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Thoracolumbar Trauma

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61. Monosegmental vs bisegmental pedicle fixation for the treatment of thoracolumbar spine fractures. (PubMed)

Monosegmental vs bisegmental pedicle fixation for the treatment of thoracolumbar spine fractures. The anatomy and biomechanics of the thoracolumbar spine place these segments at high risk of trauma injuries. Treatment options are either conservative or surgical, and there is a lack of consensus about the right indications. International scientific publications agree only on basic surgical principles: vertebral stability, deformity correction, protection of neurological structures and fast (...) functional recovery. The most commonly used approach is the posterior approach, which allows the best management of most vertebral fracture patterns. The aim of this study was to compare clinical and radiological outcomes of monosegmental stabilisation with those of bisegmental stabilisation and fusion in the treatment of traumatic thoracolumbar spine fractures.This retrospective clinical and radiological study evaluated 48 consecutive patients treated with monosegmental (Group M; n=14) or bisegmental

2016 Injury

62. Reliability of smartphone-based teleradiology for evaluating thoracolumbar spine fractures. (PubMed)

Reliability of smartphone-based teleradiology for evaluating thoracolumbar spine fractures. Timely interpretation of computed tomography (CT) scans is of paramount importance in diagnosing and managing spinal column fractures, which can be devastating. Out-of-hospital, on-call spine surgeons are often asked to evaluate CT scans of patients who have sustained trauma to the thoracolumbar spine to make diagnosis and to determine the appropriate course of urgent treatment. Capturing radiographic (...) picture archiving and communication system (PACS) and sent via a smartphone-based instant messaging application for viewing on a smartphone; and (2) viewed directly on a PACS.Reliability and agreement study.Thirty adults with thoracolumbar spine fractures who had been consecutively admitted to the Division of Orthopedic Surgery of a Level I trauma center during 2014.Intraobserver agreement.CT scans were captured by use of an iPhone 6 smartphone from a computer screen displaying PACS. Then by use

2016 The Spine Journal

63. Minimally Invasive Spine Surgery for Unstable Thoracolumbar Burst Fractures: A Case Series (PubMed)

 Retrospective clinical review of seven patients with spinal trauma who presented with thoracolumbar burst fracture from July 2012 to April 2013 and were treated with percutaneous pedicle screw fixation. Electronic patient charts and radiographic imaging were reviewed for initial presentation, fracture characteristics, operative treatment, and postoperative course. Results  The patients had a median age of 29 years (range 18 to 57), and 57% were men. The median Thoracolumbar Injury Classification (...) Minimally Invasive Spine Surgery for Unstable Thoracolumbar Burst Fractures: A Case Series Introduction  Traumatic thoracolumbar burst fracture is a common pathology without a clear consensus on best treatment approach. Minimally invasive approaches are being investigated due to potential benefits in recovery time and morbidity. We examine long-term resolution of symptoms of traumatic thoracolumbar burst fractures treated with percutaneous posterior pedicle screw fixation. Methods

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2016 The Surgery Journal

64. Outcomes of Short Segment Posterior Instrumentation in Unstable Thoracolumbar Fractures (PubMed)

Outcomes of Short Segment Posterior Instrumentation in Unstable Thoracolumbar Fractures The spinal traumas are common and leading problem in orthopaedics practice. The individuals are at a risk of high energy trauma in modern era. Unstable thoracolumbar burst fractures are serious injuries of concern, if left untreated may result in marked morbidity and disability to the patient. Thoracolumbar is the second most common segment involved in the spinal cord following spinal injuries followed (...) by cervical segment. The goal of treatment of any spinal injury is restoration of the patient to maximum possible function with disability free life.To analyse the outcomes of unstable thoracolumbar burst fractures stabilized with short segment posterior instrumentation with transpedicular screws.This prospective interventional study consisted of 32 patients with unstable thoracolumbar burst fractures carried out at Department of Orthopaedics, New Civil Hospital, Surat during Jan 2014 to Dec 2015. We

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2016 Journal of clinical and diagnostic research : JCDR

65. Radiological Prediction of Posttraumatic Kyphosis After Thoracolumbar Fracture (PubMed)

classification, age, gender, localization) that may lead to progressive kyphosis after a thoracolumbar fracture.Retrospective radiographic analysis of a consecutive patientcohort that presented in our clinic with a traumatic fracture of the thoracolumbar spine between 2004 and 2011. Cobb angle, Gardner angle, vertebral compression angle and anterior vertebral body compression were measured on plain radiographs, direct post-trauma and at follow-up.Age and localization are not significantly correlated (...) Radiological Prediction of Posttraumatic Kyphosis After Thoracolumbar Fracture Classification methods that are currently being used for clinical decision making in thoracolumbar fractures, are limited by reproducibility and prognostic value. Additionally, they do not include kyphosis. As a posttraumatic kyphosis is related to persistent pain, it is of importance to determine a risk of posttraumatic kyphosis based on fracture type and patient characteristics.To determine risk factors (AO

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2016 The open orthopaedics journal

66. A retrospective study evaluating the correlation between the severity of intervertebral disc injury and the anteroposterior type of thoracolumbar vertebral fractures (PubMed)

A retrospective study evaluating the correlation between the severity of intervertebral disc injury and the anteroposterior type of thoracolumbar vertebral fractures To evaluate the correlation between the severity of intervertebral disc injury and the anteroposterior type of thoracolumbar vertebral fractures.Fifty-six cases of thoracolumbar vertebral fractures treated in our trauma center from October 2012 to October 2013 were included in this study. The fractures were classified (...) by the anteroposterior classification, whereas the severity of intervertebral disc injury was evaluated using magnetic resonance imaging. The Spearman correlation coefficient was used to analyze the correlation between the severity of intervertebral disc injury and the anteroposterior type of thoracolumbar fractures, whereas a χ2 test was adopted to measure the variability between different fracture types and upper and lower adjacent disc injuries.The Spearman correlation coefficients between fracture types

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2016 Clinics

67. Reliability and reproducibility analysis of the AOSpine thoracolumbar spine injury classification system by Chinese spinal surgeons. (PubMed)

Reliability and reproducibility analysis of the AOSpine thoracolumbar spine injury classification system by Chinese spinal surgeons. The objective of this study was to analyze the interobserver reliability and intraobserver reproducibility of the new AOSpine thoracolumbar spine injury classification system in young Chinese orthopedic surgeons with different levels of experience in spinal trauma. Previous reports suggest that the new AOSpine thoracolumbar spine injury classification system (...) demonstrates acceptable interobserver reliability and intraobserver reproducibility. However, there are few studies in Asia, especially in China.The AOSpine thoracolumbar spine injury classification system was applied to 109 patients with acute, traumatic thoracolumbar spinal injuries by two groups of spinal surgeons with different levels of clinical experience. The Kappa coefficient was used to determine interobserver reliability and intraobserver reproducibility.The overall Kappa coefficient for all

2016 European Spine Journal

68. Anterior column reconstruction in thoracolumbar injuries utilizing a computer-assisted navigation system. (PubMed)

Anterior column reconstruction in thoracolumbar injuries utilizing a computer-assisted navigation system. Discectomy, corpectomy, and resection of isolated posterior wall fragments are technically demanding steps requiring maximum surgical precision during anterior reconstruction of the unstable thoracolumbar spine.This study investigates the feasibility of computer-aided guidance for these steps. It also analyzes the precision, advantages, and disadvantages of the procedure.Controlled clinical (...) trial.21 patients were included in the trial group; the control group consisted of 10 patients.Total time for surgery was noted. To assess surgical precision, decentralization of the cage was measured in postoperative X-rays. Additionally, parallel alignment of vertebral body endplates with the cage was evaluated in postoperative CT scans.Vertebral body fractures of the thoracolumbar spine addressed by disc-/corpectomy and subsequent cage interposition for anterior reconstruction were included. All

2016 European journal of trauma and emergency surgery : official publication of the European Trauma Society Controlled trial quality: uncertain

69. A comparison of three different surgical procedures in the treatment of type A thoracolumbar fractures: a randomized controlled trial. (PubMed)

operation related trauma which is beneficial to post-operative rehabilitation. The efficacy of three-level percutaneous fixation and two-level percutaneous fixation in the treatment of type A thoracolumbar fractures is not significantly different. (...) A comparison of three different surgical procedures in the treatment of type A thoracolumbar fractures: a randomized controlled trial. The aim of the study was to evaluate the efficacy of three different surgical procedures in the treatment of type A thoracolumbar fractures.Between September 2012 and January 2015, a total of 90 patients with type A thoracolumbar fractures were randomly assigned into three groups of 30 each. Patients in group A, B, and C were treated with three-level

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2016 International orthopaedics Controlled trial quality: uncertain

70. Biomechanics of Human Thoracolumbar Spinal Column Trauma from Vertical Impact Loading (PubMed)

Biomechanics of Human Thoracolumbar Spinal Column Trauma from Vertical Impact Loading Recent studies suggest that dorsal spine injuries occur in motor vehicle crashes to restrained occupants. Compression/compression-flexion injuries occur in frontal crashes due to seat pan and vertical loading. While injuries, mechanisms and tolerances for neck injuries have been determined, thoraco-lumbar spine data are very limited. The objective of the study was to determine the biomechanical characteristics

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2013 Annals of Advances in Automotive Medicine

71. Radiological protocol in spinal trauma: literature review and Spinal Cord Society position statement. (PubMed)

the panel members via e-mail. The draft was modified by incorporating relevant suggestions to reach a consensus.For imaging cervical and thoracolumbar spine trauma patients, CT without contrast is generally considered to be the initial line of imaging and radiographs are required if CT is unavailable or unaffordable. CT screening in polytrauma cases is best done with a multidetector CT by utilizing the reformatted images obtained when scanning the chest, abdomen, and pelvis (CT-CAP). MRI is indicated (...) Radiological protocol in spinal trauma: literature review and Spinal Cord Society position statement. The Spinal Cord Society constituted a panel tasked with reviewing the literature on the radiological evaluation of spinal trauma with or without spinal cord injury and recommend a protocol. This position statement provides recommendations for the use of each modality, i.e., radiographs (X-rays), computed tomography (CT), magnetic resonance imaging (MRI), as well as vascular imaging, and makes

2019 European Spine Journal

72. What is the purpose of log roll examination in the unconscious adult trauma patient during trauma reception? (PubMed)

What is the purpose of log roll examination in the unconscious adult trauma patient during trauma reception? During assessment after injury, the log roll examination, in particular palpation of the thoracolumbar spine, has low sensitivity for detecting spinal injury. The manoeuvre itself requires a pause during trauma resuscitation. The aim of this study was to assess the utility of the log roll examination in unconscious trauma patients for the diagnosis of soft tissue and thoracolumbar spine (...) performed.There were a total of 2028 major trauma presentations to the Alfred Hospital Emergency and Trauma Centre during the study period. Excluded cases comprised 147 patients who did not have a documented log roll, and 75 patients who did not have a CT or MRI. Of the 402 cases that met inclusion criteria, 35.3% had a thoracolumbar fracture, and the sensitivity of log roll examination was found to be 27.5%, with a specificity of 91%. The negative likelihood ratio for abnormalities on log roll was low (0.8

2016 Emergency Medicine Journal

73. Cervical Spine Collar Clearance in the Obtunded Adult Blunt Trauma Patient

Cervical Spine Collar Clearance in the Obtunded Adult Blunt Trauma Patient Cervical Spine Collar Clearance in the Obtunded Adult Blunt Trauma Patient - Practice Management Guideline Search » Cervical Spine Collar Clearance in the Obtunded Adult Blunt Trauma Patient Published 2015 Citation: Authors Patel, Mayur B. MD, MPH; Humble, Stephen S.; Cullinane, Daniel C. MD; Day, Matthew A. MD; Jawa, Randeep S. MD; Devin, Clinton J. MD; Delozier, Margaret S.; Smith, Lou M. MD; Smith, Miya A.; Capella (...) , Jeannette M. MD, MEd; Long, Andrea M. MD; Cheng, Joseph S. MD, MS; Leath, Taylor C. BS, MPH; Falck-Ytter, Yngve MD; Haut, Elliott R. MD, PhD; Como, John J. MD, MPH Supplemental Author Material Author Information From the Veterans Affairs (VA) Tennessee Valley Healthcare System (M.B.P.), Nashville VA Medical Center; Division of Trauma and Surgical Critical Care (M.B.P., S.S.H., M.A.S., T.C.L.), Department of Surgery, and Department of Neurosurgery (M.B.P., J.S.C.), Section of Surgical Sciences

2015 Eastern Association for the Surgery of Trauma

74. O-Arm Technology in Spinal, Neurological, Orthopedic, or Trauma Surgery Settings

E, Kim Y, Jeon S, et al. Comparison of operator radiation exposure between C-arm and O-arm fluoroscopy for orthopaedic surgery. Radiat Prot Dosimetry. 2012 Mar;148(4):431-8. PubMed: PM21525041 PREPARED BY: Canadian Agency for Drugs and Technologies in Health Tel: 1-866-898-8439 www.cadth.ca O-Arm Technology in Spinal, Neurological, Orthopedic, or Trauma Surgery Settings 5 APPENDIX – FURTHER INFORMATION: Non-Randomized Studies – non-comparative 11. Ammirati M, Salma A. Placement of thoracolumbar (...) O-Arm Technology in Spinal, Neurological, Orthopedic, or Trauma Surgery Settings TITLE: O-Arm Technology in Spinal, Neurological, Orthopedic, or Trauma Surgery Settings: Clinical Effectiveness, and Benefits and Harms DATE: 07 August 2013 RESEARCH QUESTIONS 1. What is the clinical effectiveness of O-arm technology used in spinal, neurological, orthopedic, or trauma surgery settings? 2. What are the benefits and harms associated with O-arm technology in patients undergoing spinal, neurological

2013 Canadian Agency for Drugs and Technologies in Health - Rapid Review

75. Osteostimulative Bone Graft Substitutes or Demineralized Bone Matrix Preparations for use in Spinal Surgery and Long Bone Trauma Surgery: Clinical Effectiveness and Safety

Osteostimulative Bone Graft Substitutes or Demineralized Bone Matrix Preparations for use in Spinal Surgery and Long Bone Trauma Surgery: Clinical Effectiveness and Safety Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources of the best evidence on the topic that CADTH (...) by the owners’ own terms and conditions. TITLE: Osteostimulative Bone Graft Substitutes or Demineralized Bone Matrix Preparations for use in Spinal Surgery and Long Bone Trauma Surgery: Clinical Effectiveness and Safety DATE: 28 February 2013 RESEARCH QUESTIONS 1. What is the evidence for the clinical effectiveness and safety of osteostimulative bone graft substitutes used in spinal surgery or surgery for long bone trauma? 2. What is the evidence for the clinical effectiveness and safety of demineralized

2013 Canadian Agency for Drugs and Technologies in Health - Rapid Review

76. Bone Morphogenetic Proteins for use in Spinal Surgery and Long Bone Trauma Surgery

Bone Morphogenetic Proteins for use in Spinal Surgery and Long Bone Trauma Surgery Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources of the best evidence on the topic that CADTH could identify using all reasonable efforts within the time allowed. Rapid responses should (...) Surgery and Long Bone Trauma Surgery: A Review of the Clinical Effectiveness and Safety DATE: 08 March 2013 CONTEXT AND POLICY ISSUES Bone morphogenetic proteins (BMPs) are a group of growth factors capable of inducing the formation of bone. In addition to other vital tissue development functions, these proteins signal new bone growth through multiple pathways during the healing of bone. Osteoblasts are one cell type that respond to BMP signaling and are directly responsible for deposition of new bone

2013 Canadian Agency for Drugs and Technologies in Health - Rapid Review

77. Spine Fractures in Ankylosing Diseases: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU) (PubMed)

Spine Fractures in Ankylosing Diseases: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU) Review of literature and case series.Update and review of current treatment concepts for spine fractures in patients with ankylosing spinal disorders.Case presentation and description of a diagnostic and therapeutic algorithm for unstable spinal injuries with an underlying ankylosing spinal disorder (ASD) of the cervical and thoracolumbar spine.Nondisplaced (...) fractures can be missed easily using conventional X-rays. Thus, computed tomography (CT) scans are recommended for all trauma patients with ASD. In doubt or presence of any neurologic involvement additional magnetic resonance imaging (MRI) scans should be obtained. Spine precautions should be maintained all times and until definitive treatment (<24 h). Nonoperative fracture treatment is not recommended given the mechanical instability of the most commonly seen fracture patterns (AOSpine B- and C-type

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2018 Global spine journal

78. Stability of the Subaxial Spine after Penetrating Trauma: Do Classification Systems Apply? (PubMed)

Stability of the Subaxial Spine after Penetrating Trauma: Do Classification Systems Apply? Blunt spinal trauma classification systems are well established and provide reliable treatment algorithms. To date, stability of the spine after civilian gunshot wounds (CGSWS) is poorly understood. Herein, we investigate the validity of trauma classification systems including the Thoracolumbar Injury Classification and Severity Score (TLICS), Subaxial Cervical Spine Injury Classification and Severity (...) Score (SLIC), and Denis' three-column model when applied to spinal penetrating trauma from gunshots, while secondarily evaluating stability of these injuries.Gunshot injuries to the spine were identified from an institutional database from ICD-nine codes. Trauma scorings systems were applied using traditional criteria. Neurologic compromise and spinal stability were evaluated using follow-up clinic notes and radiographs.Thirty-one patients with CSGSW were evaluated. There was an equal distribution

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2018 Advances in orthopedics

79. Spine Trauma-What Are the Current Controversies? (PubMed)

the management of these injuries. At this moment there is persistent controversy within the spinal trauma community, which can be grouped under 6 headings. First of all there is still no unanimity on the role and timing of medical and surgical interventions for patients with associated neurologic injury. The same is also true for type and timing of surgical intervention in multiply injured patients. In some common injury types like odontoid fractures and burst type (A3-A4) fractures in thoracolumbar spine (...) Spine Trauma-What Are the Current Controversies? Although less common than other musculoskeletal injuries, spinal trauma may lead to significantly more disability and costs. During the last 2 decades there was substantial improvement in our understanding of the basic patterns of spinal fractures leading to more reliable classification and injury severity assessment systems but also rapid developments in surgical techniques. Despite these advancements, there remain unresolved issues concerning

2017 Journal of Orthopaedic Trauma

80. Assessment of variability in Turkish spine surgeons' trauma practices (PubMed)

Assessment of variability in Turkish spine surgeons' trauma practices The aim of this study was to analyse the variability among Turkish spinal surgeons in the management of thoracolumbar fractures by carrying out a web survey.An invitation text and web-link of the survey were sent to the members of the Turkish Spine Society mail group. A fictitious spine trauma vignette, a 23 year-old male with a L1 burst fracture, was presented and 25 questions were asked to participants. Variability (...) (IQV ≥ 0.80), 5 had high variability (0.58-0.75) and 2 had low variability (IQV≤0.20). The question with the highest variability was related to the use of brace after surgery (IQV = 0.93). Following one was about the selection of fixation levels (IQV = 0.91). Neurosurgeons were more likely to use brace postoperatively and professors were less likely to perform decompression.This survey shows that thoracolumbar spine trauma practice significantly varies among Turkish spine surgeons. Surgeons

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2017 Acta orthopaedica et traumatologica turcica

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