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Cervical Spine Fracture

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81. Screening via CT angiogram after traumatic cervical spine fractures: narrowing imaging to improve cost effectiveness. Experience of a Level I trauma center Full Text available with Trip Pro

Screening via CT angiogram after traumatic cervical spine fractures: narrowing imaging to improve cost effectiveness. Experience of a Level I trauma center Screening for vertebral artery injury (VAI) following cervical spine fractures is routinely performed across trauma centers in North America. From 2002 to 2007, the total number of neck CT angiography (CTA) studies performed in the Medicare population after trauma increased from 9796 to 115,021. In the era of cost-effective medical care (...) , the authors aimed to evaluate the utility of CTA screening in detecting VAI and reduce chances of posterior circulation strokes after traumatic cervical spine fractures.A retrospective review of all patients presenting with cervical spine fractures to Northeast Ohio's Level I trauma institution from 2002 to 2012 was performed.There was a total of 1717 cervical spine fractures in patients presenting to Northeast Ohio's Level I trauma institution between 2002 and 2012. CTA screening was performed in 732

2015 Journal of neurosurgery. Spine

82. Femur fractures should not be considered distracting injuries for cervical spine assessment. (Abstract)

Femur fractures should not be considered distracting injuries for cervical spine assessment. The National Emergency X-Radiography Utilization Study (NEXUS) clinical decision rule is extremely sensitive for clearance of cervical spine (C-spine) injury in blunt trauma patients with distracting injuries.We sought to determine whether the NEXUS criteria would maintain sensitivity for blunt trauma patients when femur fractures were not considered a distracting injury and an absolute indication (...) for diagnostic imaging.We retrospectively analyzed blunt trauma patients with at least 1 femur fracture who presented to our emergency department as trauma activations from 2009 to 2011 and underwent C-spine injury evaluation. Presence of C-spine injury requiring surgical intervention was evaluated.Of 566 trauma patients included, 77 (13.6%) were younger than 18 years. Cervical spine injury was diagnosed in 53 (9.4%) of 566. A total of 241 patients (42.6%) had positive NEXUS findings in addition

2015 American Journal of Emergency Medicine

83. Intubation Biomechanics: Laryngoscope Force and Cervical Spine Motion during Intubation in Cadavers-Cadavers versus Patients, the Effect of Repeated Intubations, and the Effect of Type II Odontoid Fracture on C1-C2 Motion. Full Text available with Trip Pro

Intubation Biomechanics: Laryngoscope Force and Cervical Spine Motion during Intubation in Cadavers-Cadavers versus Patients, the Effect of Repeated Intubations, and the Effect of Type II Odontoid Fracture on C1-C2 Motion. The aims of this study are to characterize (1) the cadaver intubation biomechanics, including the effect of repeated intubations, and (2) the relation between intubation force and the motion of an injured cervical segment.Fourteen cadavers were serially intubated using force (...) -sensing Macintosh and Airtraq laryngoscopes in random order, with simultaneous cervical spine motion recorded with lateral fluoroscopy. Motion of the C1-C2 segment was measured in the intact and injured state (type II odontoid fracture). Injured C1-C2 motion was proportionately corrected for changes in intubation forces that occurred with repeated intubations.Cadaver intubation biomechanics were comparable with those of patients in all parameters other than C2-C5 extension. In cadavers, intubation

2015 Anesthesiology

84. Predicting In-Hospital Mortality in Elderly Patients with Cervical Spine Fractures: A Comparison of the Charlson and Elixhauser Comorbidity Measures. (Abstract)

Predicting In-Hospital Mortality in Elderly Patients with Cervical Spine Fractures: A Comparison of the Charlson and Elixhauser Comorbidity Measures. Retrospective analysis of nationally representative data collected for the National Hospital Discharge Survey.To compare the performance of the Charlson and Elixhauser comorbidity-based measures for predicting in-hospital mortality after cervical spine fractures.Mortality occurring as a consequence of cervical spine fractures is very high (...) in the elderly. The Charlson comorbidity measure has been associated with an increased risk of mortality, but its predictive accuracy has yet to be compared with the more recent and increasingly used Elixhauser measure.Using the National Hospital Discharge Survey for the years 1990 through 2007, we identified all patients aged 65 years or older hospitalized with a diagnosis of cervical spine fracture. The association of each Charlson and Elixhauser comorbidity with mortality was assessed in bivariate

2015 Spine

85. Assessment of ultrasound as a diagnostic modality for detecting potentially unstable cervical spine fractures in pediatric severe traumatic brain injury: A feasibility study Full Text available with Trip Pro

Assessment of ultrasound as a diagnostic modality for detecting potentially unstable cervical spine fractures in pediatric severe traumatic brain injury: A feasibility study Early cervical spine clearance is extremely important in unconscious trauma patients and may be difficult to achieve in emergency setting.The aim of this study was to assess the feasibility of standard portable ultrasound in detecting potentially unstable cervical spine injuries in severe traumatic brain injured (TBI (...) department underwent an ultrasound examination.The best window for the cervical spine was through the anterior triangle using the linear array probe (6-13 MHz). In the ten patients with documented cervical spine injury, bilateral facet dislocation at C5-C6 was seen in 4 patients and at C6-C7 was seen in 3 patients. C5 burst fracture was present in one and cervical vertebra (C2) anterolisthesis was seen in one patient. Cervical ultrasound could easily detect fracture lines, canal compromise and ligamental

2015 Journal of pediatric neurosciences

86. Changes in the care of patients with cervical spine fractures following health reform in Massachusetts. (Abstract)

Changes in the care of patients with cervical spine fractures following health reform in Massachusetts. There is a substantial concern among spine surgeons that healthcare reform efforts will alter the processes through which spinal care is delivered and decrease overall quality. We used the Statewide Inpatient Dataset for Massachusetts to evaluate changes in hospital processes and quality of care for patients with cervical fractures following the implementation of health reform.This was a pre (...) : 0.40, 0.89), a 30% decrease in surveillance insensitive complications (95% CI: 0.51, 0.96) and a 67% reduction in FTR after surveillance insensitive morbidity (95% CI: 0.11, 0.94).In the period following Massachusetts healthcare reform, significant improvements were noted in hospital process and quality measures around the care of patients with cervical spine fractures. Such findings were particularly robust among academic centers. These results may forecast changes in the delivery of spine

2015 Injury

87. Traumatic upper cervical spinal fractures in teaching hospitals of China over 13 years: A retrospective observational study. Full Text available with Trip Pro

Traumatic upper cervical spinal fractures in teaching hospitals of China over 13 years: A retrospective observational study. To investigate the incidence and pattern of patients managed for traumatic upper cervical spinal fractures (TUCSFs) in teaching hospitals in China over 13 years.We retrospectively reviewed 351 patients with TUCSF admitted to our teaching hospitals. Incidence rates were calculated with respect to age, gender, etiologies of trauma, anatomical distribution, anatomical (...) of neurological deficits. Eighty-two patients had combined injuries; the most common pattern was cervical + cervical spine (n = 44, 12.5%), followed by cervical + thoracic spine (n = 27, 7.7%). A total of 121 patients (34.5%) suffered neurological deficits. Of all patients with TUCSF without combined injuries, single C2 fractures accounted for the highest rate of neurological deficits (n = 62, 32.0%). Multivariate logistic regression analysis indicated that sex (OR = 1.876, 95% CI: 1.022-3.443, P = 0.042

2016 Medicine

88. An Investigation of the Metal Concentration in Patients Implanted With the PRESTIGE LPâ„¢ Cervical Disc at Two Contiguous Levels in the Cervical Spine

140 pounds. Postmenopausal female who has sustained a non-traumatic hip, spine or wrist fracture. Male over the age of 70. Male over the age of 60 who has sustained a non-traumatic hip or spine fracture. If the level of BMD is a T score of -3.5 or lower (i.e., -3.6, -3.7, etc.) or a T score of -2.5 or lower (i.e., -2.6, -2.7 etc.) with vertebral crush fracture, then the patient is excluded from the study Has presence of spinal metastases; Has overt or active bacterial infection, either local (...) An Investigation of the Metal Concentration in Patients Implanted With the PRESTIGE LPâ„¢ Cervical Disc at Two Contiguous Levels in the Cervical Spine An Investigation of the Metal Concentration in Patients Implanted With the PRESTIGE LP™ Cervical Disc at Two Contiguous Levels in the Cervical Spine - 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

2017 Clinical Trials

89. I heard a snap! Clay Shoveler’s Fracture

Definition and Mechanism The Clay Shoveler’s fracture is an avulsion fracture of a vertebral spinous process, most commonly C6 or C7. Clay Shoveler’s fractures are relatively rare and can easily be confused with cervical spine sprain or strain. This injury is believed to be caused by strain on the cervical muscles and resultant snapping of the paraspinous ligamentous complex against the spinous process 1 . It is named for its occurrence in Australian clay miners during the 1930’s, who sometimes sustained (...) rotation, flexion, and extension. He also has exquisite, sharp tenderness on palpation over the C6 vertebrae. Initial Impression and Investigations While on history you had suspected a cervical sprain or strain, due to his midline tenderness over C6 and age you decide to obtain a x-ray of his cervical spine. Uh-oh, what happened to Reginald? Image courtesy of: Dr Chris O’Donnell (https://radiopaedia.org/cases/barbell-injury-to-cervical-spine-c6-clay-shoveler-fracture-1) Clay Shoveler’s Fracture

2018 CandiEM

90. Management of Vertebral Compression Fractures

Not Appropriate MRI spine area of interest without and with IV contrast Usually Not Appropriate Percutaneous thermal ablation Usually Not Appropriate Radiation oncology consultation Usually Not Appropriate Variant 2: Osteoporotic compression fracture, with or without edema on MRI and no “red flags”. With or without spinal deformity, worsening symptoms, or pulmonary dysfunction. Procedure Appropriateness Category Medical management Usually Appropriate Percutaneous vertebral augmentation Usually Appropriate (...) body May Be Appropriate Tc-99m SPECT/CT spine area of interest May Be Appropriate MRI spine area of interest with IV contrast May Be Appropriate Variant 5: Asymptomatic pathologic spinal fracture with or without edema on MRI. Procedure Appropriateness Category Radiation oncology consultation Usually Appropriate Medical management Usually Appropriate Percutaneous vertebral augmentation May Be Appropriate Percutaneous thermal ablation May Be Appropriate Surgical consultation May Be Appropriate

2018 American College of Radiology

91. Fractures in Spinal Ankylosing Disorders: A Narrative Review of Disease and Injury Types, Treatment Techniques, and Outcomes. (Abstract)

Fractures in Spinal Ankylosing Disorders: A Narrative Review of Disease and Injury Types, Treatment Techniques, and Outcomes. Spinal ankylosing disorders encompass ankylosing spondylitis (AS), disseminated hyperostosis of the spine, and end-stage spondylosis. All these result in a stiffened and frequently deformed spinal column. This makes the spinal column highly susceptible to severe injuries that are commonly associated with unfavorable outcomes. Improved understanding of the underlying (...) follow-up.Twenty-one identified articles were analyzed. Average age was 63.4 years. Most patients were men. Ground level fall or low energy trauma caused most injuries. Diagnosis was delayed in 15%-41% cases. Hyperextension fracture patterns were most common. Cervical spine fractures were more common than thoracolumbar fractures, with the highest prevalence between C5 and C7. Neurologic deficits were encountered in 21%-100% of patients. Operative fixation and fusion were performed in 40%-100

2017 Journal of Orthopaedic Trauma

92. GLASS Clinical Decision Rule Applied to Thoracolumbar Spinal Fractures in Patients Involved in Motor Vehicle Crashes Full Text available with Trip Pro

GLASS Clinical Decision Rule Applied to Thoracolumbar Spinal Fractures in Patients Involved in Motor Vehicle Crashes There are established and validated clinical decision tools for cervical spine clearance. Almost all the rules include spinal tenderness on exam as an indication for imaging. Our goal was to apply GLASS, a previously derived clinical decision tool for cervical spine clearance, to thoracolumbar injuries. GLass intact Assures Safe Spine (GLASS) is a simple, objective method (...) 14,191 occupants involved in motor vehicle collisions in this analysis. GLASS had a sensitivity of 94.4% (95% CI [86.3-98.4%]), specificity of 54.1% (95% CI [53.2-54.9%]), and negative predictive value of 99.9% (95% CI [99.8-99.9%]) for thoracic injuries, and a sensitivity of 90.3% (95% CI [82.8-95.2%]), specificity of 54.2% (95% CI [53.3-54.9%]), and negative predictive value of 99.9% (95% CI [99.7-99.9%]) for lumbar injuries.The GLASS rule represents the possibility of a novel, more-objective

2017 Western Journal of Emergency Medicine

93. Posterior pedicle screw fixation to treat lower cervical fractures associated with ankylosing spondylitis: a retrospective study of 35 cases. Full Text available with Trip Pro

Posterior pedicle screw fixation to treat lower cervical fractures associated with ankylosing spondylitis: a retrospective study of 35 cases. The most common site of fractures in patients with ankylosing spondylitis (AS) is the cervical spine, especially the lower cervical spine and cervicothoracic junction. The optimal treatment for cervical spine fractures secondary to AS is controversial. This study aimed to explore the effects of posterior pedicle screw fixation alone on fractures (...) of the lower cervical spine in patients with AS.From January 2006 to January 2013, a total of 35 patients with AS and a lower cervical spine fracture were treated using only posterior cervical/thoracic pedicle screw fixation. In this retrospective study, we reviewed the patients' charts to assess their case histories, operations, neurological outcomes, and complications. We also evaluated their postoperative radiographs to determine the time of bone fusion.Altogether, 32 (91.4%) of the 35 fractures

2017 BMC Musculoskeletal Disorders

94. Subacute post-traumatic ascending myelopathy after T12 burst fracture in a 32-year-old male: case report and surgical result of cervical durotomy Full Text available with Trip Pro

Subacute post-traumatic ascending myelopathy after T12 burst fracture in a 32-year-old male: case report and surgical result of cervical durotomy To draw attention to a rare neurological deterioration after spinal cord injury (SCI) and to discuss evidence supporting an increase in cerebrospinal fluid pressure (CSFP), we present an extremely rare case of subacute post-traumatic ascending myelopathy (SPAM) in which the patient sustained a T12 fracture initially resulting in paraplegia and after (...) undergoing posterior fixation and anterior decompression. The patient was a 32-year-old healthy man who sustained a T12 burst fracture with complete paraplegia after a fall injury. The patient underwent a posterior reduction and short-segment fixation 8 h after the injury and an anterior thoracoscopic-assisted decompression on post-traumatic day 8. On post-traumatic day 21, he had a progressive neurological deterioration with dyspnoea and decreased muscle strength of both upper extremities that could

2016 Spinal cord series and cases

95. Traumatic cervical epidural hematoma due to fusion mass fracture following elective rod removal Full Text available with Trip Pro

Traumatic cervical epidural hematoma due to fusion mass fracture following elective rod removal Many studies have examined complications associated with spinal instrumentation, however, few have analyzed complications associated with removal. In this case report, we outline the course of a patient who presented with cervical epidural hematoma secondary to fusion mass fracture five years after removal of spinal hardware.

2017 Journal of orthopaedics

96. Spinal cord injuries related to cervical spine fractures in elderly patients: factors affecting mortality. (Abstract)

Spinal cord injuries related to cervical spine fractures in elderly patients: factors affecting mortality. Spinal cord injuries (SCIs) related to cervical spine (C-spine) fractures can cause significant morbidity and mortality. Aggressive treatment often required to manage instability associated with C-spine fractures is complicated and hazardous in the elderly population.To determine the mortality rate of elderly patients with SCIs related to C-spine fractures and identify factors (...) factors for mortality were injury level and severity of SCI. Although each case of SCI related to C-spine fractures is different, physicians may be able to use these findings to help better determine the prognosis and guide subsequent treatment.Copyright © 2013 Elsevier Inc. All rights reserved.

2013 The Spine Journal

97. The Global Spine Care Initiative: a summary of guidelines on invasive interventions for the management of persistent and disabling spinal pain in low- and middle-income communities. (Abstract)

The Global Spine Care Initiative: a summary of guidelines on invasive interventions for the management of persistent and disabling spinal pain in low- and middle-income communities. The purpose of this study was to synthesize recommendations on the use of common elective surgical and interventional procedures for individuals with persistent and disabling non-radicular/axial with or without myelopathy, radicular back pain, cervical myelopathy, symptomatic spinal stenosis, and fractures due (...) /decompressive surgery for cervical or lumbar radiculopathy, cervical myelopathy, and lumbar spinal stenosis. Epidural steroid injections are less expensive than most surgeries with fewer harms; however, benefits are small and short lived. Vertebroplasty should be considered over kyphoplasty as an option for patients with severe pain and disability due to osteoporotic vertebral compression fracture.Elective surgery and interventional procedures could be limited in medically underserved areas and low

2018 European Spine Journal

98. Impact of Practitioner and Instructional Set on Subject Perceptions and Expectations of Cervical Spine Manipulation

or chiropractor within the last 5 years. Exclusion Criteria: 'Red flag' items indicated in your Neck Medical Screening Questionnaire such as: history of a tumor, bone fracture, metabolic diseases, rheumatoid arthritis, osteoporosis, severe atherosclerosis, prolonged history of steroid use, heart disease, and stroke. History of neck whiplash injury. Diagnosis from your physician of cervical spinal stenosis (narrowing of spinal canal) or presence of symptoms (pain, pins and needles, numbness) in both arms (...) Impact of Practitioner and Instructional Set on Subject Perceptions and Expectations of Cervical Spine Manipulation Impact of Practitioner and Instructional Set on Subject Perceptions and Expectations of Cervical Spine Manipulation - 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

2018 Clinical Trials

99. Brown tumor of the cervical spine in a patient with secondary hyperparathyroidism: A case report Full Text available with Trip Pro

tumor in C4 vertebra.A 25-year-old woman with an history of 2 months of worsening cervicalgia without history of trauma. She complained about progressive neck pain with irradiation to both shoulders and right arm paresthesias, spontaneous fracture or brown spinal cord tumor were suspected. She presented cervical spine instability, was managed with corpectomy of C4 and biopsy.The initial suspicion of this disease must be since the first clinician contact of the patient and with the past medical (...) Brown tumor of the cervical spine in a patient with secondary hyperparathyroidism: A case report Brown tumors are non-neoplastic, expansive bone lesions that occur only in the setting of hyperparathyroidism. The most usual localization of brown tumors is in mandible, ribs and large bones. In cervical spine, to date, there are only 11 cases reported. The aim of this work is to report the case of a patient with Wegener´s granulomatosis with secondary end stage renal failure who developed a brown

2018 International journal of surgery case reports

100. Management of irreducible unilateral facet joint dislocations in subaxial cervical spine: two case reports and a review of the literature Full Text available with Trip Pro

fixation, and intervertebral fusion after the failure of skull traction and closed reduction. At the postoperative 24-month follow-up, intervertebral fusion was achieved and our patients' neurological status improved based on the American Spinal Injury Association scale, compared with their preoperative status.Unilateral facet joint dislocations of subaxial cervical spine are difficult to reduce when complicated with posterior facet fractures or ligamentous injury. Magnetic resonance imaging can (...) Management of irreducible unilateral facet joint dislocations in subaxial cervical spine: two case reports and a review of the literature Skeletal and soft tissue damage are often associated with unilateral facet dislocations, which undoubtedly lead to instability of the spine and further increase difficulties in cervical reduction. This type of irreducible facet dislocation is usually accompanied with potential catastrophic consequences including neurological deficit and severe disability

2018 Journal of medical case reports

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