scholarly journals Neurological Outcome following Early versus Delayed Lower Cervical Spine Surgery

2007 ◽  
Vol 15 (2) ◽  
pp. 183-186 ◽  
Author(s):  
GS Sapkas ◽  
SA Papadakis
Keyword(s):  
Cervical Spine ◽  
Neurological Outcome ◽  
Medical Condition ◽  
Cervical Vertebrae ◽  
Timing Of Surgery ◽  
Fracture Dislocation ◽  
Lower Cervical Spine ◽  
Cervical Spine Surgery ◽  
Significant Difference ◽  
Cord Injury

Purpose. To determine whether the timing of surgery affects neurological outcome in patients with lower cervical spine trauma. Methods. 29 patients with a fracture and 38 with a fracture-dislocation of C3 to C7 cervical vertebrae were treated operatively during the inclusive period January 1987 to December 2000. Surgery was performed as soon as the patient's medical condition allowed, within 72 hours in 31 and more than 72 hours after the injury in 36. Results. Only patients with incomplete spinal cord injury had neurological improvement after surgery. There was no statistically significant difference in final neurological outcomes in patients having early as opposed to delayed surgery. Conclusion. Surgical intervention for cervical injuries is safe, as no postoperative neurological deterioration was recorded. Timing of surgery does not affect neurological outcome.

scholarly journals Neurological outcome and postoperative stability after anterior cervical spine fixation by the use of cervical spine locking plate

2017 ◽  
Vol 4 (12) ◽  
pp. 3805
Author(s):  
Ch Ali Manzoor ◽  
Muhammad Irshad ◽  
Muhammad Aamir
Keyword(s):  
Cervical Spine ◽  
Standard Deviation ◽  
Neurological Outcome ◽  
Locking Plate ◽  
Fracture Dislocation ◽  
Upper Cervical Spine ◽  
Lower Cervical Spine ◽  
Cord Injury ◽  
Spine Fixation ◽  
Cervical Spine Fixation

Background: The fractures of cervical spine are divided into upper cervical spine (C1-C2) and lower cervical spine (C3-C7) also called sub axial cervical spine. Sub axial cervical injuries are common, ranging in severity from minor ligamentous strain or spinous process fracture to complete fracture dislocation with bone and ligament disruption, resulting in severe spinal cord injury. The objective of this study was to determine the neurological outcome and postoperative stability after anterior cervical spine fixation by the use of cervical spine locking plate (CSLP) attached with cancellous screws.Methods: This descriptive study was carried out in the Department of Neurosurgery, Nishtar Hospital, Multan, Pakistan. One hundred and fifteen patients fulfilled the inclusion criteria were selected. Patient of either gender more than 15 years of age and less than 60 years of age having unstable lower cervical spine injuries from C-3 to C 7 on X-ray underwent anterior cervical fixation.Results: Age range from 15 to 60 years with mean 32.34±standard deviation (SD) =12.06. The mean Frankel grading of the patients was 3.26±standard deviation (SD) =1.33. There were 97 (84.3%) male patients and 18 (15.7%) female patients. The neurological outcome was good in 107(89.6%) patients and poor in 12 (10.4%). The postoperative stability was YES in 109 (94.8%) patients and NO in 06 (5.2%). In the mode of injury there were 65 (56.5%) patients having road traffic accident, 41 (35.7%) patients having fall from tree/roof/stairs, 6 (65.2%) patients having fall of brick on the patient, 1 (0.9%) patient having Buffalo hit/animal contact, 2 (1.7%) patient having contact of head at floor of swimming pool after jumped in.Conclusions: It is concluded from this study that good results were achieved with the use of the CSLP. The use of anterior approach in treatment of the injured lower spine is safe and effective.

scholarly journals Use of 3D Navigation in Subaxial Cervical Spine Lateral Mass Screw Insertion

2018 ◽  
Vol 79 (01) ◽  
pp. e1-e8 ◽  
Author(s):  
Abdullah Arab ◽  
Fahad Alkherayf ◽  
Adam Sachs ◽  
Eugene Wai
Keyword(s):  
Cervical Spine ◽  
Navigation System ◽  
Lateral Mass ◽  
3D Navigation ◽  
Subaxial Cervical Spine ◽  
Navigation Group ◽  
Freehand Technique ◽  
Significant Difference ◽  
Cord Injury ◽  
Screw Malposition

Objective Cervical spine can be stabilized by different techniques. One of the common techniques used is the lateral mass screws (LMSs), which can be inserted either by freehand techniques or three-dimensional (3D) navigation system. The purpose of this study is to evaluate the difference between the 3D navigation system and the freehand technique for cervical spine LMS placement in terms of complications. Including intraoperative complications (vertebral artery injury [VAI], nerve root injury [NRI], spinal cord injury [SCI], lateral mass fracture [LMF]) and postoperative complications (screw malposition, screw complications). Methods Patients who had LMS fixation for their subaxial cervical spine from January 2014 to April 2015 at the Ottawa Hospital were included. A total of 284 subaxial cervical LMS were inserted in 40 consecutive patients. Surgical indications were cervical myelopathy and fractures. The screws' size was 3.5 mm in diameter and 8 to 16 mm in length. During the insertion of the subaxial cervical LMS, the 3D navigation system was used for 20 patients, and the freehand technique was used for the remaining 20 patients. We reviewed the charts, X-rays, computed tomography (CT) scans, and follow-up notes for all the patients pre- and postoperatively. Results Postoperative assessment showed that the incidence of VAI, SCI, and NRI were the same between the two groups. The CT scan analysis showed that the screw breakage, screw pull-outs, and screw loosening were the same between the two groups. LMF was less in the 3D navigation group but statistically insignificant. Screw malposition was less in the 3D navigation group compared with the freehand group and was statistically significant. The hospital stay, operative time, and blood loss were statistically insignificant between the two groups. Conclusions The use of CT-based navigation in LMS insertion decreased the rate of screw malpositions as compared with the freehand technique. Further investigations and trials will determine the effect of malpositions on the c-spine biomechanics. The use of navigation in LMS insertion did not show a significant difference in VAI, LMF, SCI, or NRI as compared with the freehand technique.

scholarly journals Orthostatic Hypotension Following Cervical Spine Surgery: Prevalence and Risk Factors

2019 ◽  
Vol 10 (5) ◽  
pp. 578-582
Author(s):  
Edward Tien-En Ong ◽  
Lincoln Kai-Pheng Yeo ◽  
Arun-Kumar Kaliya-Perumal ◽  
Jacob Yoong-Leong Oh
Keyword(s):  
Risk Factors ◽  
Cervical Spine ◽  
Orthostatic Hypotension ◽  
Functional Status ◽  
Spine Surgery ◽  
Surgical Approach ◽  
Mechanism Of Injury ◽  
Medical Comorbidities ◽  
Cervical Spine Surgery ◽  
Cord Injury

Study Design: Retrospective case series. Objectives: This study aims to determine the prevalence and risk factors for orthostatic hypotension (OH) in patients undergoing cervical spine surgery. Methods: Data was collected from records of 190 consecutive patients who underwent cervical spine procedures at our center over 24 months. Statistical comparison was made between patients who developed postoperative OH and those who did not by analyzing characteristics such as age, gender, premorbid medical comorbidities, functional status, mechanism of spinal cord injury, preoperative neurological function, surgical approach, estimated blood loss, and length of stay. Results: Twenty-two of 190 patients (11.6%) developed OH postoperatively. No significant differences in age, gender, medical comorbidities, or premorbid functional status were observed. Based on univariate comparisons, traumatic mechanism of injury ( P = .002), poor ASIA (American Spinal Injury Association) grades (A, B, or C) ( P < .001), and posterior surgical approach ( P = .045) were found to significantly influence occurrence of OH. Among the significant variables, after adjusting for mechanism of injury and surgical approach, only ASIA grade was found to be an independent predictor. Having an ASIA grade of A, B, or C increased the likelihood of developing OH by approximately 5.978 times ( P = .003). Conclusion: Our study highlights that OH is not an uncommon manifestation following cervical spine surgery. Patients with poorer ASIA grades A, B, or C were more likely to have OH when compared with those with ASIA grades D or E (43.5% vs 7.2%). Hence, we suggest that postural blood pressure should be routinely monitored in this group of patients so that early intervention can be initiated.

scholarly journals Fracture-Dislocation of the Lower Cervical Spine with Slight Neurologic Complications: A Case Report

2004 ◽  
Vol 53 (4) ◽  
pp. 732-734
Author(s):  
Shinya Yuasa ◽  
Hideo Yasumatsu ◽  
Goro Higashi ◽  
Masataka Hirotsu ◽  
Kazunori Yone ◽  
...  
Keyword(s):  
Case Report ◽  
Cervical Spine ◽  
Fracture Dislocation ◽  
Neurologic Complications ◽  
Lower Cervical Spine

Unusual Fracture/Dislocation of the Lower Cervical Spine: Case Report

Neurosurgery ◽  
1984 ◽  
Vol 14 (1) ◽  
pp. 76-77 ◽  
Author(s):  
Hang S. Byun ◽  
Pratap P. Patel
Keyword(s):  
Case Report ◽  
Cervical Spine ◽  
Fracture Dislocation ◽  
Lower Cervical Spine ◽  
Mechanism Of Injury ◽  
Spine Case

Abstract An unusual fracture/dislocation of the lower cervical spine is described, and a possible mechanism of injury is postulated.

scholarly journals Iatrogenic Spinal Cord Injury Resulting From Cervical Spine Surgery

2017 ◽  
Vol 7 (1_suppl) ◽  
pp. 84S-90S ◽  
Author(s):  
Alan H. Daniels ◽  
Robert A. Hart ◽  
Alan S. Hilibrand ◽  
David E. Fish ◽  
Jeffrey C. Wang ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spine ◽  
Spine Surgery ◽  
Cervical Spine Surgery ◽  
Cord Injury

scholarly journals Successful surgical repair and recovery in a 2-week-old infant after birth-related cervical fracture dislocation

2018 ◽  
Vol 21 (1) ◽  
pp. 16-20
Author(s):  
Sara Saleh ◽  
Kyle I. Swanson ◽  
Taryn Bragg
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spine ◽  
Fracture Dislocation ◽  
Interdisciplinary Management ◽  
Cervical Fracture ◽  
Spine Stabilization ◽  
Cord Injury ◽  
Spine Injuries

Cervical spine injuries are the most common spine injuries in the pediatric population. The authors present the youngest known patient who underwent cervical spine fusion to repair birth trauma–induced cervical fracture dislocation, resulting in spondyloptosis and spinal cord injury. A 2-week-old boy was found to have spondyloptosis and spinal cord injury after concerns arose from reduced movement of the extremities. The patient’s birth was complicated by undiagnosed abdominal dystocia, which led to cervical distraction injury. At 15 days of age, the boy underwent successful C-5 corpectomy, with anterior C4–6 and posterior C2–7 arthrodesis, using an autologous rib graft for a C-5 fracture dislocation. MRI performed 2 weeks postoperatively revealed significant improvement in the alignment of the spinal canal. The patient was discharged from the hospital in a custom Minerva brace and underwent close follow-up in addition to occupational therapy and physical therapy. At the latest follow-up 4.5 years later, the patient was able to walk and ride a tricycle by himself. The authors describe the patient’s surgery and the challenges faced in achieving successful repair and cervical spine stabilization in such a young patient. The authors suggest that significant neurological recovery after spinal cord injury in infants is possible with appropriate, timely, and interdisciplinary management.

scholarly journals Oblique Sagittal Images Prevent Underestimation of the Neuroforaminal Stenosis Grade Caused by Disc Herniation in Cervical Spine MRI

2018 ◽  
Vol 190 (10) ◽  
pp. 946-954 ◽  
Author(s):  
Laurent Kintzelé ◽  
Christoph Rehnitz ◽  
Hans-Ulrich Kauczor ◽  
Marc-André Weber
Keyword(s):  
Cervical Spine ◽  
Disc Herniation ◽  
Sagittal Plane ◽  
Cervical Disc ◽  
Cervical Spine Surgery ◽  
Valuable Adjunct ◽  
Significant Difference ◽  
Disc Herniations ◽  
Oblique Images ◽  
Spine Mri

Purpose To identify whether standard sagittal MRI images result in underestimation of the neuroforaminal stenosis grade compared to oblique sagittal MRI images in patients with cervical spine disc herniation. Materials and Methods 74 patients with a total of 104 cervical disc herniations compromising the corresponding nerve root were evaluated. Neuroforaminal stenosis grades were evaluated in standard and oblique sagittal images by one senior and one resident radiologist experienced in musculoskeletal imaging. Oblique images were angled 30° towards the standard sagittal plane. Neuroforaminal stenosis grades were classified from 0 (no stenosis) to 3 (high grade stenosis). Results Average neuroforaminal stenosis grades of both readers were significantly lower in standard compared to oblique sagittal images (p < 0.001). For 47.1 % of the cases, one or both readers reported a stenosis grade, which was at least 1 grade lower in standard compared to oblique sagittal images. There was also a significant difference when looking at patients who had neurological symptoms (p = 0.002) or underwent cervical spine surgery subsequently (p = 0.004). Interreader reliability, as measured by kappa value, and accordance rates were better for oblique sagittal images (0.94 vs. 0.88 and 99 % vs. 93 %). Conclusion Standard sagittal images tend to underestimate neuroforaminal stenosis grades compared to oblique sagittal images and are less reliable in the evaluation of disc herniations within the cervical spine MRI. In order to assess the potential therapeutic consequence, oblique images should therefore be considered as a valuable adjunct to the standard MRI protocol for patients with a radiculopathy. Key Points  Citation Format

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