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Cervical Spine Fracture

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101. Biomechanical evaluation of surgical constructs for stabilization of cervical teardrop fractures. (PubMed)

Biomechanical evaluation of surgical constructs for stabilization of cervical teardrop fractures. Cervical flexion teardrop fractures (CFTF) are highly unstable injuries, and the optimal internal fixation construct is not always clearly indicated.The purpose of the current study was to determine whether the type of fixation construct (anterior, posterior, or combined) or number of joint levels involved in fixation (one or two) affected the relative stability of a CFTF injury at C5-C6.Human (...) cadaveric cervical spine specimens were mechanically tested under displacement control in the intact state and after creation of CFTF at C5-C6 with stabilization using five different instrumentation constructs. Joint stiffness and intervertebral translation of the constructs were compared with the intact state and normalized (instrumented/intact) to assess relative differences across the five constructs.Spine specimens were mechanically tested in the intact state during flexion, extension, lateral

2017 The Spine Journal

102. Operative stabilization of the remaining mobile segment in ankylosed cervical spine in systemic onset - juvenile idiopathic arthritis: A case report (PubMed)

Operative stabilization of the remaining mobile segment in ankylosed cervical spine in systemic onset - juvenile idiopathic arthritis: A case report We describe a case of a 19-year-old young man with oligoarthritis type of juvenile idiopathic arthritis, who presented with several month duration of lower neck pain and progressive muscular weakness of all four limbs. X-rays of the cervical spine demonstrated spontaneous apophyseal joint fusion from the occipital condyle to C6 and from C7 to Th2 (...) with marked instability between C6 and C7. Surgical intervention began with anterolateral approach to the cervical spine performing decompression, insertion of cage and anterior vertebral plate and screws, followed by posterior approach and fixation. Care was taken to restore sagittal balance. The condition was successfully operatively managed with multisegmental, both column fixation and fusion, resulting in pain cessation and resolution of myelopathy. Postoperatively, minor swallowing difficulties were

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2016 World journal of orthopedics

103. Manual Therapy Techniques on Cervical Spine and Psychological Interaction

Manual Therapy Techniques on Cervical Spine and Psychological Interaction Manual Therapy Techniques on Cervical Spine and Psychological Interaction - 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. Manual (...) Therapy Techniques on Cervical Spine and Psychological Interaction 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: NCT02782585 Recruitment Status : Completed First Posted : May 25, 2016 Last Update Posted : May 25, 2016 Sponsor: Fondazione Don Carlo Gnocchi Onlus Information provided by (Responsible Party

2016 Clinical Trials

104. Early Postoperative Home Exercise Program After Cervical Spine Surgery

Early Postoperative Home Exercise Program After Cervical Spine Surgery Early Postoperative Home Exercise Program After Cervical Spine Surgery - 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. Early (...) Postoperative Home Exercise Program After Cervical Spine Surgery 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: NCT02720172 Recruitment Status : Completed First Posted : March 25, 2016 Last Update Posted : February 12, 2019 Sponsor: Vanderbilt University Medical Center Information provided by (Responsible

2016 Clinical Trials

105. The sensitivity and negative predictive value of a pediatric cervical spine clearance algorithm that minimizes computerized tomography. (PubMed)

in the Emergency Department and 11,331 were admitted. Of the admitted children, 1023 patients arrived in a cervical collar without advanced cervical spine imaging and were evaluated using the cervical spine clearance algorithm. Algorithm sensitivity was 94.4% and the negative predictive value was 99.9%. There was one missed injury, a spinous process tip fracture in a teenager maintained in a collar.Our algorithm was associated with a low missed injury rate and low CT utilization rate, even in children <3years (...) The sensitivity and negative predictive value of a pediatric cervical spine clearance algorithm that minimizes computerized tomography. It is crucial to identify cervical spine injuries while minimizing ionizing radiation. This study analyzes the sensitivity and negative predictive value of a pediatric cervical spine clearance algorithm.We performed a retrospective review of all children <21years old who were admitted following blunt trauma and underwent cervical spine clearance utilizing our

2016 Journal of Pediatric Surgery

106. Yield of computed tomography of the cervical spine in cases of simple assault. (PubMed)

the amount of unnecessary imaging of the C-spine, overutilization of CT is still of concern.A retrospective, cross-sectional study was performed of the electronic medical record (EMR) database at an urban, Level I Trauma Center over a 6-month period for patients receiving a C-spine CT. The primary outcome of interest was prevalence of cervical spine fracture. Secondary outcomes of interest included appropriateness of C-spine imaging after retrospective application of NEXUS and CCR. The hypothesis (...) clinical decision rules. With no fractures identified regardless of other factors, the likelihood that a CT of the cervical spine will identify clinically significant findings in the setting of "simple" assault is extremely low, approaching zero. At minimum, adherence to CCR and NEXUS within this patient population would serve to reduce both imaging costs and population radiation dose exposure.Copyright © 2016 Elsevier Ltd. All rights reserved.

2016 Injury

107. Efficacy of Intraoperative Neurophysiologic Monitoring for Pediatric Cervical Spine Surgery. (PubMed)

extracted. Sensitivity and specificity for the detection of neurologic deficits were calculated with exact 95% confidence intervals. Positive and negative predictive values were calculated with estimated 95% confidence intervals.Sixty-seven patients who underwent cervical spine instrumentation were identified with a mean age of 11.6 years (range 1-18). Diagnoses included instability (27), congenital (11), kyphosis (8), fracture (7), tumor (7), arthritis (4), and basilar invagination (3). Mean number (...) Efficacy of Intraoperative Neurophysiologic Monitoring for Pediatric Cervical Spine Surgery. Clinical case series.To investigate the efficacy of intraoperative neuromonitoring in pediatric cervical spine surgery.Intraoperative neuromonitoring (IONM) consisting of somatosensory-evoked potentials (SSEP) and transcranial motor-evoked potentials (tcMEP) has been shown to effectively prevent permaneny neurologic injury in deformity surgery. The role of IONM during pediatric cervical spine surgery

2016 Spine

108. Cervical Spine Injuries in Children Associated With Sports and Recreational Activities. (PubMed)

from sports or recreational activities (n = 179). Comparison groups sustained (1) cervical spine injury from other mechanisms (n = 361) or (2) other injuries from sports and recreational activities but were free of cervical spine injury (n = 180).For children with sport and recreational activity-related cervical spine injuries, common injury patterns were subaxial (49%) and fractures (56%). These children were at increased odds of spinal cord injury without radiographic abnormalities compared (...) Cervical Spine Injuries in Children Associated With Sports and Recreational Activities. The aim of this study was to ascertain potential factors associated with cervical spine injuries in children injured during sports and recreational activities.This is a secondary analysis of a multicenter retrospective case-control study involving children younger than 16 years who presented to emergency departments after blunt trauma and underwent cervical spine radiography. Cases had cervical spine injury

2016 Pediatric Emergency Care

109. Demographic, Clinical, and Operative Factors Affecting Long-Term Revision Rates After Cervical Spine Arthrodesis. (PubMed)

approaches at a hazard ratio of 0.53 (95% CI, 0.42 to 0.66). Patient age of 18 to 34 years, white race, insurance status of Workers' Compensation or Medicare, and surgical procedures for spinal stenosis, spondylosis, deformity, and neoplasm were associated with elevated revision risk. Arthrodeses spanning few levels and those performed for fractures had a lower revision risk.Primary subaxial cervical spine arthrodeses had a probability of revision approaching 13% over a 16-year period, with elevated (...) Demographic, Clinical, and Operative Factors Affecting Long-Term Revision Rates After Cervical Spine Arthrodesis. Limited data exist on long-term revision rates following cervical spine arthrodeses. The purposes of this study were to define reoperation rates after primary cervical arthrodeses and to identify risk factors for revisions.New York State's all-payer health-care database was queried to identify all primary subaxial cervical arthrodeses occurring in the 16 years from 1997 through 2012

2016 The Journal of Bone and Joint Surgery. American Volume

110. Cervical spine immobilization in the elderly population (PubMed)

commonly seen in elderly patients, the routine use of the 'neutral position' adopted for cervical spine immobilization may not be appropriate in this population. We suggest that consideration be taken in cervical spine immobilization, with patients assessed on an individual basis including the fracture morphology, to minimize the risk of fracture displacement and worsened neurological deficit. (...) Cervical spine immobilization in the elderly population Immobilization of the cervical spine is a cornerstone of spinal injury management. In the context of suspected cervical spine injury, patients are immobilized in a 'neutral position' based on the head and trunk resting on a flat surface. It is hypothesized that the increased thoracic kyphosis and loss of cervical lordosis seen in elderly patients may require alternative cervical immobilization, compared with the 'neutral position

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2016 Journal of Spine Surgery

111. A game of two discs: a case of non-contiguous and occult cervical spine injury in a rugby player (PubMed)

radiographs and computed tomography (CT) imaging modalities of the C-Spine revealed bilateral C4/C5 facetal subluxation with no obvious fractures; however, the MR imaging of the C-Spine revealed a non-contiguous and occult injury to C6/C7 disc with a posterior annular tear and associated disc extrusion. This altered the operative intervention that was initially planned. MR imaging proved an invaluable diagnostic addition in this particular case of cervical trauma in a rugby player following (...) A game of two discs: a case of non-contiguous and occult cervical spine injury in a rugby player The aim of this case report was to highlight the application of magnetic resonance imaging (MRI) in elucidating serious and occult injuries in a single case of hyperflextion injury of a patient cervical spine (C-Spine). A chart and radiology review was performed to establish the sequence of care and how the results of imaging studies influenced the clinical management in this trauma case. Plain

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2016 Journal of surgical case reports

112. Return to Play after Cervical Spine Injuries: A Consensus of Opinion (PubMed)

Return to Play after Cervical Spine Injuries: A Consensus of Opinion Study Design Survey. Objective Sports-related spinal cord injury (SCI) represents a growing proportion of total SCIs but lacks evidence or guidelines to guide clinical decision-making on return to play (RTP). Our objective is to offer the treating physician a consensus analysis of expert opinion regarding RTP that can be incorporated with the unique factors of a case for clinical decision-making. Methods Ten common clinical (...) scenarios involving neurapraxia and stenosis, atlantoaxial injury, subaxial injury, and general cervical spine injury were presented to 25 spine surgeons from level 1 trauma centers for whom spine trauma is a significant component of their practice. We evaluated responses to questions about patient RTP, level of contact, imaging required for a clinical decision, and time to return for each scenario. The chi-square test was used for statistical analysis, with p < 0.05 considered significant. Results

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2016 Global spine journal

113. Pediatric Cervical Spine Injury

Most commonly fatal at the accident scene s may provoke the distraction Findings on CT Joint widening between occiput-C1 or C1-C2 (unilateral or bilateral) Retropharyngeal space widening on C2 VIII. Types: Dens Fracture Age Age <7 years old Findings on Peg of the dens is displaced anteriorly occurs at the synchondrosis (weak bony ) IX. Imaging: Cervical Spine XRay Precautions can not rule out high suspicion Pediatric CT or MRI is indicated where suspicion is high Odontoid view Unreliable (...) Pediatric Cervical Spine Injury Pediatric Cervical Spine Injury Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Pediatric Cervical

2018 FP Notebook

114. Cervical spine immobilization may be of value following firearm injury to the head and neck. (PubMed)

Cervical spine immobilization may be of value following firearm injury to the head and neck. Penetrating injuries to the head and neck may not be able to cause unstable fractures without concomitant spinal cord injury, rendering prehospital spinal immobilization (PHSI) ineffectual, and possibly harmful. However, this premise is based on reports including predominantly chest and abdominal injuries, which are unlikely to cause cervical spine (CS) injuries.We performed a retrospective review (...) -4.9). Eight of 156 surviving patients eventually died (5.1%), and the odds of mortality were greater among those that had PHSI than those without (OR 5.54; CI 1.08-28.4). Six (3.8%; 5 GSW, 1 SW) patients had a CS fracture. Two GSW patients (5.6%) had unstable CS fractures with a normal neurological exam at initial evaluation.Of patients with a GSW to the head or neck that survived to be evaluated, 5.6% had unstable fractures without an initial neurologic deficit. PHSI may be appropriate

2016 American Journal of Emergency Medicine

115. Evaluation of Paraspinal Fat Pad as an Indicator of Posterior Ligamentous Complex Injury in Cervical Spine Trauma. (PubMed)

and was waived for patients. First, PFP appearance was evaluated in an anatomic specimen and in 10 healthy subjects on spine CT scans by three radiologists (readers 1, 2, and 3) working in consensus. Then, in 85 patients with suspicion of cervical spine trauma following high-velocity trauma, readers 2 and 3 reviewed in consensus the cervical spine CT (reference for fracture and luxation) and 1.5-T magnetic resonance images (T1, T2, and short inversion time inversion-recovery sequences; reference for ligament (...) and disk injuries and contusion or occult fracture) for traumatic injuries. CT appearance of PFP was independently analyzed by readers 1 and 2, and interobserver agreement (weighted kappa) was calculated. Relationships between PFP changes and injuries and descriptive analysis were calculated by using logistic regression and Fisher test, respectively. Results The PFP could be identified as a well-circumscribed fatty area between cervical spine and posterior muscles. Interobserver agreement was 0.76

2016 Radiology

116. "Quality of life of patients after surgical treatment of cervical spine metastases". (PubMed)

"Quality of life of patients after surgical treatment of cervical spine metastases". Metastases of malignant neoplasms to the cervical spine are relatively rare. The most common symptom of metastatic disease is pain. Symptoms associated with roots damage or spinal cord compression indicate locally advanced disease. In a large number of patients, surgical treatment brings benefits such as pain reduction and improvement of the quality of life. Pain intensity, neurological status, and quality (...) of patients' lives are measured with the VAS, Frankel, and Karnofsky scales.Symptoms of the disease, morphology of the metastasis and treatment outcomes were evaluated in 57 patients treated surgically because of metastases to the cervical spine over the period 2010-2014 in Brzozów. The morphology of the metastases was assessed on the basis of CT and MR examinations. Pre- and postoperative functional status of the patients was evaluated using Karnofsky scale. The intensity of pain was assessed with VAS

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2016 BMC Musculoskeletal Disorders

117. Subaxial cervical spine trauma (PubMed)

Subaxial cervical spine trauma Subaxial cervical spine trauma is common and an often missed diagnosis. Accurate and efficient diagnosis and management is necessary to avoid devastating complications such as spinal cord injury. Several classification schemes have been devised to help categorize fractures of the subaxial spine and define treatment algorithms. The Subaxial Cervical Spine Injury Classification System (SLIC) is widely used and evaluates not only fracture morphology but also (...) operative intervention if indicated. Surgical techniques include both anterior and posterior approaches to the cervical spine depending on fracture classification.

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2016 Current reviews in musculoskeletal medicine

118. The need to immobilise the cervical spine during cardiopulmonary resuscitation and electric shock administration in out-of-hospital cardiac arrest (PubMed)

The need to immobilise the cervical spine during cardiopulmonary resuscitation and electric shock administration in out-of-hospital cardiac arrest In cases of out-of hospital cardiac arrest (OHCA), falling to the ground can cause brain and neck trauma to the patient. We present a case of a man in his mid-60s who suffered from an OHCA resulting in a violent collapse. The patient received immediate cardiopulmonary resuscitation, but his spine was immobilised only after a large frontal haematoma (...) was found. The resuscitation efforts resulted in return of spontaneous circulation and discharge from hospital. After this, doctors performed angioplasty, followed by a cardiopulmonary bypass. Later, CT scan examination reported a displaced and unstable fracture of the 6th vertebra without bone marrow involvement. The patient underwent a second operation. 40 days later, he was able to return home without sequela. This case shows the importance of analysing the circumstances of a fall, considering

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2016 BMJ case reports

119. Anatomic Study of Anterior Transdiscal Axial Screw Fixation for Subaxial Cervical Spine Injuries. (PubMed)

, C3-C4, C4-C5, and C5-C6 levels, but impossible at C6-C7 due to the obstacle of the sternum. All screws were placed accurately. None of the screws penetrated into the spinal canal and caused fractures determined by dissecting the specimens.The anterior transdiscal axial screw fixation, as an alternative or supplementary instrumentation for subaxial cervical spine injuries, is feasible and safe with meticulous surgical planning. (...) Anatomic Study of Anterior Transdiscal Axial Screw Fixation for Subaxial Cervical Spine Injuries. Anterior transdiscal axial screw (ATAS) fixation is an alternative or supplement to the plate and screw constructs for the upper cervical spine injury. However, no existing literatures clarified the anatomic feasibility of this technique for subaxial cervical spine. Therefore, the objective of this study was to evaluate the anatomical feasibility and to establish guidelines for the use of the ATAS

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2016 Medicine

120. Cervical spine injuries, mechanisms, stability and AIS scores from vertical loading applied to military environments. (PubMed)

Cervical spine injuries, mechanisms, stability and AIS scores from vertical loading applied to military environments. The purpose of this study was to determine injuries to osteo-ligamentous structures of cervical column, mechanisms, forces, severities and AIS scores from vertical accelerative loading.Seven human cadaver head-neck complexes (56.9 ± 9.5 years) were aligned based on seated the posture of military soldiers. Army combat helmets were used. Specimens were attached to a vertical (...) was determined.Injuries occurred in tests only when the roof structure was included. Responses were tri-phasic: initial thrust, secondary tensile, tertiary roof contact phases. Peak forces: 1364-4382 N, initial thrust, 165-169 N, secondary tensile, 868-3368 N tertiary helmet-head roof contact phases. Times of attainments: 5.3-9.6, 31.7-42.6, 55.0-70.8 ms. Injuries included fractures and joint disruptions. Multiple injuries occurred in all but one specimen. A majority of injury severities were AIS = 2. Spines were

2016 European Spine Journal

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