative neurological status, duration, complicated injuries; surgical variables: surgery time, blood loss, vertebral artery

2018 Medicine

60. Fragility Fracture Risk in Elderly Patients with Cervical Myelopathy. (Abstract)

humerus, proximal femur, and lumbar spine were assessed and compared between cohorts, adjusted by age, sex, osteoporosis, dementia, cerebrovascular disease, and Charlson Comorbidity Index.A total of 891,864 patients were identified, of which 60,332 had a diagnosis of CSM and 24,439 underwent cervical spine surgery. Compared to general population controls, the 12-month adjusted odds of experiencing at least one fragility fracture were 1.59 times higher in patients with CSM who were not treated (...) falls.Records of elderly patients with Medicare insurance from 2005 to 2014 were retrospectively reviewed. Three mutually exclusive populations of patients were identified for analysis, including a cohort of patients with a diagnosis of CSM who were not treated with surgery; a cohort of patients with CSM who were treated with surgery; and a group of control patients who had never been treated with cervical spine surgery nor were diagnosed with CSM. Incidence of fractures of the distal radius, proximal

2018 Spine

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