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Cervical Spine Fracture

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161. Pediatric Cervical Spine Injury

Spine Injury Pediatric Cervical Spine Injury Aka: Pediatric Cervical Spine Injury , Spinal Cord Injury without Radiographic Abnormality , SCIWORA From Related Chapters II. Epidemiology Pediatric Cervical Spine Injury is a rare event, but requires vigilance in all potential cases (see pitfalls) Percentage of patients with a : <1% Percentage that children under age 8 represent of all injuries: <4% Most common injuries in children ( instability risk) Spinal cord or edema III. Pitfalls Missing a can (...) 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

2018 FP Notebook

162. Analysis of Associated Spinal Fractures in Cases of Traumatic Intracranial Hemorrhage or Skull Fracture (Full text)

, Ground level fall and traffic accident were the most frequent etiologies of trauma (47.0% and 23.9% respectively). Glasgow coma scale on admission was 15-13 for 106 patients (79.1%). spinal fracture was identified in 10 of 134 patients (7.5%). Two patients had cervical, 8 had thoracolumbar fractures. In the analysis of risk factors, an accidental fall and skull fracture was observed significantly more in the spinal fracture cases. Conclusion: The majority of traumatic ICH or skull fracture cases (...) treated in the Department of Neurosurgery were caused by minor head impacts. When treating these patients, it is necessary to investigate not only the cervical, but also the thoracolumbar spine, especially when the cause of injury is an accidental fall and a skull fracture is identified.

2016 Malaysian orthopaedic journal PubMed abstract

163. Neck-to-shoulder pain as an unusual presentation of pulmonary embolism in a patient with cervical spinal cord injury: A case report. (Full text)

Neck-to-shoulder pain as an unusual presentation of pulmonary embolism in a patient with cervical spinal cord injury: A case report. Information on referred pain can be helpful for diagnosing diseases of the visceral organs. Here, the authors report a patient with cervical spinal cord injury (SCI) who had referred pain at the right side from the neck to shoulder, as a presentation of pulmonary embolism (PE).A 55-year-old man with complete tetraplegia, due to cervical SCI after C5 and C6 (...) vertebral body fracture, complained of right neck-to-shoulder pain (numerical scale rating: 6). Despite pain medication (meloxicam 15 mg, gabapentin 400 mg, and propacetamol HCl 1 g), the pain was not reduced. Along with right neck-to-shoulder pain, he presented mild fever (37.8°C) and mildly elevated respiratory rate (20 breaths/min). D-dimer level was also mildly elevated to 6.09 mg/mL (normal value: < 0.5 mg/mL).Computed tomography pulmonary angiography revealed PE in the right lower lobe pulmonary

2017 Medicine PubMed abstract

164. Can the Acute MRI Features Reflect Neurological Prognosis in Patients With Cervical Spinal Cord Injury? (Abstract)

Can the Acute MRI Features Reflect Neurological Prognosis in Patients With Cervical Spinal Cord Injury? Several prognostic studies looked for an association between the degree of spinal cord injury (SCI), as depicted by primary magnetic resonance imaging (MRI) within 72 hours of injury, and neurologic outcome. It was not clearly demonstrated whether the MRI at any time correlates with neurologic prognosis.The purpose of the present study was to investigate the relationship between acute MRI (...) features and neurologic prognosis, especially walking ability of patients with cervical spinal cord injury (CSCI). Moreover, at any point, MRI was clearly correlated with the patient's prognosis.Retrospective image study.From January 2010 to October 2015, 102 patients with CSCI were treated in our hospital. Patients who were admitted to our hospital within 3 days after injury were included in this study. The diagnosis was 78 patients for CSCI with no or minor bony injury and 24 patients for CSCI

2017 The Spine Journal

165. Osteolysis and Cervical Cord Compression Secondary to Silicone Granuloma Formation around a Dorsal Spinal Cord Stimulator: A Case Report (Full text)

Osteolysis and Cervical Cord Compression Secondary to Silicone Granuloma Formation around a Dorsal Spinal Cord Stimulator: A Case Report Spinal cord stimulators (SCSs) have long been in use as a modality for the management of numerous pain pathologies. Along with commonly anticipated morbidities such as displacement, failure (due to fracture or breakage), or infection, there have also been rare but well-documented complications of fibrous scarring, resulting in spinal cord compression (...) . This is the first known case that demonstrates osteolysis and bony destruction of the vertebrae adjacent to the SCS along with the foreign-body granulomatous reaction. A 61-year-old man who underwent prior posterior cervical implantation with an SCS followed by multiple revisions presented with progressive paresthesias, numbness, and weakness of his upper extremities 10 years later. The SCS was removed followed by decompression, and instrumented fusion of the cervical spine. Histopathologic analysis reveals

2016 Journal of neurological surgery reports PubMed abstract

166. Cardiac arrest attributable to dysfunction of the autonomic nervous system after traumatic cervical spinal cord injury (Full text)

Cardiac arrest attributable to dysfunction of the autonomic nervous system after traumatic cervical spinal cord injury Bradycardia is the most common form of dysrhythmia developing after disruption of the sympathetic pathway by a spinal cord injury (SCI), and it can have fatal consequences, including cardiac arrest. Here, we report a case of cardiac arrest developing after cervical SCI attributable to sympathetic hypoactivity. A 26-year-old male pedestrian was admitted after a traffic accident (...) . Radiologically, fractures were apparent at the C6-7 bilateral articular facets, and cord contusion with hemorrhage was evident at C4-7. During his stay in ICU, intermittent bradycardia was noted, but the symptoms were not specific. On the 22nd postoperative day, the patient was taken to the computed tomography suite for further evaluation and experienced cardiac arrest during a positional change. After immediate cardiac massage, the patient was resuscitated. We scheduled Holter monitoring, which detected 26

2017 Chinese Journal of Traumatology PubMed abstract

167. Obstetric Management of Patients with Spinal Cord Injuries

and leg elevation features available on high-tech power wheelchairs . Pulmonary Function Impaired pulmonary function may be present in women with high thoracic or cervical spine lesions, usually above the T5 level . Breathing difficulties accompany many movement disabilities, with a variety of causes including anatomic limitations that compromise the ability to fully inflate lungs, musculoskeletal strength and structural problems, and neurological factors that affect respiratory function . Diminished (...) Obstetric Management of Patients with Spinal Cord Injuries Obstetric Management of Patients with Spinal Cord Injuries | ACOG Clinical Guidance Journals & Publications Patient Education Topics Featured Clinical Topics Hi, Featured Clinical Topics Clinical Guidance Obstetric Management of Patients with Spinal Cord Injuries Committee Opinion Number 808 May 2020 Jump to Resources Share By reading this page you agree to ACOG's Terms and Conditions. . Nearly half (47.6%) occur in persons between

2020 American College of Obstetricians and Gynecologists

168. Posterior temporary C1-2 fixation for 3-part fractures of the axis (odontoid dens and Hangman fractures). (Full text)

prior to surgery were used to evaluate the cervical spine injury. Grauer classification, fracture angulation, and fracture translation were used to evaluate the fracture of dens. The neck disability index (NDI) and range of neck rotary motion were used to assess the neck function.The preoperative fracture angulation and fracture translation were 4.6 ± 1.3° and 2.4 ± 0.6 mm, respectively. The average operation time and blood loss were 109 ± 27 minutes and 49 ± 15 mL. No infection, vascular injuries (...) Posterior temporary C1-2 fixation for 3-part fractures of the axis (odontoid dens and Hangman fractures). Case series study.To report the clinical outcomes of posterior temporary C1-2 fixation for 3-part fracture of the axis (Type II odontoid fracture according to Grauer classification combined with Hangman fracture).The 3-part fracture of the axis is rare and the treatment is controversy.A total of 8 patients with 3-part fracture of the axis were included in this study. X-rays, CT, and MRI

2018 Medicine PubMed abstract

169. Health-care costs of conservative management of spine fractures in trauma patients. (Abstract)

on relevant diagnostic codes. Inclusion criteria were: (1) spine fractures (C1-L5); (2) age >18; and (3) conservative treatment. Exclusion criteria were: (1) neurological involvement and (2) fractures secondary to osteoporosis/malignancy. Health-care utilization and costs were retrieved from national administrative databases covering the entire health-care sector.201 cervical, 150 thoracic, and 140 lumbar fracture patients were included in the study. The total health cost was estimated at €18,919 (16,199 (...) ; 21,756), €8571 (6062; 11,733), €5526 (3473; 7465) for cervical, thoracic, and lumbar regions, respectively. Hospital admissions accounted for the vast majority of costs while primary health care accounted for less than 3 % and prescription medication for less than 2 %. The determinants of costs included fracture site (p < 0.001) and concomitant lower limb injuries (p = 0.009).Spinal fractures, even mild ones, appear to incur substantial health-care utilization and costs. Health-care costs

2016 European Spine Journal

170. Commentary on the management of type II odontoid process fractures in octogenarians: Article by Graffeo et al. and Editorial by Falavigna (J Neurosurgery Spine August 19, 2016) (Full text)

Commentary on the management of type II odontoid process fractures in octogenarians: Article by Graffeo et al. and Editorial by Falavigna (J Neurosurgery Spine August 19, 2016) Establishing a clear treatment paradigm for octogenarians with type II odontoid fractures in hampered by a literature replete with level III articles.In the study by Graffeo et al., the authors evaluated 111 patients over the age of 79 (average age: 87) with type II odontoid fractures undergoing nonoperative (94 patients (...) cervical fractures, mechanisms of injury, GCS of 8 or under, AIS/ISS scores, and disposition to "nonhome" facilities. Furthermore, both appeared to have increased mortality rates at 1-year post injury; 13% during hospitalization, 26% within the first post-injury month, and 41% at 1 year.In the editorial by Falavigna, his major criticism of Graffeo's article was the marked disparity in the number of patients in the operative (17 patients) vs. the nonoperative group (94 patients), making it difficult

2016 Surgical neurology international PubMed abstract

171. Measurement of kyphosis and vertebral body height loss in traumatic spine fractures: an international study. (Full text)

Measurement of kyphosis and vertebral body height loss in traumatic spine fractures: an international study. To investigate whether wide variations are seen in the measurement techniques preferred by spine surgeons around the world to assess traumatic fracture kyphosis and vertebral body height loss (VBHL).An online survey was conducted at two time points among an international community of spine trauma experts from all world regions. The first survey (TL-survey) focused on the thoracic (...) , thoracolumbar and lumbar spine, the second survey (C-survey) on the subaxial cervical spine. Participants were asked to indicate which measurement technique(s) they used for measuring kyphosis and VBHL. Descriptive statistics, frequency analysis and the Fisher exact test were used to analyze the responses.Of the 279 invited experts, 107 (38.4 %) participated in the TL-survey, and 108 (38.7 %) in the C-survey. The Cobb angle was the most frequently used for all spine regions to assess kyphosis (55.6-75.7

2016 European Spine Journal PubMed abstract

172. Fractures of the cervical spine (Full text)

of the spine; currently, the most widely used classification is the SLIC (Subaxial Injury Classification), which predicts the prognosis of an injury based on morphology, the integrity of the disc-ligamentous complex, and the patient's neurological status. It is important to correctly classify the fracture to ensure appropriate treatment. Nerve or spinal cord injuries, pseudarthrosis or malunion, and postoperative infection are the main complications of cervical spine fractures.Fractures of the cervical (...) 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

2013 Clinics PubMed abstract

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

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

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

on computed tomographic scan alone. These additional findings can affect the management in acute cervical spine fractures. The rational of the on-call spine surgeon to order an MRI for a cervical spine fracture is well founded and often that MRI will affect the fracture management. Magnetic resonance imaging particularly helps with better defining the type of spinal cord compression. Picking up occult instability missed on computed tomographic scan was possible with MRI but not as common.Copyright © 2014 (...) 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

2013 The Spine Journal

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

"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

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

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

2015 Journal of the American Geriatrics Society PubMed abstract

177. Australian and New Zealand Guideline for Hip Fracture Care - Improving Outcomes in Hip Fracture Management of Adults

Australian and New Zealand Guideline for Hip Fracture Care - Improving Outcomes in Hip Fracture Management of Adults Australian and New Zealand Guideline for Hip Fracture Care Improving Outcomes in Hip Fracture Management of Adults September 2014© Australian and New Zealand Hip Fracture Registry (ANZHFR) Steering Group 2014 ISBN Print: 978-0-7334-3450-1 ISBN Online: 978-0-7334-3451-8 Published: September 2014 Suggested citation: Australian and New Zealand Hip Fracture Registry (ANZHFR) Steering (...) Group. Australian and New Zealand Guideline for Hip Fracture Care: Improving Outcomes in Hip Fracture Management of Adults. Sydney: Australian and New Zealand Hip Fracture Registry Steering Group; 2014. Copies of this Guideline and supporting documentation (Administrative Report, Technical Report, Dissemination Plan and Public Consultation Submissions Summary) can be downloaded from www.anzhfr.org/guidelines. Disclaimer: This document is a general guide to appropriate practice, to be followed

2014 Clinical Practice Guidelines Portal

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

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

2016 American College of Radiology

179. Answer to the Letter to the Editor of He Maolin et al. concerning "Comparison of unilateral versus bilateral percutaneous kyphoplasty for the treatment of patients with osteoporosis vertebral compression fracture (OVCF): a systematic review and meta-analy (Abstract)

Answer to the Letter to the Editor of He Maolin et al. concerning "Comparison of unilateral versus bilateral percutaneous kyphoplasty for the treatment of patients with osteoporosis vertebral compression fracture (OVCF): a systematic review and meta-analy 28168337 2018 04 02 2018 12 02 1432-0932 26 4 2017 04 European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society Eur Spine (...) J Answer to the Letter to the Editor of He Maolin et al. concerning "Comparison of unilateral versus bilateral percutaneous kyphoplasty for the treatment of patients with osteoporosis vertebral compression fracture (OVCF): a systematic review and meta-analysis" by Cheng X, Long HQ, Xu JH, et al. Eur Spine J (2016) 25: 3439. doi:10.1007/s00586-016-4395-6. 1322-1323 10.1007/s00586-017-4965-2 Cheng Xing X Department of Spine Surgery, The First Affiliated Hospital of Sun Yat-sen University

2017 European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

180. Traumatic Cervical Spondyloptosis of the Subaxial Cervical Spine: A Case Series with a Literature Review and a New Classification (Full text)

Traumatic Cervical Spondyloptosis of the Subaxial Cervical Spine: A Case Series with a Literature Review and a New Classification This is a retrospective study on patients with traumatic subaxial cervical spondyloptosis and includes a review of the available literature regarding the management of this injury.This study aimed to assess the biomechanics and varied clinical presentations of this rare but devastating injury.This is a case series of three patients and a review of the available (...) literature on subaxial cervical spondyloptosis. Traumatic cervical spondyloptosis of the subaxial spine is rare, with varied clinical presentations.The management of cervical subaxial spondyloptosis represents a challenge to all spine care specialists, and there is a paucity of literature on the best methods for managing this condition. Our experience includes three such patients who visited our tertiary trauma center. This article explains the diverse clinical features of the injury as well

2016 Asian spine journal PubMed abstract

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