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Thoracolumbar Trauma

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181. Blunt multifocal aortic injury with abdominal aortic intimointimal intussusception Full Text available with Trip Pro

Blunt multifocal aortic injury with abdominal aortic intimointimal intussusception Blunt abdominal aortic injury is an infrequent occurrence after blunt trauma. The majority of these injuries result from deceleration forces sustained in motor vehicle collisions. Effects of these forces on the thoracic aorta are well described, but associated spinal compression or distraction can also lead to injury of the affixed abdominal aorta. We present a case of multifocal blunt thoracic and abdominal (...) aortic injury with circumferential abdominal aortic dissection, resulting in aortoaortic intussusception associated with a thoracolumbar spinal injury. The unique diagnostic challenge and subsequent successful endovascular management of a rare nonocclusive abdominal aortic intussusception are herein discussed.

2018 Journal of Vascular Surgery Cases and Innovative Techniques

182. Physiotherapeutic Scoliosis Specific Exercises As Treatment for Adult Degenerative Scoliosis

Posted : January 29, 2018 Last Update Posted : January 29, 2018 See Sponsor: Columbia University Information provided by (Responsible Party): Allen Chen, Columbia University Study Details Study Description Go to Brief Summary: This is a pilot study to lead to a larger prospective, randomized, controlled study of older adult (ages 50 and older) spinal patients with thoracolumbar/lumbar scoliosis evaluating improvement with physiotherapeutic scoliosis-specific exercise (PSSE) compared to traditional (...) ) Sexes Eligible for Study: All Accepts Healthy Volunteers: No Criteria Inclusion Criteria: 50+ years old Diagnosis of adolescent idiopathic scoliosis or adult idiopathic scoliosis; either with a Cobb angle ranging from 20-100 degrees Complaint of back pain that has lasted longer than 6 weeks Exclusion Criteria: Any patient who has completed PSSE in the past Previous spinal surgery, trauma, or presence of neoplasms Diagnosis of congenital or neuromuscular scoliosis Subjects who are involved

2018 Clinical Trials

183. Motor, Sensory, and Autonomic Function in Traumatic Spinal Cord Injury After the LION Procedure.

traumatic thoracolumbar spinal cord injury with spastic paraplegia is associated with increased walking capacity. Condition or disease Intervention/treatment Phase Spinal Cord Injuries Device: LION procedure Device: NMES Not Applicable Detailed Description: Sustaining a spinal cord injury impacts the mental and physical wellbeing of the injured individuals profoundly; quality of life suffers and subsequently the risk of suicide is greatly increased as compared to the general population. While spinal (...) capable of voluntary stepping. The primary objective of this randomized clinical trial is therefore to investigate whether the LION procedure and the subsequent neurostimulation in individuals with chronic traumatic thoracolumbar spinal cord injury with spastic paraplegia is associated with increased walking capacity. Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Estimated Enrollment : 20 participants Allocation: Randomized Intervention Model

2018 Clinical Trials

184. Functional Recovery Following Early Kyphoplasty Versus Conservative Management in Stable Thoracuolumbar Fractures in Parachute Jumpers: A Randomized Clinical Trial. (Abstract)

data are not available for supporting each.We included 70 paratroopers with stable thoracolumbar fractures (A1 and A2 classification according to AOSpine thoracolumbar spine injury classification system) presenting <60 days after trauma and hyperintensity in T2-weighted magnetic resonance imaging. Old fractures and those requiring fixation were excluded. Patients were randomly assigned to 2 study groups to undergo percutaneous balloon kyphoplasty (n=34) or conservative care (n=36) by applying (...) Functional Recovery Following Early Kyphoplasty Versus Conservative Management in Stable Thoracuolumbar Fractures in Parachute Jumpers: A Randomized Clinical Trial. A randomized clinical trial.To compare the functional recovery between early kyphoplasty and conservative care in paratroopers with stable thoracolumbar fractures.Treatment of traumatic stable thoracolumbar fractures in young individuals is still a debate. Conservative management and kyphoplasty are options of therapy. But enough

2018 Clinical spine surgery Controlled trial quality: uncertain

187. Antibiotic Prophylaxis in Spine Surgery (Revised 2013)

injuries. The authors concluded that aggressive and earlier intervention is required in this patient population. In critique, the study was designed to assess the inci- dence of spinal infection in a spine trauma population and does not state the duration of follow-up. It offers Level III prognostic evidence the infection rate in spinal surgery for trauma in pa- tients receiving antibiotic prophylaxis is 10%. With neurologic injury, the infection rate is higher and the infections are poly- microbial (...) of all circumstances presented by the patient and the needs and resources particular to the locality or institution 19 plications were recorded. When comparing preoperative patient characteristics, mean body mass index was significantly higher in the diabetic group versus non-diabetic group, 27.11 vs. 25.59, p=0.02, respectively. Diabetic patients also had significantly higher preoperative blood surgar levels (p 125 mg/dL or a postoperative serum glucose level of >200 mg/dL, trauma and prolonged

2013 North American Spine Society

188. Deep Venous Thrombosis and Thromboembolism in Patients With Cervical Spinal Cord Injuries

was that postoperative pharmacologic thromboprophylaxis was unnecessary in patients with cervical spinal injuries without SCI; however, it was recommended in instances of cervical spine trauma with SCI or patients treated with anterior thoracolumbar procedures, irrespective of SCI. It was recommended that pharmacologic thromboprophylaxis be initiated preoperatively as soon as possible in patients with SCI and in cases requiring a delay in surgical treatment. Pharmacologic prophylaxis was recommended (...) Table format ( ). Supporting references included 4 evidence-based reviews on VTE prophylaxis and treatment in a variety of patient populations. Finally, several series dealing with VTE in general trauma patients with results germane to a discussion of spinal cord injured patients are included in the bibliography as supporting documents. Table Evidentiary Table: Deep Vein Thrombosis and Venous Thromboembolism Table Evidentiary Table: Deep Vein Thrombosis and Venous Thromboembolism SCIENTIFIC

2013 Congress of Neurological Surgeons

189. Spinal Cord Injury Without Radiographic Abnormality (SCIWORA) Full Text available with Trip Pro

weeks. Early discontinuation of external immobilization is recommended for patients who become asymptomatic and in whom spinal stability is confirmed with flexion and extension radiographs. Avoidance of “high-risk” activities for up to 6 months following SCIWORA is recommended. RATIONALE Diagnosis Pang and Wilberger defined the term spinal cord injury without radiographic abnormality (SCIWORA) in 1982 as “objective signs of myelopathy as a result of trauma” with no evidence of fracture (...) or ligamentous instability on plain spine radiographs and tomography. The definition specifically excluded all magnetic resonance imaging (MRI) findings and any injuries from penetrating trauma, electric shock, and obstetrical complications and those associated with congenital spinal anomalies. Although many practitioners may consider this diagnostic terminology anachronistic in light of the current near-universal availability of MRI, pediatric neurosurgeons continue to refer to this predominantly pediatric

2013 Congress of Neurological Surgeons

190. Management of Pediatric Cervical Spine and Spinal Cord Injuries Full Text available with Trip Pro

II: Cervical spine imaging is not recommended in children who are > 3 years of age and who have experienced trauma and who: are alert, have no neurological deficit, have no midline cervical tenderness, have no painful distracting injury, do not have unexplained hypotension, and are not intoxicated. Cervical spine imaging is not recommended in children who are < 3 years of age who have experienced trauma and who: have a Glasgow Coma Scale (GCS) > 13, have no neurological deficit, have no midline (...) cervical tenderness, have no painful distracting injury, are not intoxicated, do not have unexplained hypotension, and do not have motor vehicle collision (MVC), a fall from a height > 10 feet, or non-accidental trauma (NAT) as a known or suspected mechanism of injury. Cervical spine radiographs or high resolution CT is recommended for children who have experienced trauma and who do not meet either set of criteria above. Three-position CT with C1-C2 motion analysis to confirm and classify the diagnosis

2013 Congress of Neurological Surgeons

191. Management of Acute Traumatic Central Cord Syndrome (ATCCS) Full Text available with Trip Pro

there was signal change on T2 weighted MR images of the spinal cord in these patients. Kato et al identified 127 trauma patients with cervical spinal cord injuries without bony injury on plain films or computed tomography. The incidence of ATCCS without bony injury was 32.2%. High-energy mechanisms of injury were significantly more common for younger patients. Older patients had a high incidence of injury sustained from a fall. Degenerative changes in the cervical spine and spinal stenosis were identified (...) as risk factors for developing ATCCS without bony injury. The authors noted that ATCCS can occur in young adults during high energy injuries in the absence of pre-existing spinal disease. In the original necropsy descriptions of Schneider et al, , , in 5 patients with ATCCS and spinal stenosis who died between four and 38 days following trauma, the dominant pathological finding was central necrosis of the spinal cord in association with degeneration of neurons and white matter fibers. Swelling

2013 Congress of Neurological Surgeons

192. Subaxial Cervical Spine Injury Classification Systems Full Text available with Trip Pro

classification systems using MEDLINE medical subject headings and keywords “cervical spine trauma,” “cervical spine injury,” “cervical spine injury classification,” and “subaxial cervical spine injury.” Approximately 28 500 citations were obtained. Additional search terms “Cervical Spine Injury Classification” resulted in 593 citations, “lower cervical spine injury classification” resulted in 87 citations, and “subaxial cervical spine injury classification” resulted in 25 citations. Titles and abstracts (...) . CLASSIFICATION SYSTEMS Holdsworth Classification In 1949, Nicoll introduced the concept of stability and instability in the treatment of thoracolumbar injuries. In 1963, based on clinical, radiological, surgical, and postmortem observational studies of 1000 patients, Holdsworth , , proposed his 2-column concept of thoracolumbar and cervical spine stability/instability, emphasizing the importance of posterior ligamentous complex (PLC) and the morphology of facet joint sustaining violence. PLC was composed

2013 Congress of Neurological Surgeons

193. The Acute Cardiopulmonary Management of Patients With Cervical Spinal Cord Injuries Full Text available with Trip Pro

spinal cord ischemia after acute injury. , , – It appears that the earlier cardiac and/or ventilatory/pulmonary dysfunction is detected, the more likely effective, often life-saving treatment can be initiated. It is for these reasons that the issues of early ICU care and cardiac and pulmonary monitoring for human patients following acute SCI have been raised. Acute traumatic SCI is frequently associated with systemic hypotension. Hypotension may be due to hypovolemia, direct severe spinal cord trauma (...) and lumbar SCI injuries had this finding. Marked bradycardia (< 45 bpm) was frequent in patients with severe cervical SCI (71%) and less common in patients with more mild cervical (12%) and thoracolumbar (4%) SCI. Sinus node slowing was profound enough to produce hemodynamic compromise and systemic hypotension necessitating bolus injections of atropine or placement of a temporary pacemaker in 29% of the severe cervical SCI patients. Episodic hypotension unrelated to hypovolemia was identified in 68

2013 Congress of Neurological Surgeons

194. Clinical Assessment Following Acute Cervical Spinal Cord Injury Full Text available with Trip Pro

, Bernardi M , Castellano VM Walking Index for Spinal Cord Injury (WISCI): an international multicenter validity and reliability study . Spinal Cord . 2000 ; 38 ( 4 ): 234 – 243 . 46. Ditunno JJ Functional assessment measures in CNS trauma . J Neurotrauma . 1992 ; 9 (suppl 1 ): S301 – S305 . 47. Dodds TA , Martin DP , Stolov WC , Deyo RA A validation of the functional independence measurement and its performance among rehabilitation inpatients . Arch Phys Med Rehabil . 1993 ; 74 ( 5 ): 531 – 536 . 48

2013 Congress of Neurological Surgeons

196. Ataxia

screening of the thoracolumbar spine in trauma. J Trauma 2003;55:228-34; discussion 34-5. 34. Inaba K, Munera F, McKenney M, et al. Visceral torso computed tomography for clearance of the thoracolumbar spine in trauma: a review of the literature. J Trauma 2006;60:915-20. 35. Karul M, Bannas P, Schoennagel BP, et al. Fractures of the thoracic spine in patients with minor trauma: comparison of diagnostic accuracy and dose of biplane radiography and MDCT. Eur J Radiol 2013;82:1273-7. 36. Rajasekaran S (...) , Vaccaro AR, Kanna RM, et al. The value of CT and MRI in the classification and surgical decision-making among spine surgeons in thoracolumbar spinal injuries. Eur Spine J 2017;26:1463-69. ACR Appropriateness Criteria ® 12 Ataxia 37. Rhea JT, Sheridan RL, Mullins ME, Novelline RA. Can chest and abdominal trauma CT eliminate the need for plain films of the spine? – Experience with 329 multiple trauma patients. Emerg Radiol 2001;8:99-104. 38. Sheridan R, Peralta R, Rhea J, Ptak T, Novelline R

2012 American College of Radiology

197. ACR-ASNR-SCBT-MR Practice Guideline for the Performance of Magnetic Resonance Imaging (MRI) of the Adult Spine

, and epidural abscess. b. Spinal cord infection including abscess. 4. Vascular disorders a. Spinal vascular malformations and/or the cause of occult subarachnoid hemorrhage. b. Spinal cord infarction. 5. Degenerative conditions a. Degenerative disk disease and its sequelae in the lumbar, thoracic, and cervical spine. b. Neurodegenerative disorders such as subacute combined degeneration, spinal muscular atrophy, amyotrophic lateral sclerosis. 6. Trauma Nature and extent of injury to spinal cord, vertebral (...) column, ligaments, thecal sac, and paraspinal soft tissues following trauma. 7. Neoplastic abnormalities a. Intramedullary tumors. b. Intradural extramedullary masses. c. Intradural leptomeningeal disease. d. Extradural soft tissue and bony neoplasms. e. Treatment fields for radiation therapy. 8. Miscellaneous a. Spinal abnormalities associated with scoliosis. b. Syringohydromyelia (multiple etiologies, including Chiari malformations, trauma, etc.). c. Postoperative fluid collections and soft tissue

2012 American Society of Neuroradiology

200. Downhill Skiing

Downhill Skiing Downhill Skiing 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 Downhill Skiing Downhill Skiing Aka: Downhill Skiing (...) participates in activities (and risks) above their ability Equipment failure (or improper) Failure to acclimitize to altitude Going off trail, to closed areas, or ignoring posted warnings IV. Associated Conditions: Head and Torso Injuries (7-18%) Most common cause of serious injury and death Thoracolumbar spine injury Spinal Compression Spinous process Transverse process V. Associated Conditions: Skiers (lower extremity injuries are more common) See Medial Collateral Ligament Tear or MCL (25%) or ACL (25

2019 FP Notebook

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