Cervical spine alignment in the pediatric population: a radiographic normative study of 150 asymptomatic patients

2014 ◽  
Vol 23 (7) ◽  
pp. 1442-1448 ◽  
Author(s):  
K. Abelin-Genevois ◽  
A. Idjerouidene ◽  
P. Roussouly ◽  
J. M. Vital ◽  
C. Garin
Keyword(s):  
Cervical Spine ◽  
Pediatric Population ◽  
Normative Study ◽  
Asymptomatic Patients ◽  
Cervical Spine Alignment

scholarly journals Using cervical spine clearance guidelines in a pediatric population: a survey of physician practices and opinions

CJEM ◽  
2011 ◽  
Vol 13 (01) ◽  
pp. 1-6 ◽  
Author(s):  
Emma C. Burns ◽  
Natalie L. Yanchar
Keyword(s):  
Cervical Spine ◽  
Design Method ◽  
Pediatric Population ◽  
Trauma Team ◽  
Pediatric Emergency ◽  
Team Leaders ◽  
Physician Practices ◽  
Clinical Criteria ◽  
Radiologic Imaging ◽  
National Emergency

ABSTRACT Background: Unlike in adults, there are currently no standardized, validated guidelines to aid practitioners in clearing the pediatric cervical spine (C-spine). Many pediatric centres in Canada have locally produced, adult-modified guidelines, but the extent to which these or other guidelines are used is unknown. Objective: The purpose of this study was to determine if Canadian physicians are using either locally produced or adult C-spine guidelines to clear the C- spines of patients < 16 years of age. The study also characterized the common methods used by physicians to clear pediatric C-spine injuries in terms of clinical examination and radiologic imaging. Methods: A 20-question survey was distributed to 240 Canadian pediatric emergency physicians and trauma team leaders using the Dillman Total Design Method. Results: The response rate was 68%. The results showed that 61% of physicians currently use guidelines to assist in the clearance of pediatric C-spines. Of those physicians not using guidelines, 85% stated that they would use them if they were available. The clinical criteria most often used to clear pediatric C-spines were a normal neurologic examination (97%) and the absence of C-spine tenderness (95%), intoxication (94%), and distracting injuries (87%). Conclusions: Guidelines are commonly used by Canadian physicians when clearing the pediatric C-spine, yet few are validated in children. Those most commonly used are locally developed guidelines, the Canadian C-spine guidelines, or National Emergency X-Radiography Utilization Study (NEXUS) low-risk criteria.

scholarly journals Ergonomic Consideration in Pillow Height Determinants and Evaluation

Healthcare ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1333
Author(s):  
Jia-Xing Lei ◽  
Peng-Fei Yang ◽  
Ai-Ling Yang ◽  
Yan-Feng Gong ◽  
Peng Shang ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Muscle Activity ◽  
Sleep Problems ◽  
Comprehensive Evaluation ◽  
Sufficient Evidence ◽  
Health Issues ◽  
Body Dimension ◽  
Current Trends ◽  
Shoulder Complex ◽  
Cervical Spine Alignment

(1) Background: Sleep problems have become one of the current serious public health issues. Pillow height affects the alignment of the cervical spine and is closely related to the mechanical environment of the cervical spine. An appropriate pillow height can provide adequate support for the head and neck to reduce the stress in the cervical spine and relax the muscles of the neck and shoulder, thereby relieving pain and improving sleep quality. (2) Methods: We reviewed the current trends, research methodologies, and determinants of pillow height evaluation, summarizing the evidences published since 1997. In particular, we scrutinized articles dealing with the physiological and mechanical characteristics of the head-neck-shoulder complex. (3) Results: Through the investigation and analysis of these articles, we presented several quantitative and objective determinants for pillow height evaluation, including cervical spine alignment, body dimension, contact pressure, and muscle activity. The measurement methods and selection criteria for these parameters are described in detail. However, the suggested range for achieving optimal cervical spine alignment, appropriate pressure distribution, and minimal muscle activity during sleep cannot yet be identified considering the lack of sufficient evidence. Moreover, there remain no firm conclusions about the optimal pillow height for the supine and lateral positions. (4) Conclusions: A comprehensive evaluation combining the above determinants provides a unique solution for ergonomic pillow design and proper pillow height selection, which can effectively promote the public sleep health. Therefore, it is necessary to develop a reasonable algorithm to weigh multiple determinants.

scholarly journals C1-C2 Subluxation after Mild Cervical Spine Trauma in a Child

2020 ◽  
pp. 1-3
Author(s):  
Isabel Snee ◽  
Isabel Snee ◽  
Catherine A. Mazzola
Keyword(s):  
Cervical Spine ◽  
Head Tilt ◽  
Spine Injury ◽  
Halo Traction ◽  
Cord Injury ◽  
Magnetic Resonance Imaging Mri ◽  
Cervical Spine Alignment ◽  
Atlanto Axial Joint ◽  
Spine Radiographs ◽  
Halo Device

We report a case of a seven-year-old girl who presented with a “Cock-Robin” head tilt and cervical spine injury after falling from her bed. Initial cervical spine X-ray reported a fractured clavicle. However, almost four weeks later, the torticollis had not resolved. Computerized tomography (CT) of the cervical spine revealed subluxation of the atlanto-axial joint at C1-C2. Cervical spine magnetic resonance imaging (MRI) did not show any spinal cord injury. Manual reduction and hard collar placement were attempted, yet C1- C2 subluxation recurred. The child was placed into halo traction and then into a halo vest. CT scan showed near complete resolution of C1-C2 subluxation. Three months later the halo device was removed, and the patient was placed in a hard cervical collar then transitioned into a soft collar over a four month period. During this time, the patient received physical therapy. Final cervical spine radiographs revealed proper cervical spine alignment and resolution of C1-C2 subluxation.

scholarly journals Lacrosse Equipment and Cervical Spinal Cord Space During Immobilization: Preliminary Analysis

2010 ◽  
Vol 45 (1) ◽  
pp. 39-43 ◽  
Author(s):  
Michael Higgins ◽  
Ryan T. Tierney ◽  
Jeffrey B. Driban ◽  
Steven Edell ◽  
Randall Watkins
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Repeated Measures ◽  
Cervical Spinal Cord ◽  
Spine Injury ◽  
Imaging Center ◽  
Mri Scans ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Cervical Spine Alignment

Abstract Context: Removal of the lacrosse helmet to achieve airway access has been discouraged based only on research in which cervical alignment was examined. No researchers have examined the effect of lacrosse equipment on the cervical space available for the spinal cord (SAC). Objective: To determine the effect of lacrosse equipment on the cervical SAC and cervical-thoracic angle (CTA) in the immobilized athlete. Design: Observational study. Setting: Outpatient imaging center. Patients or Other Participants: Ten volunteer lacrosse athletes (age  =  20.7 ± 1.87 years, height  =  180.3 ± 8.3 cm, mass  =  91 ± 12.8 kg) with no history of cervical spine injury or disease and no contraindications to magnetic resonance imaging (MRI). Intervention(s): The lacrosse players were positioned supine on a spine board for all test conditions. An MRI scan was completed for each condition. Main Outcome Measure(s): The independent variables were condition (no equipment, shoulder pads only [SP], and full gear that included helmet and shoulder pads [FG]), and cervical spine level (C3–C7). The dependent variables were the SAC and CTA. The MRI scans were evaluated midsagittally. The average of 3 measures was used as the criterion variable. The SAC data were analyzed using a 3 × 5 analysis of variance (ANOVA) with repeated measures. The CTA data were analyzed with a 1-way repeated-measures ANOVA. Results: We found no equipment × level interaction effect (F3.7,72  =  1.34, P  =  .279) or equipment main effect (F2,18  =  1.20, P  =  .325) for the SAC (no equipment  =  5.04 ± 1.44 mm, SP  =  4.69 ± 1.36 mm, FG  =  4.62 ± 1.38 mm). The CTA was greater (ie, more extension; critical P  =  .0167) during the SP (32.64° ± 3.9°) condition than during the no-equipment (25.34° ± 2.3°; t9  =  7.67, P  =  .001) or FG (26.81° ± 5.1°; t9  =  4.80, P  =  .001) condition. Conclusions: Immobilizing healthy lacrosse athletes with shoulder pads and no helmets affected cervical spine alignment but did not affect SAC. Further research is needed to determine and identify appropriate care of the lacrosse athlete with a spine injury.

scholarly journals Case Series of an Intraoral Balancing Appliance Therapy on Subjective Symptom Severity and Cervical Spine Alignment

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Young Jun Lee ◽  
Joo Kang Lee ◽  
Soo Chang Jung ◽  
Hwang-woo Lee ◽  
Chang Shik Yin ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Symptom Severity ◽  
Case Series ◽  
Subjective Symptom ◽  
Cervical Spine Alignment

scholarly journals Histologic and Laboratory Characteristics of Symptomatic and Asymptomatic Castleman Disease in the Pediatric Population

2020 ◽  
Vol 153 (6) ◽  
pp. 821-832
Author(s):  
Karen M Chisholm ◽  
Mark D Fleming
Keyword(s):  
Lymph Nodes ◽  
Pediatric Population ◽  
Germinal Centers ◽  
Castleman Disease ◽  
Microcytic Anemia ◽  
Laboratory Findings ◽  
Reactive Protein ◽  
Asymptomatic Patients ◽  
Histopathologic Evaluation ◽  
Clinical Records

Abstract Objectives Compare the morphologic, laboratory, and clinical features of asymptomatic and symptomatic Castleman disease in the pediatric population. Methods We reviewed clinical records and histopathology of patients with Castleman disease from 2 pediatric institutions. Results Of 39 patients with pediatric Castleman disease, 37 had unicentric disease, all classified with the hyaline vascular variant of Castleman disease, 8 of which were clinically symptomatic. These 8 patients demonstrated abnormal laboratory findings, including microcytic anemia, elevated erythrocyte sedimentation rate and C-reactive protein, and hypoalbuminemia. In addition, histopathologic evaluation showed that the 8 symptomatic cases had more hyperplastic germinal centers, fewer atrophic or regressed germinal centers, fewer mantle zones containing multiple germinal centers, reduced “onion skinning” of mantle zones, and fewer “lollipop” formations compared with the asymptomatic cases. Conclusions This series of pediatric Castleman disease showed that lymph nodes from asymptomatic patients generally demonstrated the more classic hyaline vascular histology, whereas those with symptoms could lack or have only focal classic findings. As such, reactive lymph nodes with subtle Castleman-like features should prompt clinical correlation to ensure proper diagnosis.

scholarly journals Analysis of Cervical Spine Alignment and its Relationship with Other Spinopelvic Parameters after Laminoplasty in Patients with Degenerative Cervical Myelopathy

2020 ◽  
Vol 9 (3) ◽  
pp. 713 ◽  
Author(s):  
Seok Woo Kim ◽  
Seung Bo Jang ◽  
Hyung Min Lee ◽  
Jeong Hwan Lee ◽  
Min Uk Lee ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Posterior Longitudinal Ligament ◽  
Intervertebral Disc Herniation ◽  
Spinopelvic Parameters ◽  
Cervical Alignment ◽  
Before And After ◽  
Reducible Group ◽  
Cervical Spine Alignment ◽  
Degenerative Cervical Myelopathy ◽  
Cervical Motion

For patients with kyphosis of the cervical spine, laminoplasty is usually incapable of improving neurological symptoms as it worsens kyphotic alignment. Thus, laminoplasty is not recommended in the presence of kyphotic alignment. Nevertheless, laminoplasty may be selected for myelopathy due to multiple-segment intervertebral disc herniation or ossification of posterior longitudinal ligament despite kyphotic alignment. This study examined whether cervical alignment influences surgical outcomes. Cervical alignment before the surgery was classified into lordosis and non-lordosis, and the non-lordosis group was subclassified into reducible and non-reducible groups to determine the change in cervical alignment before and after the surgery and to analyze its relationship with spinopelvic parameters. The lordosis group showed an increase in upper cervical motion (C0-2 Range of Motion (ROM), C0-2ROM/C0-7ROM) after surgery, while the non-lordosis group exhibited a decrease in C2-7ROM and C0-7ROM. The C0-2ROM was maintained without any reduction in the reducible group, while there was no significant change in cervical alignment and ROM of the non-reducible group. None of these changes showed significant association with the spinopelvic parameters of other sites. However, having a non-reducible type non-lordosis is not a proper indication for laminoplasty, as it does not change the alignment after surgery. Therefore, cervical alignment and reducibility should be identified before surgery.

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