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1. Thoracolumbar spine trauma

Thoracolumbar spine trauma Thoracolumbar spine trauma - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Thoracolumbar spine trauma Last reviewed: February 2019 Last updated: March 2018 Summary Usually occurs as a result of high-energy trauma (e.g., road traffic accidents, falls from heights). May occur spontaneously in patients with osteoporotic, neoplastic, or metabolic disorders of the spine. Initial on-the-scene (...) or compression of neural structures. Thoracolumbar fractures are the usual outcome of thoracolumbar trauma. Other outcomes include traumatic disc prolapse, ligamentous injury, and epidural haematoma causing pressure on the spinal cord or nerve roots; these occur very rarely without a fracture. This monograph focuses on thoracolumbar spine fracture. History and exam presence of risk factors back pain bruising acute numbness/paraesthesia weakness muscle spasticity/clonus (hypertonicity) or hypotonia

2018 BMJ Best Practice

2. A Randomized Controlled Trial of Topical Application of Tranexamic Acid in Patients with Thoracolumbar Spine Trauma Undergoing Long-Segment Instrumented Posterior Spinal Fusion. (PubMed)

A Randomized Controlled Trial of Topical Application of Tranexamic Acid in Patients with Thoracolumbar Spine Trauma Undergoing Long-Segment Instrumented Posterior Spinal Fusion. Prospective, randomized controlled trial.To evaluate the effect of topically applied tranexamic acid (TXA) on postoperative blood loss of neurologically intact patients with thoracolumbar spine trauma.Few articles exist regarding the use of topical TXA for postoperative bleeding and blood transfusion in spinal surgery.A (...) of topically administered 1 g TXA in thoracic and lumbar spinal trauma cases effectively decreased postoperative transfusion requirements and minimized postoperative blood loss, as determined by the total drainage volume.

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2019 Asian spine journal

3. Does MRI of the Thoracolumbar Spine Change Management in Blunt Trauma Patients with Stable Thoracolumbar Spinal Injuries Without Neurologic Deficits? (PubMed)

Does MRI of the Thoracolumbar Spine Change Management in Blunt Trauma Patients with Stable Thoracolumbar Spinal Injuries Without Neurologic Deficits? In blunt trauma patients with computed tomography (CT) findings of stable thoracolumbar (TL) spinal injury without neurologic deficits, magnetic resonance imaging (MRI) studies are commonly obtained, though the impact on overall management remains unclear. The indication for MRI in patients with TL injury without neurologic deficits continues (...) concordant with MRI findings. Our results suggest that MRI may not affect intervention decisions in blunt trauma patients with CT findings of stable thoracolumbar spinal injury without neurological deficits.

2016 World Journal of Surgery

4. Blunt Thoracolumbar-Spine Trauma Evaluation in the Emergency Department: A Meta- Analysis of Diagnostic Accuracy for History, Physical Examination, and Imaging. (PubMed)

Blunt Thoracolumbar-Spine Trauma Evaluation in the Emergency Department: A Meta- Analysis of Diagnostic Accuracy for History, Physical Examination, and Imaging. Delayed diagnoses of unstable thoracolumbar spine (TL-spine) fractures can result in neurologic deficits and avoidable pain, so it is important for clinicians to reach prompt diagnostic decisions. There are no validated decision aids for determining which trauma patients warrant TL-spine imaging.Our aim was to quantify the diagnostic (...) accuracy of the injury mechanism, physical examination, associated injuries, clinical decision aids, and imaging for evaluating blunt TL-spine trauma patients.A search strategy for studies including adult blunt TL-spine trauma using PubMed, Embase, Scopus, CENTRAL, Cochrane Database of Systematic Reviews, and ClinicalTrials.gov was performed. Excluded studies lacked data to construct 2 × 2 tables, were duplicates, were not primary research, did not focus on blunt trauma, examined associated injuries

2018 Journal of Emergency Medicine

5. Classification of Osteoporotic Thoracolumbar Spine Fractures: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU) (PubMed)

Classification of Osteoporotic Thoracolumbar Spine Fractures: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU) Expert opinion.Osteoporotic vertebral fractures are of increasing medical importance. For an adequate treatment strategy, an easy and reliable classification is needed.The working group "Osteoporotic Fractures" of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU) has developed a classification system (...) (OF classification) for osteoporotic thoracolumbar fractures. The consensus decision followed an established pathway including review of the current literature.The OF classification consists of 5 groups: OF 1, no vertebral deformation (vertebral edema); OF 2, deformation with no or minor (<1/5) involvement of the posterior wall; OF 3, deformation with distinct involvement (>1/5) of the posterior wall; OF 4, loss of integrity of the vertebral frame or vertebral body collapse or pincer-type fracture; OF 5

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2018 Global spine journal

6. Treatment of Fractures of the Thoracolumbar Spine: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU) (PubMed)

Treatment of Fractures of the Thoracolumbar Spine: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU) consensus paper with systematic literature review.The aim of this study was to establish recommendations for treatment of thoracolumbar spine fractures based on systematic review of current literature and consensus of several spine surgery experts.The project was initiated in September 2008 and published in Germany in 2011. It was redone in 2017 based (...) to be indicated individually based on clinical presentation, general condition of the patient, and radiological parameters. The following specific parameters have to be regarded and are proposed as morphological modifiers in addition to AOSpine classification: sagittal and coronal alignment of spine, degree of vertebral body destruction, stenosis of spinal canal, and intervertebral disc lesion. Meanwhile, the recommendations are used as standard algorithm in many German spine clinics and trauma

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2018 Global spine journal

7. Minimally invasive surgery for thoracolumbar spinal trauma (PubMed)

Minimally invasive surgery for thoracolumbar spinal trauma The indications for operative intervention after thoracolumbar spine trauma have been well described. Advances in minimally invasive techniques, including percutaneous pedicle screw fixation and mini-open anterolateral retractor-based approaches can improve surgical outcomes when appropriately applied by reducing blood loss, operative duration and post-operative pain. Moreover, they allow for theoretical advantages by preservation (...) to treat the defect. These further allow for placement of wide rectangular-footprint expandable vertebral body replacement devices to provide anterior column support. We believe this allows for lower rates of subsidence and helps to maintain the biomechanical integrity necessary to prevent post-traumatic malalignment and kyphosis. Together, these minimally invasive techniques combined supply the spine surgeon with a minimally invasive armamentarium to treat nearly all thoracolumbar spine trauma

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2018 Annals of Translational Medicine

8. Assessment of injury to the posterior ligamentous complex in thoracolumbar spine trauma. (PubMed)

Assessment of injury to the posterior ligamentous complex in thoracolumbar spine trauma. Posterior ligamentous complex (PLC), consisting of supraspinous ligament (SSL), interspinous ligament (ISL), ligamentum flavum (LF), and the facet joint capsules is thought to contribute significantly to the stability of thoracolumbar spine. Currently, no consensus exists on radiographic imaging parameters that may indicate injury to the posterior ligamentous complex.To identify imaging parameters that may (...) suggest a disruption of the PLC of the thoracolumbar spine.A survey analysis of members of the Spine Trauma Study Group.None.Compilation of survey results.An extensive review of the literature from 1949 to the present was performed to identify key radiographic elements that have been suggested as indicators of PLC injury. Twelve items identified as such were placed on a survey and sent to the members of the Spine Trauma Study Group. They were asked to rank the items from most important to least

2017 The Spine Journal

9. Thoracolumbar Spinal Injuries in Blunt Trauma, Screening for

Thoracolumbar Spinal Injuries in Blunt Trauma, Screening for Thoracolumbar Spinal Injuries in Blunt Trauma, Screening for - Practice Management Guideline Search » Thoracolumbar Spinal Injuries in Blunt Trauma, Screening for Published 2012 Citation: Authors Sixta, Sherry MD; Moore, Forrest O. MD; Ditillo, Michael F. DO; Fox, Adam D. DO; Garcia, Alejandro J. MD; Holena, Daniel MD; Joseph, Bellal MD; Tyrie, Leslie MD; Cotton, Bryan MD, MPH Author Information From the Division of Acute Care Surgery (...) for reprints: Sherry Sixta, MD, Cooper University Hospital, Camden, NJ; email: Sixta-Sherry@CooperHealth.edu. Statement of the Problem Thoracic and lumbar spinal fractures are commonly encountered in blunt trauma patients. Approximately 50% of all vertebral fractures occur in the thoracolumbar spine (TLS), and the incidence of TLS fractures in trauma patients presenting to Level 1 trauma centers is 4% to 5%. [1] Neurologic injury to the spinal cord occurs in 19% to 50% of these patients, and a delay

2012 Eastern Association for the Surgery of Trauma

10. Early Spinal Surgery following Thoracolumbar Spinal Cord Injury: Process of Care From Trauma to Theatre. (PubMed)

Early Spinal Surgery following Thoracolumbar Spinal Cord Injury: Process of Care From Trauma to Theatre. A retrospective cohort study.The aims of this study were to (1) determine the timing of surgery for traumatic thoracolumbar spinal cord injury (TLSCI) between 2010 and 2014 and (2) identify major delays in the process of care from accident scene to surgery.Early spinal surgery may promote neurological recovery and reduce acute complications after TLSCI; however, it is difficult to achieve

2016 Spine

11. Open Versus Minimally Invasive Fixation Techniques for Thoracolumbar Trauma: A Meta-Analysis. (PubMed)

Open Versus Minimally Invasive Fixation Techniques for Thoracolumbar Trauma: A Meta-Analysis. Study Design Systematic literature review and meta-analysis of studies published in English. Objective This study evaluated differences in outcome variables between percutaneous and open pedicle screws for traumatic thoracolumbar fractures. Methods A systematic review of PubMed, Cochrane, and Embase was performed. The variables of interest included postoperative visual analog scale (VAS) pain score (...) to meet inclusion criteria and were included in the meta-analysis. The combined effect size was found to be in favor of percutaneous fixation for blood loss and operative time (p < 0.05); however, there were no differences in vertebral body height (VBH), kyphosis angle, or VAS scores between open and percutaneous fixation. All of the studies demonstrated relative homogeneity, with I (2) < 25. Conclusions Patients with thoracolumbar fractures can be effectively managed with percutaneous or open pedicle

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2016 Global spine journal

12. Thoracolumbar Trauma

Thoracolumbar Trauma Thoracolumbar Trauma 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 Thoracolumbar Trauma Thoracolumbar Trauma (...) Aka: Thoracolumbar Trauma , Thoracolumbar Injury , Lumbar Spine Trauma , Lumbar Spine Injury , Thoracic Spine Trauma , Thoracic Spine Injury From Related Chapters II. Precautions Physical Exam is inadequate alone to exclude significant thoracolumbar spine injury III. Exam l tenderness Midline spine deformity correlated to spinal levels and s IV. Associated Conditions l (including ) l dislocation l instability Paraplegia Quadriplegia Nerve root injury V. Imaging Indications Not alert Not able

2018 FP Notebook

13. Reliability of the evaluation of posterior ligamentous complex injury in thoracolumbar spine trauma with the use of computed tomography scan. (PubMed)

Reliability of the evaluation of posterior ligamentous complex injury in thoracolumbar spine trauma with the use of computed tomography scan. The AOSpine thoracolumbar (TL) spine injury classification system is based mainly on computed tomography (CT). The main purpose of this study was to evaluate the reliability of CT scan in the diagnosis of posterior ligamentous complex (PLC) injury in thoracolumbar spine trauma (TLST).We performed a cross-sectional study of 43 patients with TLST. CT scans

2016 European Spine Journal

14. The epidemiology of thoracolumbar trauma: A meta-analysis. (PubMed)

The epidemiology of thoracolumbar trauma: A meta-analysis. To describe the epidemiology of thoracolumbar fractures and associated injuries in blunt trauma patients.A systematic review and metaanalysis was performed based on a MEDLINE database search using MeSH terms for studies matching our inclusion criteria. The search yielded 21 full-length articles, each sub-grouped according to content. Data extraction and multiple analyses were performed on descriptive data.The rate of thoracolumbar (...) fracture in blunt trauma patients was 6.90% (±3.77, 95% CI). The rate of spinal cord injury was 26.56% (±10.70), and non-contiguous cervical spine fracture occurred in 10.49% (±4.17). Associated injury was as follows: abdominal trauma 7.63% (±9.74), thoracic trauma 22.64% (±13.94), pelvic trauma 9.39% (±6.45), extremity trauma 18.26% (±5.95), and head trauma 12.96% (±2.01). Studies that included cervical spine fracture with thoracolumbar fracture had the following rates of associated trauma: 3.78

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2016 Journal of orthopaedics

15. Reliability assessment of AOSpine thoracolumbar spine injury classification system and Thoracolumbar Injury Classification and Severity Score (TLICS) for thoracolumbar spine injuries: results of a multicentre study. (PubMed)

Reliability assessment of AOSpine thoracolumbar spine injury classification system and Thoracolumbar Injury Classification and Severity Score (TLICS) for thoracolumbar spine injuries: results of a multicentre study. The aim of this multicentre study was to determine whether the recently introduced AOSpine Classification and Injury Severity System has better interrater and intrarater reliability than the already existing Thoracolumbar Injury Classification and Severity Score (TLICS (...) ) for thoracolumbar spine injuries.Clinical and radiological data of 50 consecutive patients admitted at a single centre with a diagnosis of an acute traumatic thoracolumbar spine injury were distributed to eleven attending spine surgeons from six different institutions in the form of PowerPoint presentation, who classified them according to both classifications. After time span of 6 weeks, cases were randomly rearranged and sent again to same surgeons for re-classification. Interobserver and intraobserver

2016 European Spine Journal

16. Establishing the Injury Severity of Thoracolumbar Trauma: Confirmation of the Hierarchical Structure of the AOSpine Thoracolumbar Spine Injury Classification System. (PubMed)

Establishing the Injury Severity of Thoracolumbar Trauma: Confirmation of the Hierarchical Structure of the AOSpine Thoracolumbar Spine Injury Classification System. Survey of spine surgeons.To develop a validated regional and global injury severity scoring system for thoracolumbar trauma.The AOSpine Thoracolumbar Spine Injury Classification System was recently published and combines elements of both the Magerl system and the Thoracolumbar Injury Classification System; however, the injury (...) . Finally, no regional or experiential difference in severity or classification was identified.Development of a globally applicable injury severity scoring system for thoracolumbar trauma is possible. This study demonstrates no regional or experiential difference in perceived severity or thoracolumbar spine trauma. The AOSpine Thoracolumbar Spine Injury Classification System provides a logical approach to assessing these injuries and enables rational strategies for treatment.4.

2015 Spine

17. Application of a modified thoracoabdominal approach that avoids cutting open the costal portion of diaphragm during anterior thoracolumbar spine surgery. (PubMed)

Application of a modified thoracoabdominal approach that avoids cutting open the costal portion of diaphragm during anterior thoracolumbar spine surgery. In the present prospective randomized controlled study, we compared the feasibility and effectiveness of our modified thoracoabdominal approach to anterior thoracolumbar spine surgery without cutting open the costal portion of diaphragm (extradiaphragmatic approach) with the traditional transdiaphragmatic thoracoabdominal approach (...) . The traditional combined thoracoabdominal approach in anterior thoracolumbar surgery for spine tuberculosis is effective but seriously damages the diaphragm and causes various lung complications. We used an extradiaphragmatic approach for complete anterior debridement, bone grafting, and nerve decompression and compared its efficacy and complications with those of the traditional transdiaphragmatic thoracolumbar approach.The study included 106 patients with spinal tuberculosis. After a standard preoperative

2018 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

18. Modified pedicle screw placement at the fracture level for treatment of thoracolumbar burst fractures: a study protocol of a randomised controlled trial. (PubMed)

Modified pedicle screw placement at the fracture level for treatment of thoracolumbar burst fractures: a study protocol of a randomised controlled trial. The optimal treatment for burst fractures of the thoracolumbar spine is controversial. The addition of screws in the fractured segment has been shown to improve construct stiffness, but can aggravate the trauma to the fractured vertebra. Therefore, optimised placement of two pedicle screws at the fracture level is required for the treatment (...) of thoracolumbar burst fractures. This randomised controlled study is the first to examine the efficacy of diverse orders of pedicle screw placement and will provide recommendations for the treatment of patients with thoracolumbar burst fractures.A randomised controlled trial with blinding of patients and the statistician, but not the clinicians and researchers, will be conducted. A total of 70 patients with single AO type A3 or A4 thoracolumbar fractures who are candidates for application of short-segment

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2019 BMJ open

19. Hybrid stabilization of unstable osteoporotic thoracolumbar vertebral body fractures: clinical and radiological outcome after a mean of 4 years. (PubMed)

Hybrid stabilization of unstable osteoporotic thoracolumbar vertebral body fractures: clinical and radiological outcome after a mean of 4 years. The aim of this study was to evaluate midterm results after hybrid stabilization of unstable osteoporotic fractures of the thoracolumbar junction.This retrospective study was performed at a level I trauma center. A total of 113 patients aged 61 and older were stabilized using hybrid stabilization consisting of short-segmental posterior instrumentation (...) and augmentation of the fractured vertebral body after suffering an unstable osteoporotic vertebral body fracture at the thoracolumbar spine. All patients were treated by hybrid stabilization. The primary outcome parameters were the ODI score and loss of reduction. Secondary radiological outcome parameters were the sagittal alignment parameters.Seventy-two women and 41 men (74.6 ± 6.8 years) were included. Sixty-nine patients (61%) were re-evaluated after a mean of 48 months. Seventeen patients have died

2019 European Spine Journal

20. Suspected Spine Trauma ? Child

O MRI cervical spine without and with IV contrast Usually Not Appropriate O US cervical spine Usually Not Appropriate O Variant 4: Child, younger than 16 years of age, suspected thoracolumbar spine trauma. Initial imaging. Procedure Appropriateness Category Relative Radiation Level Radiography thoracic and lumbar spine Usually Appropriate ??? CT thoracic and lumbar spine without IV contrast May Be Appropriate (Disagreement) ???? MRI thoracic and lumbar spine without IV contrast May (...) ]. Children may have cartilaginous injuries that are not visualized on radiographs but are better detected with MRI [24]. In adults, MRI is the modality of choice to evaluate thoracolumbar trauma patients with neurologic deficits, abnormal CT scans, and high clinical suspicion despite negative radiographic evaluation [25]. Recently, a scoring system based on injury morphology, neurological status, and integrity of the thoracolumbar posterior ligament complex has been introduced to guide treatment

2019 American College of Radiology

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