Progression of local kyphosis after conservative treatment for compressive cervical spine fracture with spinal cord injury

The aim of this study is to report the rare occurrence of simultaneous double spine fractures in a patient with progressive ankylosing spondylitis (AS). An 82-year-old male with established AS had low-energy falls. He had sustained simultaneous double spine fractures and died. Plain radiographs of the cervical spine were unremarkable in detecting a cervical spine fracture in a patient with AS and a spinal cord injury following a fall. CT scan showed a displaced fracture at the C6/C7 with American Spinal Injury Association-A spinal cord injury and displaced fracture at L1. The cause of death was determined to be upper spinal cord injury caused by cervical spinal fracture and dislocation that were facilitated by spinal rigidity from AS. This case report illustrates the importance of obtaining a detailed medical history and thorough imaging study when investigating deaths, including nonfatal conditions, such as AS. Furthermore, it shows the value of entire spine CT scan in the evaluation of the mechanism, further spine fractures, and manner of death. Despite the occurrence of spine fracture in AS patients, simultaneous double or multiple spine fractures are extremely rare and can be missed. Care should be taken for the further spine fracture in the entire spine in patient with AS.

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The Torg-Pavlov ratio for the prediction of acute spinal cord injury after a minor trauma to the cervical spine

The Spine Journal ◽

10.1016/j.spinee.2012.10.039 ◽

2013 ◽

Vol 13 (6) ◽

pp. 605-612 ◽

Cited By ~ 31

Author(s):

Nikolaus Aebli ◽

Anina G. Wicki ◽

Tabea B. Rüegg ◽

Nassos Petrou ◽

Heidrun Eisenlohr ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Cervical Spine ◽

Acute Spinal Cord Injury ◽

Minor Trauma ◽

Cord Injury ◽

A Minor

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Cine phase-contrast MRI measurement of CSF flow in the cervical spine: a pilot study in patients with spinal cord injury

10.1117/12.881715 ◽

2011 ◽

Cited By ~ 4

Author(s):

MJ Negahdar ◽

M. Shakeri ◽

E. McDowell ◽

J. Wells ◽

T. Vitaz ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Cervical Spine ◽

Pilot Study ◽

Phase Contrast ◽

Csf Flow ◽

Phase Contrast Mri ◽

Cord Injury ◽

Cine Phase Contrast

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Numerical Investigation of Spinal Cord Injury After Flexion-Distraction Injuries At the Cervical Spine

Journal of Biomechanical Engineering ◽

10.1115/1.4052003 ◽

2021 ◽

Author(s):

Marie-Helene Beausejour ◽

Eric Wagnac ◽

Pierre-Jean Arnoux ◽

Jean-Marc Mac-Thiong ◽

Yvan Petit

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Cervical Spine ◽

White Matter ◽

Cervical Spinal Cord ◽

Element Model ◽

Von Mises Stress ◽

Study Objective ◽

Cord Injury ◽

Post Traumatic

Abstract Flexion-distraction injuries frequently cause traumatic cervical spinal cord injury (SCI). Post-traumatic instability can cause aggravation of the secondary SCI during patient's care. However, there is little information on how the pattern of disco-ligamentous injury affects the SCI severity and mechanism. This study objective was to analyze how different flexion-distraction disco-ligamentous injuries affect the SCI mechanisms during post-traumatic flexion and extension. A cervical spine finite element model including the spinal cord was used and different combinations of partial or complete intervertebral disc (IVD) rupture and disruption of various posterior ligaments were modeled at C4-C5, C5-C6 or C6-C7. In flexion, complete IVD rupture combined with posterior ligamentous complex rupture was the most severe injury leading to the most extreme von Mises stress (47 to 66 kPa), principal strains p1 (0.32 to 0.41 in white matter) and p3 (-0.78 to -0.96 in white matter) in the spinal cord and to the most important spinal cord compression (35 to 48 %). The main post-trauma SCI mechanism was identified as compression of the anterior white matter at the injured level combined with distraction of the posterior spinal cord during flexion. There was also a concentration of the maximum stresses in the gray matter after injury. Finally, in extension, the injuries tested had little impact on the spinal cord. The capsular ligament was the most important structure in protecting the spinal cord. Its status should be carefully examined during patient's management.

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THORACOLUMBAR SPINAL ARTHRODESIS - EPIDEMIOLOGY AND COSTS

Coluna/Columna ◽

10.1590/s1808-185120171601162774 ◽

2017 ◽

Vol 16 (1) ◽

pp. 52-55

Author(s):

TOBIAS LUDWIG DO NASCIMENTO ◽

LUIZ PEDRO WILLIMANN ROGÉRIO ◽

MARCELO MARTINS DOS REIS ◽

LEANDRO PELEGRINI DE ALMEIDA ◽

GUILHERME FINGER ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Neurological Deficit ◽

Traffic Accidents ◽

Thoracolumbar Spine ◽

Hospital Costs ◽

Spine Fracture ◽

Female Ratio ◽

Cord Injury ◽

Fall From Height

ABSTRACT Objective: To describe the epidemiology of patients with thoracolumbar spine fracture submitted to surgery at Hospital Cristo Redentor and the related costs. Methods: Prospective epidemiological study between July 2014 and August 2015 of patients with thoracolumbar spine fracture with indication of surgery. The variables analyzed were sex, age, cost of hospitalization, fractured levels, levels of arthrodesis, surgical site infection, UTI or BCP, spinal cord injury, etiology, length of stay, procedure time, and visual analog scale (VAS) . Results: Thirty-two patients were evaluated in the study period, with a mean age of 38.68 years. Male-female ratio was 4:1 and the most frequent causes were fall from height (46.87%) and traffic accidents (46.87%). The thoracolumbar transition was the most affected (40.62%), with L1 vertebra involved in 23.8% of the time. Neurological deficit was present in 40.62% of patients. Hospital stay had a median of 14 days and patients with neurological deficit were hospitalized for a longer period (p<0.001), with an increase in hospital costs (p= 0.015). The average cost of hospitalization was U$2,874.80. The presence of BCP increased the cost of hospitalization, and patients with spinal cord injury had more BCP (p= 0.014) . Conclusion: Public policies with an emphasis on reducing traffic accidents and falls can help reduce the incidence of these injuries and studies focusing on hospital costs and rehabilitation need to be conducted in Brazil to determinate the burden of spinal trauma and spinal cord injury.

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