Acute Traumatic Cervical Facet Fractures

2018 ◽  
Vol 1 (2) ◽  
pp. 5
Author(s):  
Shankar Gopinat
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Early Surgery ◽  
Initial Assessment ◽  
Trauma Patients ◽  
Spinal Stability ◽  
Fracture Patterns ◽  
Spine Ct ◽  
Cervical Facet

Acute cervical facet fractures are increasingly being detected due to the use of cervical spine CT imaging in the initial assessment of trauma patients. For displaced cervical facet fractures with dislocations and subluxations, early surgery can decompress the spinal cord and stabilize the spine. For patients with non-displaced cervical facet fractures, the challenge in managing these patients is the determination of spinal stability. Although many of the patients with non-displaced cervical facet fractures can be managed with a cervical collar, the imaging needs to be analyzed carefully since certain fracture patterns may be better managed with early surgical stabilization.

Evaluating the cervical spine in confused or unconscious adults after blunt trauma

2019 ◽  
Vol 80 (6) ◽  
pp. 317-319 ◽  
Author(s):  
Christopher Deacon ◽  
Simon Craxford ◽  
Benjamin J Ollivere
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spine ◽  
Blunt Trauma ◽  
Trauma Patients ◽  
National Guidelines ◽  
Spinal Immobilization ◽  
Cord Injury ◽  
Prolonged Immobilization ◽  
Secondary Spinal Cord Injury

Potential injury to the cervical spine should be considered in all patients who have suffered blunt trauma. Early spinal immobilization is required to minimize the risk of secondary spinal cord injury. However, prolonged immobilization is associated with its own morbidity. Clinical evaluation of the cervical spine in confused or unconscious adult trauma patients is challenging, and imaging is required to safely ‘clear’ the cervical spine. Despite the existence of national guidelines, significant variations in practice exist. This article summarizes the evidence for the initial stabilization of the cervical spine in adult trauma patients. It reviews the imaging modalities available and the criteria for discontinuation of cervical spine immobilization.

scholarly journals Effectiveness of second-opinion radiology consultations to reassess the cervical spine CT scans: a study on trauma patients referred to a tertiary-care hospital

2015 ◽  
Vol 21 (5) ◽  
pp. 423-427 ◽  
Author(s):  
Omid Khalilzadeh ◽  
Maryam Rahimian ◽  
Vinay Batchu ◽  
Harshna V. Vadvala ◽  
Robert A. Novelline ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Second Opinion ◽  
Ct Scans ◽  
Trauma Patients ◽  
Care Hospital ◽  
Spine Ct

scholarly journals Traumatic cervical spinal cord injury with "negative" cervical spine CT scan

2010 ◽  
Vol 2010 (mar04 1) ◽  
pp. bcr1220092525-bcr1220092525 ◽  
Author(s):  
S. Kolli ◽  
A. Schreiber ◽  
J. Harrop ◽  
J. Jallo
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spine ◽  
Ct Scan ◽  
Cervical Spinal Cord ◽  
Cervical Spinal Cord Injury ◽  
Spine Ct ◽  
Cord Injury

scholarly journals A clinical decision rule for cervical spine CT in head or neck trauma patients

2013 ◽  
Vol 24 (4) ◽  
pp. 192-199 ◽  
Author(s):  
Takeshi Inagaki ◽  
Akio Kimura ◽  
Akiyoshi Hagiwara ◽  
Ryo Sasaki ◽  
Takuro Shimbo
Keyword(s):  
Cervical Spine ◽  
Decision Rule ◽  
Clinical Decision ◽  
Trauma Patients ◽  
Clinical Decision Rule ◽  
Neck Trauma ◽  
Spine Ct

CT Imaging in Motorcycle Collision Victims: Routine or Selective?

2009 ◽  
Vol 75 (10) ◽  
pp. 892-896 ◽  
Author(s):  
John M. Compoginis ◽  
Gabriel Akopian
Keyword(s):  
Cervical Spine ◽  
Blunt Trauma ◽  
Ct Scanning ◽  
Initial Assessment ◽  
Trauma Patients ◽  
Motorcycle Accident ◽  
The Face ◽  
Clinically Significant ◽  
Improving Accuracy ◽  
Thoracic And Abdominal

With improving accuracy and efficiency of CT, some trauma centers have used a low threshold for the use of CT scans in the evaluation and assessment of trauma patients. The purpose of this study was to evaluate the diagnostic benefits of liberal CT scanning in multisystem blunt trauma motorcycle accident victims. The trauma registry at our community-based Level II center was accessed to identify consecutive motorcycle accident victims within a 55-month period who: 1) were evaluated on presentation by an attending trauma surgeon; and 2) underwent a head, cervical spine, chest, abdomen, or pelvis CT scan or any combination as part of their initial assessment. For those patients with clinically significant findings identified on CT, the percentage of those with negative clinical examinations was calculated. We found that 48, 77, 47, and 69 per cent of patients with clinically significant findings on head, cervical spine, thoracic, and abdominal CT, respectively, had normal clinical examinations. Our data suggest lower thresholds for CT use in the evaluation of patients sustaining multisystem blunt trauma should be adopted, even in the face of normal clinical examinations. This is especially true for the neck and abdominal regions.

scholarly journals A systematic review of the need for MRI for the clearance of cervical spine injury in obtunded blunt trauma patients after normal cervical spine CT

2014 ◽  
Vol 7 (4) ◽  
pp. 251 ◽  
Author(s):  
DavidC Evans ◽  
Ahmad Moukalled ◽  
Elizabeth Yu ◽  
DavidB Tulman ◽  
StanislawPA Stawicki ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cervical Spine ◽  
Blunt Trauma ◽  
Cervical Spine Injury ◽  
Spine Injury ◽  
Trauma Patients ◽  
Spine Ct

Osteoradionecrosis of the cervical spine resulting from radiotherapy for primary head and neck malignancies: operative and nonoperative management

2005 ◽  
Vol 3 (2) ◽  
pp. 159-164 ◽  
Author(s):  
Daniel J. Donovan ◽  
Thanh V. Huynh ◽  
Eric B. Purdom ◽  
Robert E. Johnson ◽  
Joseph C. Sniezek
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Head And Neck ◽  
Hyperbaric Oxygen ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Neurological Deficits ◽  
Spinal Instability ◽  
Spinal Stability ◽  
Head And Neck Malignancies

✓ Osteoradionecrosis is a process of dysvascular bone necrosis and fibrous replacement following exposure to high doses of radiation. The poorly vascularized necrotic tissue may cause pain and/or instability, and it cannot resist infection well, which may result in secondary osteomyelitis. When these processes affect the cervical spine, the resulting instability and neurological deficits can be devastating, and immediate reestablishment of spinal stability is paramount. Reconstruction of the cervical spine can be particularly challenging in this subgroup of patients in whom the spine is poorly vascularized after radical surgery, high-dose irradiation, and infection. The authors report three cases of cervical spine osteoradionecrosis following radiotherapy for primary head and neck malignancies. Two patients suffered secondary osteomyelitis, severe spinal deformity, and spinal cord compression. These patients underwent surgery in which a vascularized fibular graft and instrumentation were used to reconstruct the cervical spine; subsequently hyperbaric oxygen (HBO) therapy was instituted. Fusion occurred, spinal stability was restored, and neurological dysfunction resolved at the 2- and 4-year follow-up examinations, respectively. The third patient experienced pain and dysphagia but did not have osteomyelitis, spinal instability, or neurological deficits. He underwent HBO therapy alone, with improved symptoms and imaging findings. Hyperbaric oxygen is an essential part of treatment for osteoradionecrosis and may be sufficient by itself for uncomplicated cases, but surgery is required for patients with spinal instability, spinal cord compression, and/or infection. A vascularized fibular bone graft is a very helpful adjunct in these patients because it adds little morbidity and may increase the rate of spinal fusion.

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