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Cervical Spine Fracture

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141. Multiple Cerebral Infarctions due to Unilateral Traumatic Vertebral Artery Dissection after Cervical Fractures (PubMed)

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

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2016 Korean Journal of Neurotrauma

142. Traumatic upper cervical spinal fractures in teaching hospitals of China over 13 years: A retrospective observational study. (PubMed)

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 (...) 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

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2016 Medicine

143. "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

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

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 (...) cages, none of them involving fracture at the level of convergence of blades or screws.Although hardware-related complications after the use of zero-profile anchored cages seem to be rare events, future biomechanical and clinical studies are warranted in order to evaluate the safety of employing such devices for the treatment of multilevel degenerative disc disease in the cervical spine.

2016 European Spine Journal

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

. 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

146. Cervical Fracture/Subluxation in a Patient with a Prior C2-Sacrum Fusion: Case Report and Review of Literature (PubMed)

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

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2016 Cureus

147. 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

148. Early versus delayed decompression for traumatic cervical spinal cord injury: application of the AOSpine subaxial cervical spinal injury classification system to guide surgical timing. (PubMed)

Early versus delayed decompression for traumatic cervical spinal cord injury: application of the AOSpine subaxial cervical spinal injury classification system to guide surgical timing. Application of AOSpine subaxial cervical spine injury classification system to explore the optimal surgical decompression timing for different types of traumatic cervical spinal cord injury (CSCI).A single-center prospective cohort study was conducted that included patients with traumatic CSCIs (C3-C7) between (...) February 2015 and October 2016. After enrollment, patients underwent either early (< 72 h after injury) or late (≥ 72 h after injury) decompressive surgery of the cervical spinal cord. Each group was divided into A0, A1-4, B, C/F4 and F1-3 subgroups. The primary outcomes were ordinal changes in the ASIA Impairment Scale (AIS) and the Spinal Cord Independence Measure III (SCIM version 3) at a 12-month follow-up. The secondary outcomes included length of hospital stay, postoperative neurological

2019 European Spine Journal

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

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

150. The role of Magnetic Resonance Imaging in acute cervical spine fractures in the elderly. (PubMed)

The role of Magnetic Resonance Imaging in acute cervical spine fractures in the elderly. The role of magnetic resonance imaging (MRI) in neurologically intact cervical spine fractures is not well defined. To our knowledge, there are no studies that clearly identify the indications for MRI in this particular scenario. Controversy remains regarding the use of MRI in at-risk patients, primarily the obtunded and elderly patients.The purpose of the present study was to examine the predisposing (...) injuries, neurologic examination, neurologic symptoms, sex, age, and alertness. Two experienced fellowship-trained spine surgeons determined if the MRI study changed the management in the individual cases based on the Sub-axial Cervical Spine Injury classification system.Ninety-nine patients with a cervical fracture were included in the final analysis: median age 54 years (interquartile range, 42 years), mean Glasgow Coma Scale 13 (standard deviation ± 3.0), 68% males, 32% females, 42% older patients

2013 The Spine Journal

151. "Artifactual fracture-subluxation" of cervical spine in computed tomography screening sans plain radiographs. (PubMed)

"Artifactual fracture-subluxation" of cervical spine in computed tomography screening sans plain radiographs. Computed tomography (CT) has become the sole modality of screening for cervical injury in polytrauma because of the high sensitivity, speed, and convenience, thereby eliminating the need for plain radiographs.We report two cases of misleading artifactual fracture-subluxation of cervical spine in CT, which could have resulted in needless treatment, and describe its characteristics.Case (...) report and review.Two patients who were initially diagnosed with fracture-subluxation on screening CT cervical spine were later noted to have motion artifacts and were reviewed.The artifactual nature of the supposed fracture-subluxation was unmasked by the soft-tissue findings of obscuration in sagittal reconstruction and duplication in axial images, along with the presence of double bony margins.Motion artifact in cervical CT screening can lead to a misdiagnosis of fracture subluxation. Duplication

2013 The Spine Journal

152. Understanding post-hospital morbidity associated with immobilisation of cervical spine fractures in older people using geriatric medicine assessment techniques: A pilot study. (PubMed)

Understanding post-hospital morbidity associated with immobilisation of cervical spine fractures in older people using geriatric medicine assessment techniques: A pilot study. There is a paucity of research into the outcomes and complications of cervical spine immobilisation (hard collar or halothoracic brace) in older people.To identify morbidity and mortality outcomes using geriatric medicine assessment techniques following cervical immobilisation in older people with isolated cervical spine (...) assessment techniques identified the morbidity and functional impairment associated with cervical spine immobilisation. This often results in a prolonged length of stay in supported care. This small pilot study recommends a larger study over a longer period using geriatric medicine assessment techniques to better define the issues.Copyright © 2013 Elsevier Ltd. All rights reserved.

2013 Injury

153. Fractures of the cervical spine (PubMed)

Fractures of the cervical spine The aim of this study was to review the literature on cervical spine fractures.The literature on the diagnosis, classification, and treatment of lower and upper cervical fractures and dislocations was reviewed.Fractures of the cervical spine may be present in polytraumatized patients and should be suspected in patients complaining of neck pain. These fractures are more common in men approximately 30 years of age and are most often caused by automobile accidents (...) . The cervical spine is divided into the upper cervical spine (occiput-C2) and the lower cervical spine (C3-C7), according to anatomical differences. Fractures in the upper cervical spine include fractures of the occipital condyle and the atlas, atlanto-axial dislocations, fractures of the odontoid process, and hangman's fractures in the C2 segment. These fractures are characterized based on specific classifications. In the lower cervical spine, fractures follow the same pattern as in other segments

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2013 Clinics

154. Type II odontoid fracture in elderly patients treated conservatively: is fracture healing the goal? (PubMed)

 months after treatment, functional evaluations were performed employing a second modified Rankin Scale (mRS-post) together with Neck Disability Index (NDI) and Smiley-Webster pain scale (SWPS). Radiological outcome was evaluated through dynamic cervical spine X-rays at 3 months and cervical spine CT scans 6 months after treatment. Three different conditions were identified: stable union, stable non-union and unstable non-union. Surgery was preferred whenever a fracture gap > 2 mm, an antero-posterior (...) Type II odontoid fracture in elderly patients treated conservatively: is fracture healing the goal? Analysis of functional outcome of elderly patients with type II odontoid fractures treated conservatively in relation to their radiological outcome.A total of 50 geriatric patients with type II odontoid fractures were treated with Aspen/Vista collars. On admission, each patient was assessed assigning ASA score, modified Rankin Scale (mRS-pre) and Charlson Comorbidity Index (CCI). From 12-15

2019 European Spine Journal

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

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 (...) 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

2018 CandiEM

156. Management of Vertebral Compression Fractures

. Discussion of Procedures by Variant Variant 1: New symptomatic compression fracture identified on radiographs or CT. No known malignancy. The body regions covered in this clinical scenario are cervical, thoracic, and lumbar spine. These body regions might be evaluated separately or in combination as guided by physical examination findings, patient history, and other available information including prior imaging. For some authors, focal tenderness upon palpation in correlation with radiographs (...) Management of Vertebral Compression Fractures Revised 2018 ACR Appropriateness Criteria ® 1 Vertebral Compression Fractures American College of Radiology ACR Appropriateness Criteria ® Management of Vertebral Compression Fractures Variant 1: New symptomatic compression fracture identified on radiographs or CT. No known malignancy. Procedure Appropriateness Category Medical management Usually Appropriate MRI spine area of interest without IV contrast Usually Appropriate CT spine area of interest

2018 American College of Radiology

157. Cervical Arterial Dissections and Association With Cervical Manipulative Therapy

state of evidence on the diagnosis and management of CDs and their statistical association with cervical manipulative therapy (CMT). In some forms of CMT, a high or low amplitude thrust is applied to the cervical spine by a healthcare professional. Methods— Members of the writing group were appointed by the American Heart Association Stroke Council’s Scientific Statements Oversight Committee and the American Heart Association’s Manuscript Oversight Committee. Members were assigned topics relevant (...) angiography, and magnetic resonance imaging with magnetic resonance angiography are useful in the diagnosis of CD. Follow-up neuroimaging is preferentially done with noninvasive modalities, but we suggest that no single test should be seen as the gold standard. Conclusions— CD is an important cause of ischemic stroke in young and middle-aged patients. CD is most prevalent in the upper cervical spine and can involve the internal carotid artery or vertebral artery. Although current biomechanical evidence

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2014 American Heart Association

158. The Incidence of Noncontiguous Spinal Fractures and Other Traumatic Injuries Associated with Cervical Spine Fractures: A Ten Year Experience at an Academic Medical Center. (PubMed)

The Incidence of Noncontiguous Spinal Fractures and Other Traumatic Injuries Associated with Cervical Spine Fractures: A Ten Year Experience at an Academic Medical Center. Retrospective medical record review.The purpose of this study was to describe the incidence of other injuries that commonly occur in conjunction with cervical spine fractures and dislocations.Cervical spine fractures are often associated with other significant traumatic conditions, which may also require prompt diagnosis (...) and management. However, the relative incidences of the injuries that occur in conjunction with various cervical spine fractures have not been well documented.The radiographic reports of all patients who underwent CT scans of the cervical spine at a single level 1 trauma center over a 10-year period were reviewed. The medical records of individuals with acute, nonpenetrating fractures of the cervical spine were further assessed for any associated traumatic pathology including noncontiguous spine injuries

2011 Spine

159. Mortality and Readmission After Cervical Fracture from a Fall in Older Adults: Comparison with Hip Fracture Using National Medicare Data. (PubMed)

Mortality and Readmission After Cervical Fracture from a Fall in Older Adults: Comparison with Hip Fracture Using National Medicare Data. To examine the prevalence of cervical spine fractures after falls in older Americans, to show changes in recent years, and to compare 12-month outcomes between individuals with cervical and hip fracture after falls.Retrospective study of Medicare data from 2007 to 2011.Acute care hospitals.Individuals aged 65 and older with cervical or hip fracture after (...) a fall.Cervical fracture rate, 12-month mortality, and readmission rate after injury.Rates of cervical fracture increased from 4.6 per 10,000 in 2007 to 5.3 per 10,000 in 2011; rates of hip fracture decreased from 77.3 per 10,000 in 2007 to 63.5 per 10,000 in 2011. Participants with cervical fracture with and without spinal cord injury (SCI) were more likely than those with hip fracture to receive treatment at large hospitals (59.4% and 54.1% vs 28.1%, P < .001), teaching hospitals (49.3% and 40.0% vs 13.4

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2015 Journal of the American Geriatrics Society

160. Is Cervical spine protection always necessary following penetrating neck injury

not immobilised his cervical spine, and you wonder if you should apply cervical spine immobilisation. Search Strategy Using MEDLINE via the Ovid interface, 1950 to August 2009, week 3: Medline:[exp Neck OR exp Wounds, Gunshot OR exp Wounds, Penetrating OR exp Neck Injuries OR exp Spinal Fractures OR neck trauma.mp] AND [exp Orthotic Devices OR exp Orthopedic Equipment OR collar.mp. OR stabili$.mp. OR immobili$.mp] AND [spinal cord injury.mp. OR exp Spinal Cord injuries] LIMIT TO [English language and Humans (...) ] Using Cochrane: spinal immobilisation. Search Outcome A total of 311 papers were found of which six were relevant to the question asked. One further paper was found by hand searching references from these papers. Relevant Paper(s) Author, date and country Patient group Study type (level of evidence) Outcomes Key results Study Weaknesses Apfelbaum et al One patient with unstable c-spine fracture without initial neurological deficit after cervical GSW Case report The cervical collar was removed by EMS

2010 BestBETS

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