scholarly journals Evaluation of patients with cervical spine injury and predicting the risk and severity of acute spinal cord injury after a minor trauma

2020 ◽  
Vol 6 (4) ◽  
pp. 740
Author(s):  
Ramdas Maloth
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spine ◽  
Spinal Canal ◽  
Minor Trauma ◽  
Mr Images ◽  
Canal Diameter ◽  
Cord Injury ◽  
A Minor ◽  
Disc Level

<p class="abstract"><strong>Background:</strong> Acute spinal cord injury (SCI) after a minor trauma to the cervical spine has been reported in patients without preceding neurologic symptoms. Spinal canal stenosis may be the reason for the discrepancy between the severity of the injury and that of the trauma. The objective of this study was to investigate MRI parameters of the cervical spine in patients suffering from acute SCI and to investigate the use of these parameters for predicting the risk and severity of acute cervical SCI after a minor trauma to the cervical spine.  </p><p class="abstract"><strong>Methods:</strong> Retrospective radiological study was conducted in Meenakshi Medical College and Research Institute Kanchipuram with fifty patients suffering from acute cervical SCI and 130 patients showing no neurologic deficits after a minor trauma to the cervical spine. The following calculations were performed using measurements from MR images the spinal canal to vertebral body ratio, the space available for the cord, and the canal-to-cord ratio. SPSS version 21 was used for analysis.<strong></strong></p><p class="abstract"><strong>Results:</strong> All investigated MR image parameters in the SCI group were significantly (p&lt;001) smaller compared with the control group. However, there was no significant difference in any parameter among the different American spinal injury association impairment score groups. A cut-off value of 8.0 mm for the minimal sagittal disc-level canal diameter yielded the largest positive predictive value and likelihood ratio for predicting SCI.</p><p class="abstract"><strong>Conclusions:</strong> Patients at risk of acute SCI after a minor trauma to the cervical spine can be identified by applying a disc-level canal diameter cut-off value measured on MR images. Supplementary factors to the radiological characteristics of the spinal canal affect the severity of acute SCI after trauma.</p>

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

2013 ◽  
Vol 13 (6) ◽  
pp. 605-612 ◽  
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

Predicting the risk and severity of acute spinal cord injury after a minor trauma to the cervical spine

2013 ◽  
Vol 13 (6) ◽  
pp. 597-604 ◽  
Author(s):  
Nikolaus Aebli ◽  
Tabea B. Rüegg ◽  
Anina G. Wicki ◽  
Nassos Petrou ◽  
Jörg Krebs
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spine ◽  
Acute Spinal Cord Injury ◽  
Minor Trauma ◽  
Cord Injury ◽  
A Minor

Spinal Cord Injury With a Narrow Spinal Canal: Utilizing Torg’s Ratio Method of Analyzing Cervical Spine Radiographs

1998 ◽  
Vol 16 (1) ◽  
pp. 79-82 ◽  
Author(s):  
Tareg Bey ◽  
Amy Waer ◽  
Frank G Walter ◽  
John Fortune ◽  
Joachim Seeger ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spine ◽  
Spinal Canal ◽  
Ratio Method ◽  
Cord Injury ◽  
Narrow Spinal Canal ◽  
Spine Radiographs

scholarly journals The Risk of Acute Spinal Cord Injury After Minor Trauma in Patients With Preexisting Cervical Stenosis

Neurosurgery ◽  
2015 ◽  
Vol 77 (4) ◽  
pp. 561-565 ◽  
Author(s):  
Victor Chang ◽  
Benjamin M. Ellingson ◽  
Noriko Salamon ◽  
Langston T. Holly
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Motor Vehicle ◽  
Traumatic Event ◽  
Minor Trauma ◽  
Cervical Stenosis ◽  
Canal Diameter ◽  
Cord Injury ◽  
The Mean

Abstract BACKGROUND: Cervical stenosis patients are commonly advised to undergo surgery due to the risk of spinal cord injury (SCI) after a traumatic event. However, the actual risk of SCI in this scenario is unknown. OBJECTIVE: To evaluate the risk of SCI after minor trauma in a cohort of prospectively followed cervical stenosis patients. METHODS: Clinical and radiographical analysis was performed in 55 nonoperatively treated patients evaluated between 2009 and 2014. Each patient was asked standardized questions including: 1) whether a previous physician recommended neck surgery, 2) whether a physician indicated that they would become paralyzed after a traumatic event, and 3) whether they experienced a traumatic event during the follow-up period. RESULTS: The mean age was 65, with a mean modified Japanese Orthopedic Association score of 16.6. The mean canal diameter was 6.1 mm. Nineteen patients (35%) had evidence of intramedullary T2 signal abnormality. Thirty-one patients (56%) were previously recommended for surgery. Twenty-six patients (47%) were told that they would be paralyzed after a motor vehicle accident or fall unless surgery was performed. Ten patients (18%) experienced a traumatic event during the follow-up, with none sustaining an SCI. CONCLUSION: Asymptomatic and mildly symptomatic cervical stenosis patients are commonly recommended to undergo surgery due to risk of paralysis after a traumatic event. SCI was not observed after minor trauma in our cohort of prospectively followed patients. It seems that occurrence of SCI in this patient population after minor trauma is likely smaller than many physicians surmise, yet will require future prospective study in a large cohort of patients.

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

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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