scholarly journals Cervical Spine Injuries with Acute Traumatic Spinal Cord Injury – Spinal Surgery Adverse Events and Their Association with Neurological and Functional Outcome

Spine ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Thomas Liebscher ◽  
Johanna Ludwig ◽  
Tom Lübstorf ◽  
Martin Kreutzträger ◽  
Thomas Auhuber ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spine ◽  
Adverse Events ◽  
Functional Outcome ◽  
Spinal Surgery ◽  
Traumatic Spinal Cord Injury ◽  
Cervical Spine Injuries ◽  
Cord Injury ◽  
Spine Injuries

Evaluation of cervical spine injury and predicting neurological deficit by magnetic resonance imaging

2021 ◽  
Vol 12 (2) ◽  
pp. 92-97
Author(s):  
Sushant H Bhadane ◽  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spine ◽  
Mr Imaging ◽  
Neurological Deficit ◽  
Spine Injury ◽  
Cervical Spine Injuries ◽  
Cord Injury ◽  
Spine Injuries ◽  
Posterior Element

Background: The consequences of cervical spine injuries range from simple neck pain, to quadriplegia, or even death. MR imaging has become part of the diagnostic and prognostic tools for spinal cord injury. Aim: To prospectively evaluate cervical spine injuries by MR imaging and to find out association of MR imaging findings with degree of neurological deficit. Material and Methods: Descriptive longitudinal hospital based study was conducted on 30 patients with known or suspected cervical spine trauma who presented to the emergency department. Results: Mean age of the cases was about 42 years, with female to male ratio of 1:6.5. C6-C7 spinal level was most commonly involved. Proportions complete spinal cord injury (CSCI), incomplete spinal cord injury (ISCI) and neurologically normal (NN) were 23.33%, 60% and 16.67% respectively. Out of 12 MRI findings, cord haemorrhage, contusion, posterior element fracture, disc injury, prevertebral hematoma, subluxation and soft tissue injury was statistically associated with degree of neurological deficit. Cord contusion, cord haemorrhage and posterior element fracture were potential predictors of neurological status at admission. Cord contusion, cord haemorrhage and subluxation were potential predictors at 3 months. Conclusion: MRI proved a pivotal role in the diagnosis of SCIs, deciding prompt management and predicting neurological deficit and prognosis of neurological recovery. So, MRI is an excellent diagnostic modality for the evaluation of spinal trauma and predicting the degree of neurological deficit and recovery.

Management of Athletic Injuries of the Cervical Spine and Spinal Cord

Neurosurgery ◽  
1991 ◽  
Vol 29 (4) ◽  
pp. 491-497 ◽  
Author(s):  
Julian E. Bailes ◽  
Mark N. Hadley ◽  
Matthew R. Quigley ◽  
Volker K.H. Sonntag ◽  
Leonard J. Cerullo
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spine ◽  
Vertebral Column ◽  
Sporting Events ◽  
Cervical Spine Injuries ◽  
Contact Sports ◽  
Cord Injury ◽  
Spine Injuries

Abstract Injuries to the cervical spine among athletes present inherent difficulties, especially in advising for return to contact sports. Experience with the acute care of 63 patients who sustained cervical spine injuries while participating in organized sporting events is analyzed. Forty-five patients had permanent injury to the vertebral colum n and/or spinal cord, while 18 suffered only transient spinal cord symptoms. Football mishaps accounted for the highest number of injuries, followed by wrestling and gymnastics. Twelve patients had complete spinal cord injury, 14 patients had incomplete spinal cord injury, and 19 patients had injury to the vertebral column alone. The majority of the spinal cord lesions occurred at the C4 and C5 levels, while bony injuries of C4 through C6 predominated. Twenty-five patients required surgical stabilization, and 20 were treated with orthosis only. There was no instance of associated systemic injuries, and hospital complications were few. The mean time of hospitalization was 19.1 days for injured patients and 3.0 days for patients with transient symptoms. A classification was developed to assist in the management of these patients: Type 1 athletic injuries to the cervical spine are those that cause neurological injury; patients with Type 1 injuries are not allowed to participate in contact, competitive sporting events. Type 2 injuries consist of transient neurological deficits without radiological evidence of abnormalities; these injuries usually do not prohibit further participation in contact sports unless they become repetitive. Type 3 injuries are those that cause radiological abnormality alone; these represent a heterogeneous group. The athlete with fractures involving a significant structural portion of the vertebral column, ligament instability, spinal cord contusion, or congenital cervical stenosis, is advised not to return to contact sports. Other radiological abnormalities, such as compromise of the ligaments, congenital fusion, degenerative disease, and herniated cervical disc require individual consideration. The rationale for treatment and advising for participation in sports are discussed. We believe that this classification of sports injuries offers clinicians a framework within which to make rational judgments and recommendations in the management of athletes with cervical spine injuries.

scholarly journals Persistent Hypertensive Response Following Dexmedetomidine Infusion in a Patient with Cervical Spinal Cord Injury

2018 ◽  
Vol 09 (03) ◽  
pp. 426-427 ◽  
Author(s):  
Siddharth Chavali ◽  
Shalendra Singh ◽  
Ashutosh Kaushal ◽  
Ankur Khandelwal ◽  
Hirok Roy
Keyword(s):  
Intensive Care Unit ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Intensive Care ◽  
Cervical Spine ◽  
Cervical Spinal Cord ◽  
Cervical Spine Injuries ◽  
Cord Injury ◽  
Spine Injuries ◽  
Dexmedetomidine Infusion

ABSTRACTWe report a 19-year-old male patient, an operated case of anterior cervical discectomy and fusion for traumatic C5–C6 vertebral injury, who developed persistent hypertension following dexmedetomidine infusion in the Intensive Care Unit to enable tolerance of noninvasive ventilation mask. This unusual side effect should be borne in mind when using this drug in patients with cervical spine injuries.

scholarly journals Operative Treatment of Severe Cervical Spine Injuries Sustained in Youth Sports: Experience from a Pediatric Level 1 Trauma Center over a 16-Year Period

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0008
Author(s):  
Bram P Verhofste ◽  
Daniel J Hedequist ◽  
Craig M Birch ◽  
Emily S Rademacher ◽  
Michael P Glotzbecker ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Trauma Center ◽  
Youth Sports ◽  
Axial Loading ◽  
Permanent Disability ◽  
Cervical Spine Injuries ◽  
Cord Injury ◽  
Spine Injuries ◽  
Level 1

Background: Sports-related cervical spine injuries (CSI) are devastating traumas with the potential for permanent disability. There is a paucity of literature on operative CSI sustained in youth athletes. Hypothesis/Purpose: The aims of this study aims were to review injury characteristics, surgical treatment, and outcomes of severe pediatric CSI encountered in youth sports. Methods: We reviewed children less than 18 years old with operative sports-related CSI at a pediatric Level 1 pediatric trauma center between 2004−2019. All cases underwent modern cervical spine instrumentation and fusion. SCI were stratified according to the American Spinal Injury Association Impairment Scale (ASIA). Clinical, radiographic, and surgical characteristics were compared between groups of patients with and without spinal cord injury (SCI). Results: Three thousand two hundred and thirty-one children (mean, 11.3y±4.6y) were evaluated for CSI at our institution during the 16-year period. The majority of traumas resulted from sports/recreational activities and were seen in 1365 cases (42.3%). Of these, 171/1365 patients (12.5%) were admitted and 29/1365 patients (2.1%) required surgical intervention (mean age, 14.5y±2.88y; range, 6.4y–17.8y). Sports included: eight football (28%), seven wrestling (24%), five gymnastics (17%), four diving (14%), two trampoline (7%), one hockey (3%), one snowboarding (3%), and one biking injury (3%). Mechanisms were 19 hyperflexion (65%), eight axial loading (28%), and two hyperextension injuries (7%). The majority of operative CSI were fractures (79%) and/or subaxial defects (72%). Seven patients (30%) sustained SCI and three patients (10%) spinal cord contusion or myelomalacia without neurologic deficits. The risk of SCI increased with age (15.8y vs. 14.4y; p=0.03) and axial loading mechanism (71% vs. 14%; p=0.003). Postoperatively, two SCI patients (29%) improved 1 ASIA Grade and one (14%) improved 2 ASIA Grades. Increased complications developed in SCI than patients without SCI (mean, 2.0 vs 0.1 complications; p=0.02). Clinical and radiographic fusion occurred in 24/26 patients (92%) with adequate follow-up (median, 32 months). Ten patients returned to their previous activity and nine to sports with a lower level of activity. Conclusion: The overall incidence of sports-related operative CSI is low. Age- and gender discrepancies exist, with male adolescent athletes most commonly requiring surgery. Hyperflexion injuries had a good prognosis; however, older males with axial loading CSI sustained in contact sports were at greatest risk of SCI, complications, and permanent disability. [Figure: see text][Table: see text][Table: see text]

scholarly journals A Clinical Prediction Model for Long-Term Functional Outcome after Traumatic Spinal Cord Injury Based on Acute Clinical and Imaging Factors

2012 ◽  
Vol 29 (13) ◽  
pp. 2263-2271 ◽  
Author(s):  
Jefferson R. Wilson ◽  
Robert G. Grossman ◽  
Ralph F. Frankowski ◽  
Alexander Kiss ◽  
Aileen M. Davis ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Prediction Model ◽  
Functional Outcome ◽  
Traumatic Spinal Cord Injury ◽  
Clinical Prediction ◽  
Clinical Prediction Model ◽  
Cord Injury

Reliability of the spine adverse events severity system (SAVES) for individuals with traumatic spinal cord injury

Spinal Cord ◽  
2014 ◽  
Vol 52 (10) ◽  
pp. 758-763 ◽  
Author(s):  
R A Glennie ◽  
V K Noonan ◽  
N Fallah ◽  
S E Park ◽  
N P Thorogood ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Adverse Events ◽  
Traumatic Spinal Cord Injury ◽  
Cord Injury

scholarly journals Protocol for rapid onset of mobilisation in patients with traumatic spinal cord injury (PROMPT-SCI) study: a single-arm proof-of-concept trial of early in-bed leg cycling following acute traumatic spinal cord injury

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e049884
Author(s):  
Jean-Marc Mac-Thiong ◽  
Andreane Richard-Denis ◽  
Yvan Petit ◽  
Francis Bernard ◽  
Dorothy Barthélemy ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Patient Outcomes ◽  
Spinal Surgery ◽  
Rapid Onset ◽  
Traumatic Spinal Cord Injury ◽  
Proof Of Concept ◽  
Historical Cohort ◽  
Cord Injury ◽  
Leg Cycling

IntroductionActivity-based therapy (ABT) is an important aspect of rehabilitation following traumatic spinal cord injury (SCI). Unfortunately, it has never been adapted to acute care despite compelling preclinical evidence showing that it is safe and effective for promoting neurological recovery when started within days after SCI. This article provides the protocol for a study that will determine the feasibility and explore potential benefits of early ABT in the form of in-bed leg cycling initiated within 48 hours after the end of spinal surgery for SCI.Methods and analysisPROMPT-SCI (protocol for rapid onset of mobilisation in patients with traumatic SCI) is a single-site single-arm proof-of-concept trial. Forty-five patients aged 18 years or older with a severe traumatic SCI (American Spinal Injury Association Impairment Scale grade A, B or C) from C0 to L2 undergoing spinal surgery within 48 hours of the injury will be included. Participants will receive daily 30 min continuous sessions of in-bed leg cycling for 14 consecutive days, initiated within 48 hours of the end of spinal surgery. The feasibility outcomes are: (1) absence of serious adverse events associated with cycling, (2) completion of 1 full session within 48 hours of spinal surgery for 90% of participants and (3) completion of 11 sessions for 80% of participants. Patient outcomes 6 weeks and 6 months after the injury will be measured using neurofunctional assessments, quality of life questionnaires and inpatient length of stay. Feasibility and patient outcomes will be analysed with descriptive statistics. Patient outcomes will also be compared with a matched historical cohort that has not undergone in-bed cycling using McNemar and Student’s t-tests for binary and continuous outcomes, respectively.Ethics and disseminationPROMPT-SCI is approved by the Research Ethics Board of the CIUSSS NIM. Recruitment began in April 2021. Dissemination strategies include publications in scientific journals and presentations at conferences.Trial registration numberNCT04699474.

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