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Thoracolumbar Trauma

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561. Changes in thoracolumbar computed tomography and radiography utilization among trauma patients after deployment of multidetector computed tomography in the emergency department. (Abstract)

Changes in thoracolumbar computed tomography and radiography utilization among trauma patients after deployment of multidetector computed tomography in the emergency department. Diagnostic-quality thoracolumbar spine (TLS) images, generated from routine thoracoabdominal multidetector computed tomography (MDCT) data, have been demonstrated superior to conventional radiography (CR) for TLS injury. We evaluated thoracoabdominal computed tomography (CT) and TLS utilization among trauma patients (...) after deployment of MDCT. We hypothesized that reformatted MDCT images replaced CR for evaluation of TLS trauma among patients undergoing chest or abdominal CT, and that utilization of thoracoabdominal CT and TLS screening in trauma increased postMDCT.We reviewed all TLS imaging for trauma patients undergoing chest or abdominal CT for 18 months pre- and postMDCT. We compared the relative use of CR and CT in TLS imaging, and the volume of TLS screening, and chest and abdominal CT across the study

2007 Journal of Trauma

562. Visceral torso computed tomography for clearance of the thoracolumbar spine in trauma: a review of the literature. (Abstract)

Visceral torso computed tomography for clearance of the thoracolumbar spine in trauma: a review of the literature. Accurate screening of the thoracolumbar spine (TLS) remains problematic in the care of trauma patients. The current standard of care for TLS screening is not clearly defined. In trauma patients undergoing computed tomography (CT) of the chest and or abdomen, compelling supportive evidence for reformatting and reusing this CT data to clear the thoracolumbar spine has accumulated (...) patient movement, radiation exposure, cost, or time, trauma patients undergoing visceral CT can have their thoracolumbar spine promptly evaluated. Further prospective evaluation of the CT protocols to optimize visualization of both the viscera and the bone is warranted.

2006 Journal of Trauma

563. Thoracolumbar fracture in blunt trauma: is clinical exam enough for awake patients? (Abstract)

Thoracolumbar fracture in blunt trauma: is clinical exam enough for awake patients? Physical examination is widely used to screen trauma patients for thoracolumbar fracture (TLFx). Retrospective data suggests that patients with altered sensorium may not manifest symptoms after TLFx. This study was designed to prospectively test the sensitivity of physical examination for detection of TLFx in patients with altered mentation.Prospective data collection in a large urban Level I trauma center from (...) April 2002 to December 2003. During the study period, thoracolumbar radiography was performed on patients with signs or symptoms of TLFx, and also on patients with significant blunt trauma and any alteration in mentation, including drowsiness or apparent intoxication. All patients were classified as reliable if Glasgow coma score was >13 and the treating physician judged them capable of accurately reporting pain, and those who did not met both these conditions were deemed unreliable. Patients

2006 Journal of Trauma

564. State of play: clearing the thoracolumbar spine in blunt trauma victims. (Abstract)

State of play: clearing the thoracolumbar spine in blunt trauma victims. The present article reviews the clinical and imaging clearance of the thoracic and lumbar spines of blunt trauma victims and the evolution of these strategies with the use of new imaging technologies.A comprehensive literature search was performed, and articles identified were critically appraisedTwenty papers were identified, 12 directly comparing computed tomography screening with plain X-rays. Evidence-based protocols (...) are presented. The evolution of imaging strategies in response to new technology is described.Thoracolumbar spine screening is best done using reformatted images acquired when scanning the chest and abdomen of high-risk multi-trauma patients. If computed tomography is not clinically indicated for investigation of other injuries then plain films are the first line investigation.

2006 Emergency medicine Australasia

565. Pediatric nonaccidental trauma thoracolumbar fracture-dislocation: posterior spinal fusion with pedicle screw fixation in an 8-month-old boy. (Abstract)

Pediatric nonaccidental trauma thoracolumbar fracture-dislocation: posterior spinal fusion with pedicle screw fixation in an 8-month-old boy. Case report of pedicle screw fixation in an infant with nonaccidental spine trauma.To ensure awareness of nonaccidental pediatric spine trauma and describe a safe and effective method of treating a complex problem of thoracolumbar fracture-dislocation in an infant.Nonaccidental pediatric spine trauma is rare, accounting for <1% of abuse. No previous cases (...) of spinal trauma, clinicians should do a full skeletal survey to ensure no other injuries are overlooked. Pedicle screw fixation can be used in infants with unstable traumatic spinal injuries, allowing earlier rehabilitation and return to normal activity level.

2007 Spine

566. Use of minimally invasive surgical techniques in the management of thoracolumbar trauma: current concepts. (Abstract)

Use of minimally invasive surgical techniques in the management of thoracolumbar trauma: current concepts. Literature review and expert opinion.To provide an overview of the current concepts of minimally invasive surgical (MIS) techniques for the management of thoracolumbar (TL) spinal trauma.Current surgical treatment of thoracolumbar trauma typically involves open placement of spinal instrumentation with fusion. Conventional open spinal exposures can be associated with significant muscle (...) morbidity that can lead to subsequent paraspinal muscular atrophy, scarring, decreased extensor strength and endurance, as well as pain. This approach-related morbidity is the main impetus for application MIS techniques to spinal procedures including trauma.A review of the relevant English literature was performed.The current rationale, clinical applications, outcomes, and limitation of MIS management of TL injuries are summarized.The application of MIS techniques to spinal trauma is theoretically sound

2006 Spine

567. A review of the TLICS system: a novel, user-friendly thoracolumbar trauma classification system. Full Text available with Trip Pro

A review of the TLICS system: a novel, user-friendly thoracolumbar trauma classification system. The classification and treatment of thoracolumbar injuries remain controversial. The Spine Trauma Study Group (STSG) has developed a classification system that has prognostic significance and helps guide treatment decisions. It is based on three aspects: morphology of the injury, integrity of the posterior ligamentous complex, and neurological status of the patient. A severity score is used

2008 Acta Orthopaedica

568. Thoracolumbar injury classification and severity score: a new paradigm for the treatment of thoracolumbar spine trauma Full Text available with Trip Pro

Thoracolumbar injury classification and severity score: a new paradigm for the treatment of thoracolumbar spine trauma Contemporary understanding of the biomechanics, natural history, and methods of treating thoracolumbar spine injuries continues to evolve. Current classification schemes of these injuries, however, can be either too simplified or overly complex for clinical use.The Spine Trauma Group was given a survey to identify similarities in treatment algorithms for common thoracolumbar (...) injuries, as well as to identify characteristics of injury that played a key role in the decision-making process.Based on the survey, the Spine Trauma Group has developed a classification system and an injury severity score (thoracolumbar injury classification and severity score, or TLICS), which may facilitate communication between physicians and serve as a guideline for treating these injuries. The classification system is based on the morphology of the injury, integrity of the posterior ligamentous

2005 Journal of Orthopaedic Science

569. Validating a newly proposed classification system for thoracolumbar spine trauma: looking to the future of the thoracolumbar injury classification and severity score. (Abstract)

Validating a newly proposed classification system for thoracolumbar spine trauma: looking to the future of the thoracolumbar injury classification and severity score. Although numerous systems have been proposed, there is no universally accepted classification or scoring system for thoracolumbar spine injuries. Some have gained popularity, but most systems have never been modified or advanced beyond their initial introductory state. To the authors' knowledge, no thoracolumbar classification (...) system has ever been validated in a systematic and scientific manner.To critically review previous thoracolumbar classification systems, to discuss the proposal of the new Thoracolumbar Injury Classification and Severity Score (TLICS), to review the steps taken thus far in assessing the reliability of this system, and to discuss plans for future clinical validation of TLICS.The authors performed a comprehensive search and analysis of previously published systems for classifying or scoring

2006 Journal of Orthopaedic Trauma

570. Fractures of the thoracolumbar spine in major trauma patients Full Text available with Trip Pro

Fractures of the thoracolumbar spine in major trauma patients 9822404 1999 01 07 2018 11 13 0959-8138 317 7170 1998 Nov 21 BMJ (Clinical research ed.) BMJ Lesson of the week: fractures of the thoracolumbar spine in major trauma patients. 1442-3 Meek S S Emergency Department, Royal United Hospital, Bath BA1 3NG, UK. steve.meek@ruh-bath.swest.nhs.uk eng Case Reports Journal Article Review England BMJ 8900488 0959-8138 AIM IM BMJ. 1999 May 8;318(7193):1288 10391705 BMJ. 1999 May 8;318(7193):1287-8 (...) 10231276 Accidental Falls Accidents, Occupational Accidents, Traffic Emergencies Emergency Medical Services Female Humans Lumbar Vertebrae injuries Male Spinal Fractures diagnosis etiology therapy Thoracic Vertebrae injuries 11 1998 11 20 1998 11 20 0 1 1998 11 20 0 0 ppublish 9822404 PMC1114298 Ann Emerg Med. 1992 Dec;21(12):1454-60 1443841 Ann Emerg Med. 1995 Aug;26(2):126-9 7618772 J Trauma. 1987 Sep;27(9):980-6 3656481 J Trauma. 1989 May;29(5):593-6 2724376 J Trauma. 1990 Jun;30(6):666-9

1998 BMJ : British Medical Journal

571. Fractures of the thoracolumbar spine in major trauma patients : ATLS manual does recognise importance of distracting injuries Full Text available with Trip Pro

Fractures of the thoracolumbar spine in major trauma patients : ATLS manual does recognise importance of distracting injuries 10231276 1999 06 25 2018 11 13 0959-8138 318 7193 1999 May 08 BMJ (Clinical research ed.) BMJ Fractures of the thoracolumbar spine in major trauma patients. ATLS manual does recognise importance of distracting injuries. 1287-8 McGlone R R eng Comment Letter England BMJ 8900488 0959-8138 AIM IM BMJ. 1998 Nov 21;317(7170):1442-3 9822404 Humans Manuals as Topic Multiple (...) Trauma Spinal Fractures diagnosis Thoracic Vertebrae injuries Traumatology 1999 5 7 1999 5 7 0 1 1999 5 7 0 0 ppublish 10231276 PMC1115666 J Trauma. 1995 May;38(5):692-6 7760394 BMJ. 1998 Nov 21;317(7170):1442-3 9822404

1999 BMJ : British Medical Journal

572. Prospective evaluation of criteria for obtaining thoracolumbar radiographs in trauma patients. (Abstract)

Prospective evaluation of criteria for obtaining thoracolumbar radiographs in trauma patients. This study examined if use of clinical screening criteria for selective radiography of blunt trauma patients can identify all patients with thoracolumbar (TL) spine injuries. The study was a prospective cohort of patients undergoing TL spine radiographs following blunt trauma. Patients were considered at risk for TL spine injury if they had any of the following clinical criteria: 1) complaints of TL (...) screening criteria identified virtually all blunt trauma patients with acute TL spine injuries. These criteria, however, have poor specificity and positive predictive value.Copyright 2003 Elsevier Science Inc.

2003 Journal of Emergency Medicine

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