Contribution to the Surgical Treatment of Patients with Cervical Spine Cord Injury Using Simple Procedures

2003 ◽  
Vol 33 (1) ◽  
pp. 13-14 ◽  
Author(s):  
Manoel B Leal ◽  
Guilherme Borges ◽  
Benedito Borges da Silva ◽  
Bruno Ribeiro de Almeida
Keyword(s):  
Cervical Spine ◽  
Anterior Approach ◽  
Posterior Approach ◽  
Spine Fractures ◽  
Cervical Injury ◽  
Technical Problems ◽  
Cord Injury ◽  
The Moment ◽  
Cervical Spine Fractures

Thirty-nine patients with acute cervical spine fractures and/or dislocations between C3 and C7 were submitted to an anterior approach using bone graft fixation without screw and plate systems and three required a preliminary posterior approach to reduce a dislocation. Graft dislodgement due to technical problems occurred at a rate of 7.7% postoperatively and 2.8% 1 month later. No redislodgement occurred. All fusions became solid after 3 months. Their progress was based on the Frankel scale, before surgery, at the moment of the discharge, and at 6 months follow-up. This experience shows how patients with an acute cervical injury can improve even when admitted late after trauma.

Recovery of Nerve Root Function after Complete Quadriplegia from Cervical Spine Fractures

Neurosurgery ◽  
1986 ◽  
Vol 19 (5) ◽  
pp. 809-812 ◽  
Author(s):  
C. Benzel Edward ◽  
J. Larson Sanford
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Nerve Root ◽  
Root Function ◽  
Spine Fractures ◽  
Anterior Decompression ◽  
Cord Injury ◽  
Nerve Root Decompression ◽  
Anterior Decompression And Fusion ◽  
Cervical Spine Fractures

Abstract Thirty-five patients with complete myelopathies secondary to cervical spine fractures from C-4 to C-7 underwent spinal decompressions and fusions between 1975 and 1981. Twenty-five of these patients underwent simultaneous nerve root decompressions, 23 with an accompanying anterior decompression and fusion and 2 with an accompanying posterior fusion. Substantial recovery of nerve root function occurred in 15 of these patients. A posterior reduction and fusion without nerve root decompression was performed in each of the remaining 10 patients. None of these patients demonstrated a significant improvement neurologically. Operation for nerve root decompression is indicated in selected victims of spinal cord injury.

Pilot Study: Age As A factor in Time To Surgery For Traumatic Cervical Spine Fracture Patients

2020 ◽  
Author(s):  
Ashley Chory ◽  
Matthew Bank ◽  
Cristina Sison ◽  
Ona Bloom
Keyword(s):  
Cervical Spine ◽  
Pilot Study ◽  
Statistical Difference ◽  
The Elderly ◽  
Spine Fractures ◽  
Time To Surgery ◽  
Cord Injury ◽  
Cervical Spine Fractures ◽  
Long Term Mortality

Abstract INTRODUCTION: Cervical spine fractures with or without spinal cord injury (SCI) disproportionately impact the elderly, who constitute an increasing percentage of the US population. Early surgical intervention is a safe, modifiable factor that enables early mobilization and subsequent reduction in complications and hospital length of stay. Surgical treatment of the elderly is complex, due to increased comorbidity factors and complications. METHODS: In a pilot study from a Level 1 Trauma Center, we analyzed the number of patients treated with cervical spine fractures with or without SCI by age group (<65, 65-84, 85) and determined the influence of age on time-to-surgery and long-term mortality. Acute in-hospital mortality was calculated and long-term mortality within the study period (2003-2013) was determined from the National Death Index. RESULTS: Data from patients (N=72) with cervical spine fractures treated surgically were analyzed, with nearly equal numbers under or over age 65. Although there was a trend of increasing time to surgery with increasing age, there was no statistical difference between the age groups (p=0.7015). The average time to surgery was less for patients with SCI than for all patients, and less for patients with than without central cord syndrome. The average time to surgery was longer for patients with vertebral fractures than for patients with SCI. There was no statistical difference for in-hospital or long-term mortality for patients with or without SCI or among the time-to-surgery groups. However, this is likely due to the low number of cases in this pilot study. CONCLUSION: Data from this pilot study indicate an association between time to surgery and survival status of patients in any age or time-to-surgery groups examined. This analysis will enable a larger future prospective study and local quality control initiatives to collect additional data on factors influencing time-to-surgery in patients with cervical spine fractures.

scholarly journals Risk factors of neurological lesions in low cervical spine fractures and dislocations

2000 ◽  
Vol 58 (4) ◽  
pp. 1030-1034 ◽  
Author(s):  
DANILO GONÇALVES COELHO ◽  
ALBERT V. B. BRASIL ◽  
NELSON PIRES FERREIRA
Keyword(s):  
Risk Factors ◽  
Spinal Cord ◽  
Cervical Spine ◽  
Spinal Cord Injuries ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Spine Fractures ◽  
Nerve Root Injury ◽  
Cord Injury ◽  
Cervical Spine Fractures

Eighty-nine patients with lower cervical spine fractures or dislocations were evaluated for risk factors of neurological lesion. The age, sex, level and pattern of fracture and sagittal diameter of the spinal canal were analysed. There were no significant differences on the age, gender, level and Torg's ratio between intact patients and those with nerve root injury, incomplete or complete spinal cord injuries. Bilateral facet dislocations and burst fractures are a significant risk factor of spinal cord injury.

Health care burden of cervical spine fractures in the United States: analysis of a nationwide database over a 10-year period

2010 ◽  
Vol 13 (1) ◽  
pp. 61-66 ◽  
Author(s):  
Ali A. Baaj ◽  
Juan S. Uribe ◽  
Tann A. Nichols ◽  
Nicholas Theodore ◽  
Neil R. Crawford ◽  
...  
Keyword(s):  
Health Care ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spine ◽  
Adverse Outcomes ◽  
Spine Fractures ◽  
Cord Injury ◽  
The Us ◽  
Discharge Status ◽  
Cervical Spine Fractures

Object The objective of this work was to search a national health care database of patients diagnosed with cervical spine fractures in the US to analyze discharge, demographic, and hospital charge trends over a 10-year period. Methods Clinical data were derived from the Nationwide Inpatient Sample (NIS) for the years 1997 through 2006. The NIS is maintained by the Agency for Healthcare Research and Quality and represents a 20% random stratified sample of all discharges from nonfederal hospitals within the US. Patients with cervical spine fractures with and without spinal cord injury (SCI) were identified using the appropriate ICD-9-CM codes. The volume of discharges, length of stay (LOS), hospital charges, total national charges, discharge pattern, age, and sex were analyzed. National estimates were calculated using the HCUPnet tool. Results Approximately 200,000 hospitalizations were identified. In the non-SCI group, there was a 74% increase in hospitalizations and charges between 1997 and 2006, but LOS changed minimally. There was no appreciable change in the rate of in-hospital mortality (< 3%), but discharges home with home health care and to skilled rehabilitation or nursing facilities increased slightly. In the SCI group, hospitalizations and charges increased by 29 and 38%, respectively. There were no significant changes in LOS or discharge status in this group. Spinal cord injury was associated with increases in LOS, charges, and adverse outcomes compared with fractures without SCI. Total national charges associated with both groups combined exceeded $1.3 billion US in 2006. Conclusions During the studied period, increases in hospitalizations and charges were observed in both the SCI and non-SCI groups. The percentage increase was higher in the non-SCI group. Although SCI was associated with higher adverse outcomes, there were no significant improvements in immediate discharge status in either group during the 10 years analyzed.

Halo immobilization of cervical spine fractures

1979 ◽  
Vol 50 (5) ◽  
pp. 603-610 ◽  
Author(s):  
Paul R. Cooper ◽  
Kenneth R. Maravilla ◽  
Frederick H. Sklar ◽  
Sarah F. Moody ◽  
W. Kemp Clark
Keyword(s):  
Cervical Spine ◽  
Cervical Spinal Cord ◽  
Plaster Cast ◽  
Patient Acceptance ◽  
Spine Fractures ◽  
Cervical Fusion ◽  
Content Type ◽  
Bone Injury ◽  
Cord Injury ◽  
Cervical Spine Fractures

✓ Thirty-three patients with a spectrum of cervical spine fractures or subluxations were treated with immobilization by a halo apparatus. All spines were assumed to be unstable because of the nature of the fracture or because of a subluxation noted on spine films. Treatment consisted of immobilization and fracture reduction followed by application of a halo plaster cast or molded halo plastic vest. Patient acceptance was high. Complications were few and minor. No patient experienced neurological deterioration during treatment. Reduction was well maintained during an average halo immobilization period of over 3 months. Use of the halo resulted in healing of bone and ligament and restoration of stability in 85% of the patients. Halo immobilization was efficacious in the treatment of odontoid and hangman's fractures as well as complex fractures involving multiple areas of a single vertebra. It was also used successfully as an adjunct to posterior cervical fusion. Although several patients with subluxations or angulation without bone injury were treated successfully, two of the four therapy failures occurred in this group of patients, and the halo must be used with caution in this clinical setting. Contraindications to the use of the halo include complete cervical spinal cord injury with anesthetic skin, tomographic and/or myelographic evidence of disc or bone within the spinal canal, and unsatisfactorily reduced subluxations. The halo has provided more effective and reliable immobilization than other orthoses. It is an acceptable alternative to cervical fusion for the achievement of stability in a wide variety of cervical spine fractures and dislocations avoiding both the short-term and perhaps long-term complications of spinal fusion.

scholarly journals Single-Session Combined Anterior-Posterior Approach for Treatment of Ankylosing Spondylitis with Obvious Displaced Lower Cervical Spine Fractures and Dislocations

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Baohui Yang ◽  
Teng Lu ◽  
Haopeng Li
Keyword(s):  
Cervical Spine ◽  
Posterior Approach ◽  
Perioperative Complications ◽  
Spine Fractures ◽  
Lower Cervical Spine ◽  
Single Session ◽  
Surgical Methods ◽  
Single Posterior Approach ◽  
Cervical Spine Fractures ◽  
Anterior Posterior

For patients with AS and lower cervical spine fractures, surgical methods have mainly included the single anterior approach, single posterior approach, and combined anterior-posterior approach. However, various surgical procedures were utilized because the fractures have not been clearly classified according to presence of displacement in these previous studies. Consequently, controversies have been raised regarding the selection of the surgical procedure. This study retrospective analysis was conducted in 12 patients with AS and lower cervical spine fractures and dislocations and explored single-session combined anterior-posterior approach for the treatment of AS with obvious displaced lower cervical spine fractures and dislocations which has demonstrated advantages such as good stabilization, satisfied fracture healing, and easy postoperative cares. However, to some extent, the difficulty and risk of this approach should be considered. Attention should be paid to the prevention of perioperative complications.

scholarly journals Outcomes of Halo Immobilization for Cervical Spine Fractures

2019 ◽  
Vol 9 (5) ◽  
pp. 521-526 ◽  
Author(s):  
Stacey Isidro ◽  
Robert Molinari ◽  
Tochukwu Ikpeze ◽  
Cesar Hernandez ◽  
Mohamed Salah Mahmoudi ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Clinical Success ◽  
Complication Rates ◽  
Spine Fractures ◽  
Fracture Length ◽  
Cervical Fractures ◽  
Upper Cervical ◽  
Level I ◽  
Cervical Spine Fractures

Study Design: Retrospective. Objectives: To evaluate complications and outcomes of halo immobilization in patients with cervical spine fractures treated at a level I trauma center. Methods: A retrospective evaluation of patients treated at a single institution with halo immobilization from August 2000 to February 2016 was performed. Demographic information, mechanism of injury, level and type of spine fracture, length of halo immobilization, complications associated with halo immobilization, and length of patient follow-up were collected. Results: A total of 189 patients treated with halos were identified. Of the 189 patients, 121 (64%) received halos for the management of cervical spine fractures and were included in the study. A total of 49.6% were males and 50.4% were females. The average age was 50.8 years (range 1-89 years). Overall, 10.7% sustained C1 fractures, 71.1% C2 fractures, and 18.2% subaxial spine (C3-C7) fractures. In all, 47.1% of the upper cervical fractures were either odontoid or hangman-type fractures. A total of 25.1% of patients had multiple cervical fractures. At latest follow-up, 81% had healed fractures with good alignment, minimal pain, and return to normal activities. There was an 8.3% mortality rate. The mortality group had an average age of 64.7 years (range 19-84 years). A total of 10.7% of patients failed halo immobilization and 46.3% of patients had complications such as pin site infections (5.8%), loose pins (1.7%), neck pain (20.7%), decreased range of motion (14%), thoracic skin ulcers (2.4%), and dysphagia (1.7%). Conclusions: The use of halo immobilization for cervical spine fractures resulted in clinical success in 81% of patients. Complication rates in geriatric patients were lower than previously reported in the literature.

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