Thoracolumbar, lumbar, and sacral fractures

2011 ◽  
Author(s):  
Philip Sell
Keyword(s):  
Surgical Treatment ◽  
Spinal Injury ◽  
Spinal Fractures ◽  
High Energy ◽  
Classification Systems ◽  
Junctional Zone ◽  
Cord Injury ◽  
Fracture Classification Systems ◽  
Non Surgical Treatment

♦ High-energy trauma often results in serious spinal fractures. The junctional zone between the relatively stiff thoracic spine and the more mobile lumbar spine is particularly susceptible to injury♦ The role of decompression in spinal cord injury remains uncertain at level three or four evidence♦ Unstable fractures may be stabilized using modern fracture fixation methods enabling easier nursing care in polytrauma and earlier mobilization than non-surgical treatment♦ There is level two evidence that stable thoracolumbar fractures have similar outcomes with surgical and non-surgical treatment♦ There are many fracture classification systems that are not validated or have poor inter- and intraobserver error. Recent modern validated systems may in the future assist in the rational planning of interventions for spinal injury.

scholarly journals Controversies in the Surgical Management of Spinal Cord Injuries

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Ahmed M. Raslan ◽  
Andrew N. Nemecek
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Surgical Management ◽  
Spinal Cord Injuries ◽  
Late Onset ◽  
Initial Step ◽  
Outcome Data ◽  
Cord Injury ◽  
The Usa

Traumatic spinal cord injury (SCI) affects over 200,000 people in the USA and is a major source of morbidity, mortality, and societal cost. Management of SCI includes several components. Acute management includes medical agents and surgical treatment that usually includes either all or a combination of reduction, decompression, and stabilization. Physical therapy and rehabilitation and late onset SCI problems also play a role. A review of the literature in regard to surgical management of SCI patients in the acute setting was undertaken. The controversy surrounding whether reduction is safe, or not, and whether prereduction magnetic resonance (MR) imaging to rule out traumatic disc herniation is essential is discussed. The controversial role of timing of surgical intervention and the choice of surgical approach in acute, incomplete, and acute traumatic SCI patients are reviewed. Surgical treatment is an essential tool in management of SCI patients and the controversy surrounding the timing of surgery remains unresolved. Presurgical reduction is considered safe and essential in the management of SCI with loss of alignment, at least as an initial step in the overall care of a SCI patient. Future prospective collection of outcome data that would suffice as evidence-based is recommended and necessary.

scholarly journals Our results in the treatment of tarsal dislocations

2020 ◽  
Vol 148 (9-10) ◽  
pp. 554-559
Author(s):  
Maksim Kovacevic ◽  
Marijana Kovacevic ◽  
Sanja Maric ◽  
Nenad Lalovic ◽  
Milivoje Dostic ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Functional Result ◽  
Functional Results ◽  
High Energy ◽  
University Hospital ◽  
Adequate Treatment ◽  
Tarsometatarsal Dislocation ◽  
Excellent Functional Result ◽  
The University ◽  
Non Surgical Treatment

Introduction/Objective. Tarsal dislocations are rare injuries. Usually, they are caused by high-energy trauma. Depending on the type of dislocation, surgical treatment or closed reduction is used. In this study, 13 patients are presented with the aim to analyze the type of feet dislocations, their treatment, and outcome. Methods. Tarsal dislocation cases treated in the University Hospital in Foca were analyzed during the period 2009?2016. All the cases were clinically and radiographically examined and monitored on control examinations at least three years. The mobility of joints was measured and pain existence was estimated by visual analogue scale. Results. All 13 patients with tarsal dislocation were male. Four patients were treated surgically (two patients with tarsometatarsal and one with cuboid and navicular dislocation) and other patients had non-surgical treatment. In 10 patients, an excellent functional result has been achieved and in two patients with tarsometatarsal dislocation a good functional result. In one patient with cuboidal dislocation satisfactory functional result has been achieved. Conclusion. Out of the 13 reviewed patients with tarsal dislocations, functional results were rated as excellent in 10 dislocations, good in two, and satisfactory in one. Diagnosis and treatment of foot dislocations are demanding, but a favorable functional outcome can be expected with an adequate treatment of these injuries.

Critical role of microglia in the inflammatory response after spinal injury

2015 ◽  
Vol 3 (3) ◽  
pp. 453-462
Author(s):  
Ya-Yun Shi
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Inflammatory Responses ◽  
Spinal Injury ◽  
Critical Role ◽  
Cell Types ◽  
Inflammatory Factors ◽  
Cytokines And Chemokines ◽  
Cord Injury

Spinal cord injury induces a robust neuroinflammatory response that includes marked changes in the variety of endogenous CNS cell types specially microglia. In response to spinal injury, microglia undergo dramatic changes in cell morphology and promote inflammatory responses, which result in production of inflammatory factors and oxidative stress including reactive oxygen species. Further pro-inflammatory cytokines and chemokines are also rapidly up-regulated and likely contribute to microglial activation. This topic review will explore the current research on microglial responses to spinal injury and the recent progress in the pharmacologic and molecular targeting of microglia in spinal injury. Finally, we explore the argument for a positive versus negative role of microglia after spinal cord injury.

scholarly journals Non-surgical treatment of uterine fibroids. Efficacy of the selective progesterone receptor modulator

2019 ◽  
pp. 13-20
Author(s):  
E. R. Dovletkhanova ◽  
E. A. Mezhevitinova ◽  
V. N. Prilepskaya
Keyword(s):  
Surgical Treatment ◽  
Uterine Leiomyoma ◽  
Experimental Studies ◽  
Uterine Fibroids ◽  
Leading Role ◽  
Receptor Modulator ◽  
Genetic Mechanisms ◽  
Non Surgical Treatment

The leading role of ovarian steroid hormones in the pathogenesis of uterine fibroids is confirmed by epidemiological, clinical and experimental studies. The new approaches to the treatment of this disease may be developed on the basis of the biological and genetic mechanisms underlying the occurrence and development of leiomyomas. The use of ulipristal acetate in patients with uterine leiomyoma may be a promising method for preparing them to the surgical procedures, but also for avoiding surgical treatment and related hypoestrogenic conditions, which results in the improvement of the women’s quality of life.

scholarly journals MEDICAL CARE TO PATIENTS WITH COMBINED VERTEBRAL-AND-SPINE INJURY AT TRAUMATOLOGY CENTERS OF 1 LEVEL ON FEDERAL HIGHWAYS M5, M7

2010 ◽  
Vol 16 (2) ◽  
pp. 59-61
Author(s):  
S. A. Islamov ◽  
V. V. Nikitin ◽  
A. A. Faizullin
Keyword(s):  
Surgical Treatment ◽  
Medical Care ◽  
Spinal Injury ◽  
Spine Injury ◽  
Care Organization ◽  
Locomotor System ◽  
Effective Form ◽  
Cord Injury ◽  
Priority Direction ◽  
Stage System

The aim of the work is the optimizing the organization of medical care to victims of accidents on federal roads M5 and M7. The priority direction in improving outcomes of treatment in patients with polytrauma is an organization of all the processes of diagnostics, resuscitation and surgical treatment based on the timeliness and appropriateness. A special feature of motor accidents in Russia is a long period of patients isolation affected due to geographical features, that in combination with low temperatures increases the proportion of irreversible losses. In UGKB № 21 for the last 5 years 1315 patients with polytrauma were treated. A retrospective study of clinical data showed that among them persons with injuries of the locomotor system amounted to 1,196 (91%), abdomen - 79 (6%), chest - 197 (15%), central and peripheral nervous system - ИЗО (86%). The victims with vertebral-spinal injury amounted to 96 (8%). Surgical treatment was performed after normalization of the patient general condition from 2 to 5 phases of medical care, poor results were obtained in 4 (1%) cases. The most effective form of medical care organization for vertebral-spinal cord injury is a two-stage system.

scholarly journals Outcome in patients undergoing surgery for spinal injury in an Ethiopian hospital

2015 ◽  
Vol 23 (6) ◽  
pp. 772-779 ◽  
Author(s):  
Martin Andreas Lehre ◽  
Lars Magnus Eriksen ◽  
Abenezer Tirsit ◽  
Segni Bekele ◽  
Saba Petros ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Surgical Treatment ◽  
Motor Vehicle ◽  
Spinal Injury ◽  
Addis Ababa ◽  
Cord Injury ◽  
Spine Injuries ◽  
Tract Infections

OBJECT The objective of this study was to investigate epidemiology and outcome after surgical treatment for spinal injuries in Ethiopia. METHODS Medical records of patients who underwent surgery for spine injuries at Myungsung Christian Medical Center in Addis Ababa, Ethiopia, between January 2008 and September 2012 were reviewed retrospectively. Assessment of outcome and complications was determined from patient consultations and phone interviews. RESULTS A total of 146 patients were included (129 males, 17 females). Their mean age was 31.7 years (range 15–81 years). The leading cause of injury was motor vehicle accidents (54.1%), and this was followed by falls (26.7%). The most common injury sites were lumbar (41.1%) and cervical (34.2%) regions of the spine. In 21.2% of patients, no neurological deficit was present before surgery, 46.6% had incomplete spinal cord injury (American Spinal Injury Association [ASIA] Impairment Scale [AIS] Grade B-D), and 32.2% had complete spinal cord injury (AIS Grade A). Follow-up was hampered by suboptimal infrastructure, but information regarding outcome was successfully obtained for 110 patients (75.3%). At follow-up (mean 22.9 months; range 2–57 months), 25 patients (17.1%) were confirmed dead and 85 patients (58.2%) were alive; 49 patients (33.6%) underwent physical examination. At least 8 of the 47 patients (17.0%) with a complete injury and 29 of the 68 patients (42.6%) with an incomplete injury showed neurological improvement. The reported incidences of pressure wounds, recurrent urinary tract infections, pneumonia, and thromboembolic events were 22.5%, 13.5%, 5.6%, and 1.1%, respectively. CONCLUSIONS Patients showed surprisingly good recovery considering the limited resources. Surgical treatment for spine injuries in Ethiopia is considered beneficial.

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