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Thoracolumbar Trauma

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161. Neuro-urology

The primary aims for treatment of neuro-urological symptoms and their priorities are [101, 102]: • pr otection of the UUT ; • achievement of urinary continence; • r estoration of (parts of) the LUT function; • impr ovement of the patient’ s QoL. Further considerations are the patient’s disability, cost-effectiveness, technical complexity, and possible complications [102]. Renal failure is the main mortality factor in SCI patients who survive the trauma [9, 103, 104]. Keeping the detrusor pressure during

2015 European Association of Urology

162. Chronic Pelvic Pain

Afferents in the autonomic plexus 46 6.3 Aetiology of nerve damage 46 6.3.1 Anterior groin nerves - aetiology of nerve damage 46 6.3.2 Pudendal neuralgia - aetiology of nerve damage 46 6.3.3 Surgery 46 6.3.4 Trauma 46 6.3.5 Cancer 46 6.3.6 Birth trauma 46 6.3.7 Elderly women 46 6.4 Diagnosis for pudendal neuralgia 47 6.4.1 Differential diagnosis of other disorders 47 6.4.2 Clinical presentation of pudendal neuralgia 47 Age 47 Sex 47 History 47 Associated features 48 (...) dysfunction in men 51 7.5 Chronic pelvic pain and sexual dysfunction in women 52 7.6 Treatment of sexual dysfunctions and CPP 53 7.7 Summary 53 7.8 Conclusions and recommendations: sexological aspects in CPP 53CHRONIC PELVIC PAIN - UPDATE APRIL 2014 5 8. PSYCHOLOGICAL ASPECTS OF CHRONIC PELVIC PAIN 54 8.1 Understanding the psychological components of pain 54 8.1.1 Neurophysiology of pain 54 8.1.2 Sexual abuse and trauma 54 8.1.3 Interpreting psychological differences 54 8.2 Psychological assessment

2015 European Association of Urology

163. Myelopathy

by bony fracture. O X-ray spine 7 This procedure can be the first test in multisystem trauma, especially when CT is delayed. Flexion and extension views can be used to evaluate instability only if patient is not obtunded. ??? X-ray myelography and post myelography CT spine 5 MRI is preferable. ???? MRI spine without and with IV contrast 2 O CT spine with IV contrast 2 ??? Tc-99m bone scan with SPECT spine 2 ??? CT spine without and with IV contrast 1 ???? Rating Scale: 1,2,3 Usually not appropriate (...) to the thoracic spine, though this is less common. The next most common causes of myelopathy are spinal cord compression due to extradural masses caused by bone metastases and blunt or penetrating trauma. Many primary neoplastic, infectious, inflammatory, neurodegenerative, vascular, nutritional, and idiopathic disorders can also result in myelopathy, though these are much less common than discogenic disease, metastases, and trauma. A variety of cysts and benign neoplasms can also compress the cord; they tend

2015 American College of Radiology

164. Intradural non-calcified thoracic disc herniation causing spontaneous intracranial hypotension: a case report. Full Text available with Trip Pro

identified as a major cause for ventral CSF loss through vertical longitudinal dural slits. We report a rare case of intractable SIH due to an intradural disc herniation at the thoracolumbar junction (without signs of calcification) and its management.A 46-year old woman suffered from orthostatic headache (sudden onset, no history of trauma) due to intractable SIH for over 2 month (without neurologic deficits). There was no clinical amelioration by conservative measures (analgesics, bedrest) and serial (...) unspecific epidural blood patches (repeated for 3 times). She was diagnosed with an intradural disc herniation at the thoracolumbar junction causing a CSF leak. Surgical exploration by a translaminar and transdural approach with removal of the disc herniation and closure of the CSF leak was performed with immediate cessation of orthostatic symptoms. Histological workup revealed non-calcified intervertebral disc material. After 3 months of follow-up and no evidence for clinical relapse the patient

2019 BMC Surgery

165. Isolated multiple lumbar transverse process fractures with spinal instability: an uncommon yet serious association. (Abstract)

Isolated multiple lumbar transverse process fractures with spinal instability: an uncommon yet serious association. Isolated vertebral transverse process fractures of thoracolumbar spine without other vertebral injuries and neurological deficit are generally considered as minor injuries with no concern for associated spinal instability. This report describes a case of multiple lumbar transverse fractures associated with an unexpected yet clinically significant spinal instability.A young male (...) of the major soft-tissue stabilizers of the spine presenting subtle changes on CT images. When a seemingly benign spinal injury is caused by high-energy trauma, careful scrutiny for associated instability is needed. In this case, the standing in-brace X-ray was able to avoid a misdiagnosis and potentially unfavourable outcome.

2019 European Spine Journal

166. Clinical Examination Is Insufficient to Rule Out Thoracolumbar Spine Injuries. (Abstract)

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

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

, 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

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

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

2010 Spine

169. Predictors of Complications After Spinal Stabilization of Thoracolumbar Spine Injuries. (Abstract)

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

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

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

171. Activity-Dependent Transspinal Stimulation in SCI

, transcutaneous spinal cord stimulation (termed here transspinal stimulation) in people with SCI can evoke rhythmic leg muscle activity when gravity is eliminated. A fundamental knowledge gap still exists on induction of functional neuroplasticity and recovery of leg motor function after repetitive thoracolumbar transspinal stimulation during body weight supported (BWS) assisted stepping in people with SCI. The central working hypothesis in this study is that transspinal stimulation delivered during BWS (...) combined with non-invasive thoracolumbar transspinal stimulation at 0.3 or at 30 Hz. Masking: None (Open Label) Primary Purpose: Treatment Official Title: Activity-Dependent Transspinal Stimulation for Recovery of Walking Ability After Spinal Cord Injury Actual Study Start Date : August 1, 2018 Estimated Primary Completion Date : May 30, 2021 Estimated Study Completion Date : May 30, 2021 Resource links provided by the National Library of Medicine related topics: related topics: resources: Arms

2018 Clinical Trials

172. Is Focused MRI Adequate for Treatment Decision-Making in Acute Traumatic Thoracic and Lumbar Spine Fractures seen on Whole spine CT? (Abstract)

on MRI (ligamentous disruption, epidural hematoma, and cord contusion), outside of the focused zone, an alteration in patient management, including surgical and nonsurgical, as a result of the identified pathology outside the focused zone.Records were reviewed for all adult trauma patients who presented to the emergency department between 2008 and 2016 with one or more fracture(s) of the thoracic and/or lumbar spine identified on computed tomography (CT) and who underwent MRI of the entire thoracic (...) , with a median age of 49 years. There were 81 males (64%). Sixty-two (49%) patients had isolated thoracolumbar junction injuries and 36 (29%) had injuries limited to a single fractured level. Forty-seven (37%) patients were managed operatively. PLC injury was identified by both readers in 36 (29%) patients with a percent agreement of 96% and κ coefficient of 0.91 (95% CI 0.87-0.95). Both readers independently agreed that there was no pathology identified on the complete thoracic and lumbar spine MRIs outside

2018 The Spine Journal

173. Spinal Motocross Injuries in the United Kingdom Full Text available with Trip Pro

epidemiology study.Data were prospectively collected over 5 years (August 2010-August 2015) at our regional trauma and spine unit, regardless of whether the rider was performing the sport competitively or recreationally.During the study period, spine-related injuries were identified for 174 patients (age range, 6-75 years) who were directly referred to our department following recreational or competitive motocross, with most injuries being sustained within the early spring and summer months, representing (...) the start of the motocross season. A significant number of injuries were in males (n = 203, 94%), with the majority of injuries occurring within the 21- to 30-year-old age group. A total of 116 (54%) injuries required operative treatment. The most common spinal injury was thoracolumbar burst fracture (n = 95), followed by chance fractures (n = 26).This data series emphasizes the prevalence and devastation of motocross-related spinal injuries in the United Kingdom and may serve in administering sanctions

2018 Orthopaedic journal of sports medicine

174. Epidemiology of vertebral fractures in pediatric and adolescent patients Full Text available with Trip Pro

Epidemiology of vertebral fractures in pediatric and adolescent patients Spinal injuries in children and adolescents are rare injuries, but consequences for the growing skeleton can be devastating. Knowledge of accident causes, clinical symptoms and diagnostics should be part of every trauma department treating these patients. We retrospectively analyzed patients with radiographically proven vertebral fractures of the spine. After clinical examination and tentative diagnosis the fractures (...) and injuries were proven with conventional X-ray, computed tomography (CT) scans or magnetic resonance imaging (MRI). The study included 890 fractures in 546 patients with an average age of 12.8±6.2 (6.6-19.4) years. Females had an average age of 13.7±6.3 (7.4-20.0) years, whereas males were on average 12.0 (6.0-18.0) years old. Fall from height (58%) was the main cause of accident and the most common region of fracture was the thoracolumbar spine with a shift towards the thoracic spine the more fractures

2018 Pediatric reports

175. Prevalence of diffuse idiopathic skeletal hyperostosis (DISH) assessed with whole-spine computed tomography in 1479 subjects. Full Text available with Trip Pro

and characteristic of DISH by whole spinal CT.Participants were patients who had experienced trauma who had undergone whole-spine CT scanning based on the initial clinical practice guidelines for trauma in our institute from April 2015 to February 2018. The subjects were > 20 years old and 1479 were included in the analysis. The presence and distribution of DISH and clinical parameters such as age and sex were reviewed retrospectively according to the location of DISH.The overall prevalence of DISH was 19.5% (n (...)  = 289). Subjects with DISH were older than those without. DISH was located in the thoracic spine in 65.1% and thoracolumbar spine in 24.2% of patients. More than 80% of ligamentous ossifications associated with DISH occurred at T8 (n = 255, 88%), T9 (n = 262, 91%), and T10 (n = 247, 85%). Most of the ossification occurred to the right anterior of the vertebral body, and there were few ossifications in the areas in contact with the artery and vein.The prevalence of DISH based on whole-spine CT

2018 BMC Musculoskeletal Disorders

176. The European Robotic Spinal Instrumentation (EUROSPIN) Study

for degenerative pathologies (stenosis, spondylolisthesis, degenerative disc disease, recurrent disc herniation), infections, fractures, trauma, or tumors. Criteria Inclusion Criteria Informed consent Thoracolumbar pedicle screw placement Indication for surgery: Degenerative pathologies (stenosis, spondylolisthesis, degenerative disc disease, recurrent disc herniation), infections, tumors, fractures, trauma Age ≥ 18 Exclusion Criteria Deformity surgery >5 index levels Contacts and Locations Go to Information (...) Information provided by (Responsible Party): Marc Schröder, Bergman Clinics Study Details Study Description Go to Brief Summary: In a multinational prospective study, preoperative, intraoperative, perioperative and follow-up data on patients receiving thoracolumbar pedicle screw placement for degenerative disease or infections or tumors will be collected. The three arms consist of robot-guided (RG), navigated (NV), or freehand (FH) screw insertion. Condition or disease Intervention/treatment Degenerative

2018 Clinical Trials

177. The impact of magnetic resonance imaging in the diagnostic and classification process of osteoporotic vertebral fractures. (Abstract)

on early diagnosis and classification, compared to standard radiographs alone.A total of 173 patients were enrolled in this study. All participants were 55 years of age or older (60 years for men) and complained acute back pain with suspected thoracolumbar OVFs without history of high-energy trauma. Diagnosis of OVF was initially performed on standard radiographs obtained in the emergency room. Then, all the patients underwent MRI scan with short-tau inversion recovery (STIR) sequencing within 7 days (...) . We compared the level and number of fractures identified on standard radiographs with the MRI scan results. The discordance between radiographic and MRI diagnosis was quantified. Fractures were classified according to AO Spine Classification.Mean age of the study participant was 74.2 years (range 55-92). They were 100 males and 73 females. MRI modified initial diagnosis in 52% (90/173) of our patients: in 43.9% of patients MRI identified one or more new thoracolumbar fracture. In 14 cases (8.1

2018 Injury

178. Peri-Incisional Drug Injection in Lumbar Spine Surgery

Inclusion Criteria: Any adult patient 18 years of age and older who is undergoing surgery for a lumbar spine problem. Common diagnoses in this category would include lumbar disc herniations, spinal stenosis, and spondylolisthesis, but this is not an exhaustive list. Exclusion Criteria: Patients with comorbidities excluding use of proposed injection. Patients with major head trauma such that they cannot provide consent or describe their post-operative pain. Patients with other surgical treatment during (...) with a fracture, tumor, or infection as their primary diagnosis. Patients undergoing a deformity correction. Patients with surgeries extending more than 4 levels, with surgeries that extend to the pelvis, or with surgeries that cross the thoracolumbar junction. Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Please refer to this study

2018 Clinical Trials

179. The Effect Spinal Bracing System on Gait in Adult Scoliosis Patients

- 75 years and older Clinically diagnosed thoracolumbar and/or lumbo-sacro-pelvic deformity as defined by the SRS/Schwab classification systems as Cobb angle of 25° or greater Able to ambulate without assistance and stand without assistance with their eyes open for a minimum of 10 seconds Able and willing to attend and perform the activities described in the informed consent within the boundaries of the timelines set forth for pre-, and post-treatment follow-up Exclusion Criteria: History of prior (...) attempt at fusion (successful or not) at the indicated levels, (history of one level fusion is not an exclusion) Major lower extremity surgery or previous injury that may affect gait (a successful total joint replacement is not an exclusion) BMI higher than 35 Neurological disorder, diabetic neuropathy or other disease that impairs the patient's ability to ambulate or stand without assistance Major trauma to the pelvis Pregnant or wishing to become pregnant during the study Contacts and Locations Go

2018 Clinical Trials

180. A Multi-center Study:Comparison of ACAF and ACCF in the Treatment of Cervical OPLL

, nerve root compression symptoms, may be associated with urinary dysfunction, conservative treatment is invalid or gradually increased; Exclusion Criteria: Cervical ligamentous ossification, cervical trauma, cervical cancer, cervical tuberculosis and other inflammatory diseases; accompanied by thoracolumbar spine and other spine parts of the disease affect the clinical symptoms of patients; associated with amyotrophic lateral sclerosis and other motor neuron diseases and other neurological diseases

2018 Clinical Trials

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