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Thoracolumbar Trauma

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101. Is Early Appropriate Care of axial and femoral fractures appropriate in multiply-injured elderly trauma patients? (PubMed)

of the pelvis, acetabulum, thoracolumbar spine, and/or proximal or diaphyseal femur fractures were treated at a level I trauma center and were prospectively studied. Patients aged ≤30 years (n = 114), 30 to 60 years (n = 184), and ≥60 years (n = 37) with Injury Severity Scores (ISS) ≥16 and unstable fractures of the pelvis, acetabulum, spine, and/or diaphyseal femur were treated within 36 h, provided they showed evidence of adequate resuscitation. ISS, Glasgow Coma Scale (GCS), and American Society (...) Is Early Appropriate Care of axial and femoral fractures appropriate in multiply-injured elderly trauma patients? Previous work established resuscitation parameters that minimize complications with early fracture management. This Early Appropriate Care (EAC) protocol was applied to patients with advanced age to determine if they require unique parameters to mitigate complications.Between October 2010 and March 2013, 376 consecutive skeletally mature patients with unstable fractures

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2016 Journal of orthopaedic surgery and research

102. Multi-trauma secondary to hypocalcaemia-induced seizure: A case report (PubMed)

Multi-trauma secondary to hypocalcaemia-induced seizure: A case report Fractures are known sequelae of seizures. We present a young male with bilateral acetabula and surgical neck of humerus (SNOH), right neck of femur (NOF) and thoracolumbar fractures in the context of a hypocalcaemic seizure secondary to severe malnutrition, secondary hyperparathyroidism and vitamin D deficiency. The authors believe that numerous severe injuries in a single patient secondary to seizure are extremely rare

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2016 Trauma Case Reports

103. Retrospective analysis of 616 air-rescue trauma cases related to the practice of extreme sports. (PubMed)

accidents, characterized by a large proportion of severe injuries and axial traumas (spine, thorax, pelvis and proximal femur). We identified a considerable percentage of thoracolumbar vertebral fractures, mainly in the T12-L2 junction. HEMSs dedicated to high-risk ESs implied longer and more complex interventions.Copyright © 2016 Elsevier Ltd. All rights reserved. (...) Retrospective analysis of 616 air-rescue trauma cases related to the practice of extreme sports. Extreme sports (ESs) are increasingly popular, and accidents due to ESs sometimes require helicopter emergency medical services (HEMSs). Little is known about their epidemiology, severity, specific injuries and required rescue operations.Our aims were to perform an epidemiological analysis, to identify specific injuries and to describe the characteristic of prehospital procedures in ES accidents

2016 Injury

104. The role of emergency radiology in spinal trauma (PubMed)

influence and therefore treatment. Imaging has an important role in the management of spinal trauma. The aim of this paper was to describe: incidence and type of vertebral fracture; imaging indication and guidelines for cervical trauma; imaging indication and guidelines for thoracolumbar trauma; multidetector CT indication for trauma spine; MRI indication and protocol for trauma spine. (...) The role of emergency radiology in spinal trauma Spinal trauma is very frequent injury with different severity and prognosis varying from asymptomatic condition to temporary neurological dysfunction, focal deficit or fatal event. The major causes of spinal trauma are high- and low-energy fall, traffic accident, sport and blunt impact. The radiologist has a role of great responsibility to establish the presence or absence of lesions, to define the characteristics, to assess the prognostic

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2016 The British journal of radiology

105. Role of magnetic resonance imaging in acute spinal trauma: a pictorial review. (PubMed)

describe the normal anatomy of various ligamentous structures. Indications of MRI in spinal trauma as well as the role of MRI in diagnosing spinal cord and soft tissue injuries will then be discussed. Illustrated cases are mainly of cervical spine trauma, but thoracolumbar spine injuries are also included where appropriate in our review. (...) Role of magnetic resonance imaging in acute spinal trauma: a pictorial review. Magnetic resonance imaging (MRI) has been playing an increasingly important role in the spinal trauma patients due to high sensitivity for detection of acute soft tissue and cord injuries. More and more patients are undergoing MRI for spinal trauma in the emergency settings, thus necessitating the interpreting physicians to be familiar with MRI findings in spinal trauma. In this pictorial review, we will first

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2016 BMC Musculoskeletal Disorders

106. AOSpine thoracolumbar spine injury classification system: Fracture description, neurological status and key modifiers. (PubMed)

AOSpine thoracolumbar spine injury classification system: Fracture description, neurological status and key modifiers. Reliability and agreement study, retrospective case series.To develop a widely accepted, comprehensive yet simple classification system with clinically acceptable intra- and interobserver reliability for use in both clinical practice and research.Although the Magerl classification and thoracolumbar injury classification system (TLICS) are both well-known schemes to describe (...) thoracolumbar (TL) fractures, no TL injury classification system has achieved universal international adoption. This lack of consensus limits communication between clinicians and researchers complicating the study of these injuries and the development of treatment algorithms.A simple and reproducible classification system of TL injuries was developed using a structured international consensus process. This classification system consists of a morphologic classification of the fracture, a grading system

2013 Spine

107. Surgical versus non-surgical treatment for thoracolumbar burst fractures without neurological deficit. (PubMed)

that have intruded into the vertebral canal. This is an update of a review first published in 2006.To compare the outcomes of surgical with non-surgical treatment for thoracolumbar burst fractures without neurological deficit.We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (October 2012), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 8), MEDLINE (1946 to October 2012), EMBASE (1980 to October 2012) and the Chinese (...) Surgical versus non-surgical treatment for thoracolumbar burst fractures without neurological deficit. Spinal burst fractures result from the failure of both the anterior and the middle columns of the spine under axial compression loads. Conservative management is through bed rest and immobilisation once the acute symptoms have settled. Surgical treatment involves either anterior or posterior stabilisation of the fracture, sometimes with decompression involving the removal of bone fragments

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2013 Cochrane database of systematic reviews (Online)

108. Retrospective evaluation of the validity of the Thoracolumbar Injury Classification System in 458 consecutively treated patients. (PubMed)

Retrospective evaluation of the validity of the Thoracolumbar Injury Classification System in 458 consecutively treated patients. The Thoracolumbar Injury Classification System (TLICS) system has been developed to improve injury classification and guide surgical decision-making, yet validation of this new system remains sparse.This study evaluates the use of the TLICS in a large, consecutive series of patients.This is a retrospective case series.A total of 458 patients treated for thoracic (...) or lumbar spine trauma between 2000 and 2010 at a single, tertiary medical center were included in this study.American Spinal Injury Association (ASIA) status and crossover from conservative to surgical treatment were measured.Clinical and radiological data were evaluated, classifying the injuries by ASIA status, the Magerl/AO classification, and the TLICS system.A total of 310 patients (67.6%) was treated conservatively (group 1) and 148 patients (32.3%) were surgically (group 2) treated. All patients

2013 The Spine Journal

109. Thoracolumbar Burst Fracture Treated With Pedicle Screws: Radiographic Outcomes

Accepts Healthy Volunteers: No Sampling Method: Probability Sample Study Population Patients suffered from burst fracture of the thoracolumbar and lumbar spine Criteria Inclusion Criteria: neurologically intact spine with a kyphotic angle more than 20o, decreased vertebral body height more than 50% or a canal compromise more than 50%; incomplete neurological deficit with a canal compromise less than 50%; complete neurological deficit; multilevel spinal injury or multiple trauma. Exclusion Criteria (...) Thoracolumbar Burst Fracture Treated With Pedicle Screws: Radiographic Outcomes Thoracolumbar Burst Fracture Treated With Pedicle Screws: Radiographic Outcomes - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more

2013 Clinical Trials

110. Advances made in the treatment of thoracolumbar fractures: current trends and future directions. (PubMed)

Advances made in the treatment of thoracolumbar fractures: current trends and future directions. Thoracolumbar fractures are common injuries after blunt trauma and are accompanied with significant morbidity, including neurologic deficit. Parallel to the evolution of initial management during the past few years, efforts have been concentrated on determining clear indications for surgical treatment, as there is no agreement over superiority of conservative or operative treatment. Various (...) classification systems have been used for identifying those injuries requiring surgical intervention. Moreover, novel trends in surgical techniques, including minimal invasive surgery, implants and rehabilitation protocols have provided new, promising aspects regarding the treatment and outcomes of thoracolumbar fractures. The present review focuses on these recent advances.Copyright © 2012 Elsevier Ltd. All rights reserved.

2013 Injury

111. Minimally Invasive Reduction and Fixation of Thoracolumbar Fractures

Minimally Invasive Reduction and Fixation of Thoracolumbar Fractures Minimally Invasive Reduction and Fixation of Thoracolumbar Fractures - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Minimally Invasive (...) Reduction and Fixation of Thoracolumbar Fractures (FRIFIX) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT01810094 Recruitment Status : Completed First Posted : March 13, 2013 Last Update Posted : January 26, 2017 Sponsor: Aesculap AG Information provided by (Responsible Party): Aesculap AG Study

2013 Clinical Trials

112. The Impact of Local Analgesia for Postoperative Analgesia in Posterior Thoracolumbar Operation

General Hospital of Guangzhou Military Command Information provided by (Responsible Party): bo xu, Guangzhou General Hospital of Guangzhou Military Command Study Details Study Description Go to Brief Summary: Posterior thoracolumbar operation always chooses general anesthesia. Due to surgical trauma and rich periosteum and joint capsule innervation, patients after general anesthesia immediately feel acute pain.The use of appropriate postoperative analgesia in patients with thoracolumbar surgery (...) The Impact of Local Analgesia for Postoperative Analgesia in Posterior Thoracolumbar Operation The Impact of Local Analgesia for Postoperative Analgesia in Posterior Thoracolumbar Operation - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one

2013 Clinical Trials

113. Early Predictors of Functional Disability Following Spine Trauma: A Level 1 Trauma Center Study: Early Predictors of Functional Disability. (PubMed)

spine trauma predictors of functional disability with statistical significance (P < 0.05). They were (1) hypotension (OR [odds ratio] = 1.98; CI [confidence interval] = 1.13-3.49), (2) hyperglycemia (OR = 1.67; CI = 1.09-2.56), and (3) moderate/severe traumatic brain injury (OR = 5.88; CI = 1.71-20.16). There were 305 patients with subaxial cervical spine injuries and 653 patients with thoracolumbar spine injuries. The subaxial cervical spine injury classification and thoracolumbar injury (...) classification and severity score compliance studies returned agreements of 96.1% and 98.9%, respectively.Early independent spine trauma predictors of functional disability identified in a level 1 trauma center with high compliance to the subaxial cervical spine injury classification and thoracolumbar injury classification and severity score algorithms were hypotension, hyperglycemia, and moderate or severe traumatic brain injury. Spine trauma injury variables alone were shown not to be predictive

2013 Spine

114. Supine thoracolumbar sagittal spine alignment: comparing computerized tomography and plain radiographs. (PubMed)

Supine thoracolumbar sagittal spine alignment: comparing computerized tomography and plain radiographs. Imaging supine sagittal alignment study.Our goal was to determine differences between plain radiographs and computed tomography (CT) scans in supine sagittal alignment and to establish supine reference Cobb angles for both.Few studies have compared plain radiographs versus CT scans with regard to sagittal spine alignment. None have utilized supine patients.Fifty sequential blunt trauma (...) individuals who had routine clearance of the thoracolumbar spine had their plain radiographs and CT scans reviewed independently by 2 spine surgeons. The Cobb method was utilized to determine angles at each spine level from T4 to L5. All imaging was obtained in the supine position, and no patient had acute ligamentous or bony pathology. Intraclass correlation coefficients (ICCs) were utilized to determine intraobserver, interobserver, and method reliability.Every level within the thoracic region

2012 Spine

115. Can the interpedicular distance reliably assess the severity of thoracolumbar burst fractures? (PubMed)

Can the interpedicular distance reliably assess the severity of thoracolumbar burst fractures? Retrospective analysis of 260 patients with acute spine fractures treated at a tertiary trauma center from 1989 to 2009.To correlate the Interpedicular distance (IPD) to the percentage of narrowing of the spinal canal and to the presence of neurological deficit and laminar fracture in thoracolumbar burst fractures.Several reports use radiographic findings such as severity of vertebrae collapse (...) , comminution of the vertebral body, and grade of localized kyphosis to determine the severity of spinal traumas and establish appropriate management. However, the importance of the IPD in burst fractures has rarely been mentioned, and no report specifically describes the correlation between an increased IPD and the severity of the lesion or a higher occurrence of lamina fractures.Plain radiographs of 260 patients with acute thoracolumbar burst fractures were studied. The percentage of widening between

2012 Spine

116. Can initial clinical assessment exclude thoracolumbar vertebral injury? (PubMed)

Can initial clinical assessment exclude thoracolumbar vertebral injury? The aim of this study was to test the hypothesis that all blunt trauma patients, presenting with a Glasgow coma scale (GCS) score of 15, without intoxication or neurological deficit, and no pain or tenderness on log-roll can have any thoracolumbar fracture excluded without imaging.All patients diagnosed with a thoracolumbar fracture presenting to the emergency department of a major trauma centre and having an initial GCS (...) to the thoracolumbar spine elicited on log-roll. This subgroup was significantly older (p=0.033) and a high proportion of patients (64.3%) had a concurrent fracture of the cervical spine. Within this subgroup, a clinically significant unstable thoracic fracture was present in three patients, with all three patients exhibiting symptoms and signs of neurological injury or having a concurrent cervical vertebral fracture.In this population of blunt trauma patients with a GCS score of 15, not under the influence

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2012 Emergency Medicine Journal

117. Radiological study on disc degeneration of thoracolumbar burst fractures treated by percutaneous pedicle screw fixation. (PubMed)

remains. The associated disc degeneration is less well known after 9-12 months of the short segment pedicle screw fixations. There is a major controversy whether spinal trauma with vertebral endplate fractures can result in posttraumatic disc degeneration. No study to date, however, has assessed disc degeneration of the AO type A3 thoracolumbar fractures without neurologic deficits after pedicle screw fixations.Twenty-six patients with single-level AO type A3 thoracolumbar fractures (...) Radiological study on disc degeneration of thoracolumbar burst fractures treated by percutaneous pedicle screw fixation. To examine disc degeneration at levels adjacent and next adjacent to the fractured vertebra and to analyses, if the disc degeneration is determined by the endplate fracture. Thoracolumbar burst fracture is one of the most common spinal injuries. The diagnostic (clinical and imaging) approach and treatment of a fractured vertebra is well established; however, some controversy

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2012 European Spine Journal

118. Integrity of "damage control" posterior spinal fusion constructs for poly-trauma patients: A biomechanical investigation. (PubMed)

Integrity of "damage control" posterior spinal fusion constructs for poly-trauma patients: A biomechanical investigation. Biomechanical.Evaluate spinal stability achieved with different levels of posterior percutaneous fixation (postPerc) for thoracolumbar fractures in cadavers subjected to ICU activities."Spine damage control" involves postPerc performed within 24 hours of injury and staged, elective, definitive stabilization. Amount of instrumentation needed to initially achieve adequate (...) with intact. During ex situ testing, 2 and 3 levels above/below were similar; 1 level above/below had significantly greater laxity in flexion, extension, and axial rotation.Posterior instrumentation 2 or 3 levels above/below a severe thoracolumbar fracture model can restore spinal stability back to its intact condition. 2 levels of fixation above/below this "worst-case scenario" is minimum fixation sufficient to provide absolute spinal stability in the ICU setting as a "Damage Control" technique

2015 Spine

119. Retrospective analysis of whole-body multislice computed tomography findings taken in trauma patients (PubMed)

%) and thoracic (28.6%) regions, respectively. The most common finding in the head and face region was fractures. The most common pathological findings in the thoracic region were pulmonary contusion and rib fractures. A significant relationship was detected between trauma type and spinal MSCT result (p < 0.001). In a large percentage of the patients, MSCT findings were normal in the abdominal region and genitourinary system. Vertebral fractures were most frequently detected in the thoracolumbar region.In our (...) Retrospective analysis of whole-body multislice computed tomography findings taken in trauma patients Using whole-body multislice computed tomography (MSCT) excessively or with irrelevant indications can be seen in many centers. The aim of this study was to analyze retrospectively the MSCT findings in trauma patients admitted to the emergency department.Records of the patients who have applied to the emergency department due to blunt trauma in a 12 month period and whose whole body MSCT images

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2015 Turkish journal of emergency medicine

120. Current management review of thoracolumbar cord syndromes. (PubMed)

medullaris syndrome (CMS) and cauda equina syndrome (CES).To review the current management of thoracolumbar spinal cord injuries.Literature review.Index Medicus was used to search the primary literature for articles on thoracolumbar injuries. An emphasis was placed on the current management, controversies, and newer treatment options.After blunt trauma, these syndromes may reflect a continuum of dysfunction rather than a distinct clinical entity. The transitional anatomy at the thoracolumbar junction (...) Current management review of thoracolumbar cord syndromes. Injuries to the thoracolumbar spine may lead to a complex array of clinical syndromes that result from dysfunction of the anterior motor units, lumbosacral nerve roots, and/or spinal cord. Neurologic dysfunction may manifest in the lower extremities as loss of fine and gross motor function, touch, pain, temperature, and proprioceptive and vibratory sense deficits. Two clinical syndromes sometimes associated with these injuries are conus

2011 The Spine Journal

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