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Thoracolumbar Trauma

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121. [The comparison of computer assisted minimally invasive spine surgery and traditional open treatment for thoracolumbar fractures].

[The comparison of computer assisted minimally invasive spine surgery and traditional open treatment for thoracolumbar fractures]. To compare the clinical results between computer assisted minimally invasive spine surgery (CAMISS) and traditional open fixation surgery which used in thoracolumbar fractures.A prospective randomized controlled trial of patients who had undergone surgery for thoracolumbar fracture from January 2006 to March 2011 was performed. The patients were randomly divided (...) > 0.05).CAMISS has the characteristics of fewer traumas, less bleeding, faster recovery, high accuracy of pedicle screws. It has comparable vertebral deformity correction and fixation result of the traditional open operation.

2011 Zhonghua wai ke za zhi [Chinese journal of surgery]

122. Lumbar Spine, Trauma

; and penetrating trauma, including gunshot wounds and stabbings. Fractures of the pelvis often are associated with injury to the sacral plexus and the lower lumbar spine. Lumbar spine trauma. Drawing of the thoracolumbar spine viewed from an oblique frontal projection. AF indicates annulus fibrosis; DNR, dorsal nerve root; NP, nucleus pulposus; NRG, nerve root ganglion; SC, spinal cord; SN, spinal nerve; TP, transverse process; VB, vertebral body; and VNR, ventral nerve root. Lumbar spine trauma. Lateral (...) be in spasm at the time of an examination, preventing localization of a bleeding site. Previous References Rush JK, Kelly DM, Astur N, Creek A, Dawkins R, Younas S, et al. Associated injuries in children and adolescents with spinal trauma. J Pediatr Orthop . 2013 Jun. 33(4):393-7. . Inaba K, Nosanov L, Menaker J, Bosarge P, Williams L, Turay D, et al. Prospective derivation of a clinical decision rule for thoracolumbar spine evaluation after blunt trauma: An American Association for the Surgery of Trauma

2014 eMedicine Radiology

123. Thoracic Spine, Trauma

be rudimentary. Each rib is attached to the vertebral body by 2 joint cavities. The lateral costotransverse ligament, the articular capsule, the superior costotransverse ligament, and the intra-articular ligament provide flexible stability between the transverse process and the rib facets. Depictions of the anatomy of the thoracic spine and vertebra are provided in the images below. Thoracic spine trauma. Drawing of the thoracolumbar spine viewed from an oblique frontal projection. SC indicates the spinal (...) adults. In general, anteroposterior (AP) and lateral radiographs should be obtained in the emergency department while other measures of resuscitation are performed. Multidetector CT scans with intravenous contrast enhancement are indicated in most patients to exclude intrathoracic vascular injury. In patients who have sustained blunt trauma, multidetector CT has been proposed as a screening study for thoracolumbar fracture. [ , , ] MRI of the thoracic spine should be reserved for patients

2014 eMedicine Radiology

124. Thorax, Trauma

is an important diagnostic and prognostic tool in patients with thoracolumbar compression–type fractures. MRI with breath-hold acquisition permits good visualization of diaphragmatic abnormalities, but this technique cannot be performed in emergency situations. MRI offers a major advantage in exploring the cord, disks, and ligaments and in looking for a hematoma. Nevertheless, the indication is carefully weighed in patients with multiple trauma because of monitoring difficulties during the examination, which (...) Thorax, Trauma Thoracic Trauma Imaging: Practice Essentials, Radiography, Computed Tomography Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMzU3MDA3LW92ZXJ2aWV3 processing > Thoracic Trauma Imaging Updated: Sep

2014 eMedicine Radiology

125. Evaluation of the Thoracolumbar Injury Classification System in Thoracic and Lumbar Spinal Trauma. (PubMed)

Evaluation of the Thoracolumbar Injury Classification System in Thoracic and Lumbar Spinal Trauma. Retrospective study.Evaluate the relationship among the neurologic status, the Thoracolumbar Injury Classification System (TLICS) score, and the Magerl/AO classification system.A wide range of classification schemes for thoracic and lumbar spine trauma have been described, but none has achieved widespread acceptance. A recent system proposed by Vaccaro et al has been developed to improve injury (...) classification and guide surgical decision making.Analysis of 49 patients treated surgically for thoracic and lumbar spine trauma from 2003 to 2009 in 2 spine trauma centers. Clinical and radiologic data were evaluated, classifying the trauma according to American Spinal Injury Association status, the Magerl/AO classification for fractures, and the TLICS score.The mean age was 37 years (range, 17-72). Thirty-five (71%) patients had a thoracolumbar fracture (T11-L2). A posterior approach was used in all

2010 Spine

126. Therapeutic decision making in thoracolumbar spine trauma. (PubMed)

Therapeutic decision making in thoracolumbar spine trauma. Systematic literature review.A systematic review was designed to answer 3 primary research questions: (1) What is the most useful classification system for surgical and nonsurgical decision-making with regard to thoracolumbar (TL) spine injuries? (2) For a TL burst fracture with incomplete neurologic deficit, what is the optimal surgical approach and stabilization technique? (3) Is complete disruption of the posterior ligamentous (...) for the primary research questions were as follows: (1) Thoracolumbar Injury Classification System seems to be the best system available for therapeutic decision-making for TL spine injuries (strength of recommendation: weak; quality of evidence: low). (2) There is no specific surgical approach in the case of a TL burst fracture with incomplete neurologic deficit that has any advantage with regard to neurologic recovery (strength of recommendation: weak; quality of evidence: low). (3) Complete disruption

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2010 Spine

127. PLIF in thoracolumbar trauma: technique and radiological results. (PubMed)

PLIF in thoracolumbar trauma: technique and radiological results. Patients with fractures from the 11th thoracic to the 5th lumbar vertebra had a reconstruction of the anterior column with monocortical iliac crest autograft by using a single dorsal approach. The loss of correction was observed using X-rays pre- and post-operatively, at 3 months and after implant removal (IR). Successful fusion was assessed using computed tomography after the implant removal. To assess the loss of correction

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2010 European Spine Journal

128. Abdominal aortic rupture from an impaling osteophyte following blunt trauma. (PubMed)

Abdominal aortic rupture from an impaling osteophyte following blunt trauma. Blunt injury of the abdominal aorta is highly fatal. We present an unusual case of an osteophyte impaling the abdominal aorta treated by endovascular repair. A 77-year-old man sustained a thoracolumbar fracture-dislocation with posterior aortic rupture between his celiac and superior mesenteric artery origins. His aortic injury was treated with a stent graft, excluding the celiac origin. He was dismissed

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2013 Journal of Vascular Surgery

129. Evaluation of Usefulness of Contrast Enhanced MRI in Evaluation of Spine Trauma: Prospective Study

Evaluation of Usefulness of Contrast Enhanced MRI in Evaluation of Spine Trauma: Prospective Study Evaluation of Usefulness of Contrast Enhanced MRI in Evaluation of Spine Trauma: Prospective Study - 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. Evaluation of Usefulness of Contrast Enhanced MRI in Evaluation of Spine Trauma: Prospective Study 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: NCT01880944 Recruitment Status : Completed First Posted : June 19, 2013 Last Update Posted : October 5, 2018

2013 Clinical Trials

130. Spinal and pelvic injuries in airborne sports: a retrospective analysis from a major Swiss trauma centre. (PubMed)

higher (OR 21.04, 95% CI 7.83-56.57, p<0.001) than in the general trauma population.Serious spinal and pelvic injuries account for most injuries sustained during airborne sporting activities. The thoracolumbar region was most often affected, but the lumbopelvic junction is also especially vulnerable as high impact forces from vertical and horizontal deceleration need to be absorbed. The frequency of spino-pelvic dissociation was very high in paragliding injuries, with a 21-fold higher odds ratio than (...) Spinal and pelvic injuries in airborne sports: a retrospective analysis from a major Swiss trauma centre. Adrenalin-seeking airborne sports like BASE-jumping, paragliding, parachuting, delta-gliding, speedflying, and skysurfing are now firmly with us as outdoor lifestyle activities and are associated with a high frequency of severe injuries, especially to the spine.Retrospective analysis of all airborne sports-associated spinal and pelvic injuries admitted to a Level I trauma centre

2012 Injury

131. Spinal Subdural Hemorrhage in Abusive Head Trauma: A Retrospective Study. (PubMed)

the statistical significance of the proportion of the spinal canal subdural hemorrhage in abusive head trauma versus that in accidental trauma.In the abusive head trauma cohort, 67 (26.5%) of 252 children had evaluable spinal imaging results. Of these, 38 (56%) of 67 children had undergone thoracolumbar imaging, and 24 (63%) of 38 had thoracolumbar subdural hemorrhage. Spinal imaging was performed in this cohort 0.3-141 hours after injury (mean, 23 hours ± 27 [standard deviation]), with 65 (97%) of 67 cases (...) having undergone imaging within 52 hours of injury. In the second cohort with accidental injury, only one (1%) of 70 children had spinal subdural hemorrhage at presentation; this patient had displaced occipital fracture. The comparison of incidences of spinal subdural hemorrhage in abusive head trauma versus those in accidental trauma was statistically significant (P < .001).Spinal canal subdural hemorrhage was present in more than 60% of children with abusive head trauma who underwent thoracolumbar

2011 Radiology

132. Cervical Spine Magnetic Resonance Imaging in Alert, Neurologically Intact Trauma Patients With Persistent Midline Tenderness and Negative Computed Tomography Results. (PubMed)

Cervical Spine Magnetic Resonance Imaging in Alert, Neurologically Intact Trauma Patients With Persistent Midline Tenderness and Negative Computed Tomography Results. We aim to determine the prevalence and factors associated with cervical discoligamentous injuries detected on magnetic resonance imaging (MRI) in acute, alert, neurologically intact trauma patients with computed tomography (CT) imaging negative for acute injury and persistent midline cervical spine tenderness. We present the cross (...) -sectional analysis of baseline information collected as a component of a prospective observational study.Alert, neurologically intact trauma patients presenting to a Level I trauma center with CT negative for acute injury, who underwent MRI for investigation of persistent midline cervical tenderness, were prospectively recruited. Deidentified images were assessed, and injuries were identified and graded. Outcome measures included the presence and extent of MRI-detected injury of the cervical ligaments

2011 Annals of Emergency Medicine

133. Is spine consultation needed for all thoracolumbar fractures? Evaluation of a subspecialist-sparing protocol for screening and management of stable fractures. (PubMed)

Is spine consultation needed for all thoracolumbar fractures? Evaluation of a subspecialist-sparing protocol for screening and management of stable fractures. The shortage of neurosurgeons is a problem in many US trauma centers. Most thoracolumbar spine fractures are treated conservatively, and at our institution, we found that most patients did not require surgery. We hypothesize that most spine fractures can be treated safely and effectively by the trauma team, without neurosurgical (...) consultation, using a protocol to guide diagnosis and treatment.A treatment protocol was designed, which used radiologic criteria to screen for potentially stable fractures and guide their treatment by the trauma service without obtaining a spine consult. All patients meeting criteria were ambulated 1 day to 2 days after admission, either with or without a thoracolumbar support orthotic, depending on their level of spinal injury. All received a repeat spine computed tomographic (CT) scan after ambulation

2010 Journal of Trauma

134. Does early fracture fixation of thoracolumbar spine fractures decrease morbidity or mortality? (PubMed)

Does early fracture fixation of thoracolumbar spine fractures decrease morbidity or mortality? Systematic Review.To determine whether early spinal stabilization in thoracolumbar spine trauma decreases morbidity and mortality.The role of early spinal stabilization through surgical means may have a number of benefits. These include reduced morbidity and mortality because of more rapid mobilization afforded by spinal column stabilization and a reduction in the incidence and severity of sepsis (...) and respiratory failure. There are several potential disadvantages of early surgery. The most strongly debated is the potential that the additional physiologic injury may result in an unintended increase in morbidity and mortality caused by worsening of existing injuries, such as with pulmonary or intracranial trauma. This problem may be compounded by increased hemorrhage and resulting hypotension. Operating in the presence of missed or underestimated associated injuries or under less-than-ideal conditions

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2010 Spine

135. Predictors of Complications After Spinal Stabilization of Thoracolumbar Spine Injuries. (PubMed)

Predictors of Complications After Spinal Stabilization of Thoracolumbar Spine Injuries. The management of complications after major traumatic spinal injury and surgical stabilization is a challenge. The purpose of this study is to identify factors predictive of a complication after surgical stabilization of thoracolumbar spine injuries.A review of subjects prospectively enrolled in a multicenter database for spine trauma was performed. Standard demographic data, Glasgow Coma Scores, Injury (...) Severity Score, American Spinal Injury Association score, Charlson Comorbiditiy Index (CCI), mechanism of injury, administration of methylprednisolone (National Acute Spinal Cord Injury II, III), time from injury to surgery, and surgical approach were evaluated. All perioperative complications within 6 months of surgery were recorded. Multivariate logistic regression analysis was performed to identify factors predictive of the occurrence of a complication after surgical stabilization of a thoracolumbar

2010 Journal of Trauma

136. Clinical Examination Is Insufficient to Rule Out Thoracolumbar Spine Injuries. (PubMed)

Clinical Examination Is Insufficient to Rule Out Thoracolumbar Spine Injuries. The role of clinical examination in the diagnosis of thoracolumbar (TL) spine injuries is highly controversial. The aim of this study was to assess the sensitivity and specificity of a standardized clinical examination for diagnosing TL spine injuries after blunt trauma.This was a prospective observational study conducted at a level I trauma center from March 2008 to September 2008. After Institutional Review Board (...) approval, all evaluable blunt trauma patients older than 15 years were evaluated by a senior resident or attending surgeon for TL spine deformity, tenderness to palpation, and neurologic deficits. Patients were followed through their hospital course to capture all TL spine injury diagnoses, all imaging performed, and any immobilization or stabilization procedures.Of the 884 patients enrolled, 81 (9%) had a TL spine injury. More than half (55.6%) had two or more fractures with 30.9% having three or more

2010 Journal of Trauma

137. One-Stage Combined Posterior and Anterior Approaches for Excising Thoracolumbar and Lumbar Tumors: Surgical and Oncological Outcomes. (PubMed)

, with secondary sterilization in the one stage. So the surgical time, cost and trauma, as well as blood loss, would be increased. One-stage en bloc spondylectomy with the patient lying in the lateral position may be a good way for improving it.This study retrospectively reviewed 18 patients with thoracolumbar and lumbar spinal tumors who underwent spondylectomy. All patients were observed up, and their status was evaluated by clinical and imaging studies.Total en bloc spondylectomy was performed successfully (...) One-Stage Combined Posterior and Anterior Approaches for Excising Thoracolumbar and Lumbar Tumors: Surgical and Oncological Outcomes. Retrospective clinical and radiologic evaluation.To investigate the feasibility of a 1-stage combined posterior and anterior approaches for excising thoracolumbar and lumbar tumors with the patient lying in the lateral position.Traditional anteroposterior approaches for total spondylectomy require a 2-stage operation or changing the patient's position

2010 Spine

138. Is a pelvic fracture a predictor for thoracolumbar spine fractures after blunt trauma? (PubMed)

Is a pelvic fracture a predictor for thoracolumbar spine fractures after blunt trauma? Discussion still remains which polytraumatized patients require radiologic thoracolumbar spine (TL spine) screening. The purpose of this study is to determine whether pelvic fractures are associated with TL spine fractures after a blunt trauma. Additionally, the sensitivity of conventional TL spine radiographs and pelvic radiographs (PXRs) is evaluated.We prospectively studied 721 consecutive patients who had (...) sustained a high-energy blunt trauma. The diagnostic workup in these patients included routine conventional radiographs of the pelvis and TL spine followed by a computed tomography (CT) analysis. All patients with pelvic fractures and TL spine fractures identified on conventional radiographs and CT were analyzed. A relative risk (RR) was calculated for the association between pelvic fractures and TL spine fractures. The sensitivity for conventional TL spine radiographs and PXRs in identifying fractures

2009 Journal of Trauma

139. Review article: indications for thoracolumbar imaging in blunt trauma patients: a review of current literature. (PubMed)

Review article: indications for thoracolumbar imaging in blunt trauma patients: a review of current literature. Thoracolumbar spine injury is a common complication of blunt multitrauma and up to one third of fractures are associated with spinal cord dysfunction. Delayed fracture diagnosis increases the risk of neurological complications. While validated screening guidelines exist for traumatic c-spine injury equivalent guidelines for thoracolumbar screening are lacking. We conducted (...) a literature review evaluating studies of thoracolumbar injury in trauma patients to generate indications for thoracolumbar imaging. We performed MEDLINE and Pubmed searches using MeSH terms "Wounds, Nonpenetrating", "Spinal Fractures", "Spinal Injuries" and "Diagnostic Errors", MeSH/subheading terms "Thoracic Vertebrae/injuries" and "Lumbar Vertebrae/injuries" and keyword search terms "thoracolumbar fractures", "thoracolumbar injuries", "thoracolumbar trauma", "missed diagnoses" and "delayed diagnoses

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2009 Emergency medicine Australasia

140. Optimal thoracic and lumbar spine imaging for trauma: are thoracic and lumbar spine reformats always indicated? (PubMed)

Optimal thoracic and lumbar spine imaging for trauma: are thoracic and lumbar spine reformats always indicated? Computed tomography (CT) of the thoracic and lumbar (T/L) spine with reformats has become the imaging modality of choice for the identification of T/L spine fractures. The objective of this study was to directly compare chest/abdomen/pelvis CT (CAP CT) with CT with T/L reformats (T/L CT) for the identification of T/L spine fractures.Patients who had both a CAP CT scan (5-mm imaging (...) spacing) and T/L CT reconstruction (2.5-mm image spacing with sagittal and coronal reformats) were selected. A "fracture" group (N = 35) and a "no fracture" group (N = 57) were identified. The type and level of fracture were recorded.The CAP CT correctly identified all 35 patients with a thoracolumbar fracture (100% sensitivity; 95% confidence interval: 88-100%). A total of 80 separate fracture sites were present in the 35 patients. The CAP CT accurately identified 78 of those fractures (97.5

2010 Journal of Trauma

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