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Thoracolumbar Trauma

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141. Neuro-urology

dysfunction in neurologically intact patients with thoracolumbar spinal injuries. J Urol, 1998. 159: 965. 45. Ahlberg, J., et al. Neurological signs are common in patients with urodynamically verified “idiopathic” bladder overactivity. Neurourol Urodyn, 2002. 21: 65. 46. Bemelmans, B.L., et al. Evidence for early lower urinary tract dysfunction in clinically silent multiple sclerosis. J Urol, 1991. 145: 1219. 47. Klausner, A.P., et al. The neurogenic bladder: an update with management strategies

2019 European Association of Urology

142. Neuro-urology

in neurologically intact patients with thoracolumbar spinal injuries. J Urol, 1998. 159: 965. 45. Ahlberg, J., et al. Neurological signs are common in patients with urodynamically verified “idiopathic” bladder overactivity. Neurourol Urodyn, 2002. 21: 65. 46. Bemelmans, B.L., et al. Evidence for early lower urinary tract dysfunction in clinically silent multiple sclerosis. J Urol, 1991. 145: 1219. 47. Klausner, A.P., et al. The neurogenic bladder: an update with management strategies for primary care physicians

2018 European Association of Urology

143. Spine Surgery

or lower Copyright © 2018. AIM Specialty Health. All Rights Reserved. Spine Surgery 14 ? Marked cervical instability on neutral resting lateral or flexion/extension radiographs; with greater than or equal to 3 mm translation or greater than 11 degrees of angular difference to either adjacent level ? Clinically compromised vertebral bodies at the affected level due to current or past trauma, anatomic deformity or cervical spine malignancy ? Focal kyphosis at the level of planned arthroplasty ? Moderate (...) defect ? Clinically compromised vertebral bodies at affected level due to current or past trauma ? Lytic spondylolisthesis or degenerative spondylolisthesis of grade greater than 1 ? Allergy or sensitivity to implant materials (cobalt, chromium, molybdenum, polyethylene, titanium) ? Presence of infection or tumor ? Osteopenia or osteoporosis (defined as DEXA bone density measured T-score less than -1.0) Copyright © 2018. AIM Specialty Health. All Rights Reserved. Spine Surgery 18 Exclusions

2018 AIM Specialty Health

144. Appropriate Use Criteria: Imaging of the Spine

tumor assessment; developmental vertebral abnormalities) and CT myelography Abnormalities detected on other imaging studies which require additional clarification to direct treatment Fracture evaluation ? Following initial evaluation with radiographs Post-myelogram CT or CT following other cervical spine interventional procedure Post-trauma ? Neurologic deficit with possible spinal cord injury ? Progressively worsening pain Significant acute trauma to the cervical spine region When the patient’s (...) epidural steroid injection (ESI) when either of the following criteria are met: ? Documented abnormality on neurological exam in a dermatome/radicular distribution that has not previously been imaged or has progressed since a prior imaging study has been performed ? Lack of improvement or worsening during a six (6) week course of therapy with at least two (2) different forms of treatment Post-operative or post-procedure evaluation Post-trauma ? Neurologic deficit with possible spinal cord injury

2018 AIM Specialty Health

145. Imaging Guidelines

Imaging Guidelines ACS TQIP BEST PRACTICES GUIDELINES IN IMAGING ER AS 1988 THE AMERICAN SOCIETY OFTable of Contents Introduction 3 1. Overview 4 Part 1: General Issues 4 Part 2: Contrast Considerations 8 Part 3: Sedation 10 2. Brain Imaging 15 3. Cervical Spine Imaging 21 4. Imaging for Blunt Cerebrovascular Injury 32 5. Chest Imaging 36 6. Abdominal Imaging 40 7 . Genitourinary Imaging 45 8. Thoracic and Lumbar Spine Imaging 48 9. Whole-Body CT Imaging 51 10. Imaging in Orthopaedic Trauma 56 (...) 1 1. Imaging for Extremity Vascular Injury 60 12. Interventional Radiology for Traumatic Injuries 64 13. Imaging in Penetrating Neck Injury 72 14. Imaging in Penetrating Transthoracic Trauma 76 15. Imaging in Penetrating Abdominal Trauma 80 16. Imaging in the Trauma Patient Who Is Morbidly Obese 84 17 . Imaging in the Trauma Patient Who Is Pregnant 88 18. Imaging in Geriatric Patients with Low Energy Mechanism Injuries 92 19. Imaging for Intentional Injury in Children 96 20. Imaging at Rural

2018 American College of Surgeons

146. Management of Vertebral Compression Fractures

Reitman, MD j ; Arjun Sahgal, MD k ; Matthew J. Scheidt, MD l ; Kristofer Schramm, MD m ; Daniel E. Wessell, MD, PhD n ; Mark J. Kransdorf, MD o ; Jonathan M. Lorenz, MD p ; Julie Bykowski, MD. q Summary of Literature Review Introduction/Background Vertebral compression fractures (VCFs) can be caused by osteoporosis, neoplasms, metabolic disorders including renal osteodystrophies, congenital disorders such as osteogenesis imperfecta, infections, and acute trauma. Painful VCFs may cause a marked (...) ]). Red Flag Potential Underlying Condition as Cause of LBP ? History of cancer ? Unexplained weight loss ? Immunosuppression ? Urinary infection ? Intravenous drug use ? Prolonged use of corticosteroids ? Back pain not improved with conservative management ? Fever ? Cancer or infection ? History of significant trauma ? Minor fall or heavy lift in a potentially osteoporotic or elderly individual ? Prolonged use of steroids ? Spinal fracture ? Cauda equina syndrome ? Acute onset of urinary retention

2018 American College of Radiology

147. The PediGuard for placing pedicle screws in spinal surgery

of 10 adults aged 65 years or older (NHS Choices 2013a). Spinal fractures, which happen most frequently in people with osteoporosis and as a result of trauma. Approximately 120,000 cases of vertebral fractures happen each year in the UK (van Staa et al. 2001). Age-related degenerative diseases of the spine, including osteoarthritis (spondylosis), spinal stenosis and degenerative spondylolisthesis. In the UK approximately 8.5 million people have radiologic evidence of osteoarthritis of the spine (...) : E1305–9 Department of Health (2013) NHS Reference Costs 2012–13 [accessed 26 November 2014] Mattei TA, Meneses MS, Milano JB et al. (2009) "Free-hand" technique for thoracolumbar pedicle screw instrumentation: Critical appraisal of current "State-of-Art". Neurology India 57(6): 515–21 NHS Choices (2013a) Scoliosis [accessed 5 December 2014] NHS Choices (2013b) Scoliosis - Treatment in adults [accessed 10 December 2014] NHS Choices (2013c) Scoliosis - Treatment in children [accessed 10 December 2014

2015 National Institute for Health and Clinical Excellence - Advice

150. CRACKCast 107 – Peripheral Nerve Disorders

= Central Nervous System + Peripheral Nervous System PNS divided into 12 cranial nerves (Remember episode 105?) 31 spinal nerves (8 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 1 coccygeal). Almost all of these nerves have Sensory, Motor and autonomic function Anatomically / functionally speaking the autonomic nervous system is divided into: Sympathetic (thoracolumbar) component Parasympathetic (craniosacral) component. Note: Autonomic dysfunction may cause systemic abnormalities (e.g., Orthostasis (...) Diabetic foot ulcers ranging from 2% to 10% of the population. Mechanism: Unperceived trauma [9] List 5 causes of a plexopathy & 5 causes of an isolated mononeuropathy So here we are talking about category 3: asymmetric proximal and distal peripheral neuropathies, aka radiculopathies and plexopathies, and category 4: isolated mononeuropathies Refer to boxes 97.5 and 97.6 in Rosen’s 9 th Edition for asymmetrical proximal and distal peripheral neuropathies, and isolated mononeuropathies, respectively

2017 CandiEM

151. CIRSE Guidelines on Percutaneous Vertebral Augmentation

percutaneous VAPs. Keywords Vertebral compression fracture Osteoporosis Vertebroplasty Kyphoplasty Percutaneous bone implant techniques Introduction Vertebral compression fracture (VCF) is an important cause of severe debilitating back pain, adversely affecting quality of life, physical function, psychosocial perfor- mance, mental health and survival [1, 2]. Its diverse aeti- ologies encompass osteoporosis, neoplasms (e.g. myeloma, metastasis, lymphoma and haemangioma), osteonecrosis and trauma (...) with diffuse idio- pathic skeletal hyperostosis (DISH) and ankylosing spondylitis are highly susceptible to unstable 3-column spine fractures, even with minimal trauma [31]. • Osteomyelitis, discitis or active systemic infection. • Severe uncorrectable coagulopathy. • Allergy to bone cement or opaci?cation agents. The percutaneous augmentation techniques should not be used as prophylaxis treatment in severe osteoporotic patients. Relative • Radicular pain. • Tumour extension into the vertebral canal

2017 Cardiovascular and Interventional Radiological Society of Europe

153. AIM Clinical Appropriateness Guidelines for Spine Surgery

mm translation or greater than 11 degrees of angular difference to either adjacent level ? Clinically compromised vertebral bodies at the affected level due to current or past trauma, anatomic deformity or cervical spine malignancy ? Focal kyphosis at the level of planned arthroplasty ? Moderate or severe spondylosis at the level to be treated, characterized by bridging osteophytes, loss of greater than 50% of normal disc height, or severely limited range of motion (i.e., less than 2 degrees (...) arthropathy at the operated level ? Disease above L4-L5 ? Bony lumbar spinal stenosis ? Pars defect ? Clinically compromised vertebral bodies at affected level due to current or past trauma ? Lytic spondylolisthesis or degenerative spondylolisthesis of grade greater than 1 ? Allergy or sensitivity to implant materials (cobalt, chromium, molybdenum, polyethylene, titanium) ? Presence of infection or tumor ? Osteopenia or osteoporosis (defined as DEXA bone density measured T-score less than -1.0) Copyright

2017 AIM Specialty Health

154. Therapies Targeting the Nervous System for Chronic Pelvic Pain Relief

be effective for thoracolumbar afferents. However, it is difficult to obtain appropriate stimulation from SCS for the sacral nerves, including pudendal, thus limiting the use of this therapy in chronic pelvic pain management. Nevertheless, where a specific visceral cause has been determined, such as in endometriosis, there is a possibility that it does have some impact. In a small (n = 6) study by Kapural et al., 59 SCS was used to treat visceral pelvic pain after a successful test period with hypogastric (...) osteoarthritis. Cochrane Database Syst Rev 2013;(12):CD003523. 35. Jorgensen WA, Frome BM, Wallach C. Electrochemical therapy of pelvic pain: effects of pulsed electromagnetic fields (PEMF) on tissue trauma. Eur J Surg Suppl 1994;(574):83–6. 36. de Scisciolo G, Del Corso F, Caramelli R, Schiavone V, Cassardo A, Provvedi E, et al. P15.10 Effects of repetitive magnetic stimulation (rMS) in the treatment of chronic pelvic pain syndrome (CPPS) and floor dysfunction (FD). Clin Neurophysiol 2011;122 Supp 1:S129

2015 Royal College of Obstetricians and Gynaecologists

155. Direct Lateral Interbody Fusion in Patients Requiring Surgery for Spinal Instability

in Patients Requiring Surgery for Spinal Instability: A Review of the Comparative Clinical and Cost-Effectiveness, and Guidelines DATE: 25 June 2015 CONTEXT AND POLICY ISSUES A wide range of conditions including degenerative spine diseases, spinal deformities, tumors, infection, and spine trauma can result in spinal instability. These conditions are also associated with back pain, disability, and decreased quality of life (QoL). Estimates of the economic burden of back pain in the USA is US$100 billion (...) pyogenic spondylitis, 25,32 post-laminectomy syndrome, 6,7,16,18,20,31 adjacent segment disease, 6,16,18,23,32 degenerative disc disease, 6,17-20,23,26,29,30,33 sagittal imbalance, 17 stenosis, 17,20,21,24,27,31,32 revision, 17 thoracolumbar fractures, 19 kyphosis due to disc degeneration, 19 post-traumatic kyphosis, 30 structured kyphosis, 19 recurrent disc herniation, 20 infective spondylitis, 21 instrumentation failure/nonunion, 6 prior variable screw placement instrumentation, 7 herniated nucleas

2015 Canadian Agency for Drugs and Technologies in Health - Rapid Review

157. Inherited aortopathies including Marfan Syndrome

AND increased AS/Ht (in the absence of severe scoliosis) 1 12. Scoliosis, thoracolumbar kyphosis 1 13. Reduced elbow extension 1 14. Skin striae 1 15. Dural ectasia 2 16. Protrusio acetabuli 2 FH* = Family history of MFS, where diagnosis fulfils criteria in column titled (a) AoD = aortic root dilatation Z = Z-score, derived from the internet z score calculator: http://www.marfan.org Syst = systemic features EL = ectopia lentis FBN1 = fibrillin-1 mutation yoa = years of age US/LS = upper span: lower span (...) . 2012;44(11):1249-54. 20. Luyckx I, Loeys BL, Curriculum topic: Disease of the a, trauma to the a, heart. The genetic architecture of non-syndromic thoracic aortic aneurysm. Heart. 2015;101(20):1678-84. 21. Michelena HI, Corte AD, Prakash SK, Milewicz DM, Evangelista A, Enriquez-Sarano M. Bicuspid aortic valve aortopathy in adults: Incidence, etiology, and clinical significance. Int J Cardiol. 2015;201:400-7. 22. Prakash SK, Bosse Y, Muehlschlegel JD, Michelena HI, Limongelli G, Della Corte A, et al

2016 Cardiac Society of Australia and New Zealand

158. Percutaneous cement augmentation for osteoporotic vertebral fractures Full Text available with Trip Pro

Percutaneous cement augmentation for osteoporotic vertebral fractures Thoracolumbar vertebral fracture incidents usually occur secondary to a high velocity trauma in young patients and to minor trauma or spontaneously in older people.Osteoporotic vertebral fractures are the most common osteoporotic fractures and affect one-fifth of the osteoporotic population.Percutaneous fixation by 'vertebroplasty' is a tempting alternative for open surgical management of these fractures.Despite discouraging (...) , stressing the important aspects for success, and recommend a thorough evaluation of thoracolumbar fractures in osteoporotic patients to select eligible patients that will benefit the most from percutaneous augmentation. A detailed treatment algorithm is then proposed. Cite this article: EFORT Open Rev 2017;2:293-299. DOI: 10.1302/2058-5241.2.160057.

2017 EFORT open reviews

159. Suspected Physical Abuse ? Child

debated. In a subgroup of 38 children with AHT who underwent thoracolumbar spine imaging, 24 (63%) had thoracolumbar SDH, whereas only 1 of 70 ACR Appropriateness Criteria ® 6 Suspected Physical Abuse–Child patients with accidental trauma had spinal SDH in the same study [43]. None of the children had spinal cord compression or long-term complications from the presence of the spinal SDH, and that imaging was performed mostly because of concern for thoracic or abdominal injury. Although not usually (...) prompting change in management, detection of spinal SDH is significantly increased when imaging is extended through the thoracolumbar spine [45]. The presence of thoracolumbar SDH does not imply direct trauma to the thoracolumbar spine and may be related to redistribution of blood products. Nevertheless, this finding has medicolegal implications as it may document otherwise undetected injury and may help distinguish between abusive and accidental injury. CT chest without contrast CT of the chest is more

2016 American College of Radiology

160. Assessing Fitness to Drive

driver has multiple conditions or a condition that affects multiple body systems, there may be an additive or a compounding detrimental effect on driving abilities, for example, in: • congenital disabilities such as cerebral palsy, spina bifida and various syndromes • multiple trauma causing orthopaedic and neurological injuries as well as psychiatric sequelae • multi-system diseases such as diabetes, connective tissue disease and HIV • dual diagnoses involving psychiatric illness and drug or alcohol

2016 Cardiac Society of Australia and New Zealand

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