scholarly journals A new transpedicular lag-screw fixation for treatment of unstable Hangman’s fracture: a minimum 2-year follow-up study

2020 ◽  
Author(s):  
Yijie Liu ◽  
Yi Zhu ◽  
Xuefeng Li ◽  
Jie Chen ◽  
Sen Yang ◽  
...  
Keyword(s):  
Spinal Injury ◽  
Screw Fixation ◽  
Biomechanical Testing ◽  
Biomechanical Properties ◽  
Hangman’S Fracture ◽  
Lag Screw ◽  
Associated Lesions ◽  
Cord Injury ◽  
Hangman's Fracture

Abstract Background A new C2 transpedicular lag-screw designed by our team has been used in human cadaver spines for biomechanical testing, and the results showed that the biomechanical properties of the new C2 transpedicular lag-screw were better than ordinary screws. The objective of this study is to analyze the clinical efficacy and safety of the new C2 transpedicular lag-screw fixation for treatment of an unstable Hangman’s fracture. Methods From March 2013 to June 2017, 25 patients who had unstable Hangman’s fractures were operated on with a new C2 transpedicular lag-screw fixation. The patients included 18 males and 7 females whose ages ranged from 31–62 years (average 45.4 ± 9.3 years). The cause of the injury was a traffic accident in 17 patients and a fall from height in 8 patients. Other associated lesions included rupture of the spleen (1 patient) and rib fractures (2 patients). According to the Levine-Edwards classification, 17 patients were Type II and 8 patients were Type IIA, and according to the Frankel Neurological Performance scale, 8 cases and 17 cases were graded as spinal cord injury D and E, respectively. Of the cases, 23 cases received bilateral screw fixation and 2 cases had unilateral screw fixation because another pedicle was chipped. The whole procedure was accomplished with monitoring by“C”-arm fluoroscopy. Results The mean follow-up time was (36 ± 12) months and ranged from 24 to 60 months. No obvious symptomatic or radiologic postoperative complications were found during the follow-up period. 6 cases restored from D to E while 2 cases remained D according to American Spinal Injury Association (ASIA) grade. Osseous union was achieved in all cases, and the range of cervical motion recovered to normal level up to the last follow-up. Conclusions The primary clinical and radiographic efficacies of a new C2 transpedicular lag-screw fixation for treatment of an unstable Hangman’s fracture were satisfactory. This approach could be considered a simple, effective, reliable and economic surgical method for managing unstable Hangman’s fractures.

scholarly journals A new transpedicular lag-screw fixation for treatment of unstable Hangman’s fracture: a minimum 2-year follow-up study

2020 ◽  
Author(s):  
Yijie Liu ◽  
Yi Zhu ◽  
Xuefeng Li ◽  
Jie Chen ◽  
Sen Yang ◽  
...  
Keyword(s):  
Spinal Injury ◽  
Screw Fixation ◽  
Biomechanical Testing ◽  
Neck Disability Index ◽  
Hangman’S Fracture ◽  
Lag Screw ◽  
Associated Lesions ◽  
Cord Injury ◽  
Hangman's Fracture

Abstract Background: A new C2 transpedicular lag-screw designed by our team has been used in human cadaver spines for biomechanical testing, and the results showed that the biomechanical properties of the new C2 transpedicular lag-screw were better than ordinary screws. The objective of this study is to analyze the clinical efficacy and safety of the new C2 transpedicular lag-screw fixation for treatment of an unstable Hangman’s fracture. Methods: From March 2013 to June 2017, 25 patients who had unstable Hangman’s fractures were operated on with a new C2 transpedicular lag-screw fixation. The patients included 18 males and 7 females whose ages ranged from 31-62 years (average 45.4±9.3 years). The cause of the injury was a traffic accident in 17 patients and a fall from height in 8 patients. Other associated lesions included rupture of the spleen (1 patient) and rib fractures (2 patients). According to the Levine-Edwards classification, 17 patients were Type II and 8 patients were Type IIA, and according to the Frankel Neurological Performance scale, 8 cases and 17 cases were graded as spinal cord injury D and E, respectively. 23 cases received bilateral screw fixation and 2 cases had unilateral screw fixation because another pedicle was chipped. The whole procedure was accomplished with monitoring by“C”-arm fluoroscopy. Results: The mean follow-up time was (36±12) months and ranged from 24 to 60 months. No obvious symptomatic or radiologic postoperative complications were found during the follow-up period. 6 cases restored from D to E while 2 cases remained D according to American Spinal Injury Association (ASIA) grade. Pre and postoperative Visual Analogue Scale (VAS) and Neck Disability Index (NDI) were statistically different (p<0.001). Osseous union was achieved in all cases, and the range of cervical motion recovered to normal level up to the last follow-up. Conclusions: The primary clinical and radiographic efficacies of a new C2 transpedicular lag-screw fixation for treatment of an unstable Hangman’s fracture were satisfactory. This approach could be considered a simple, effective, reliable and economic surgical method for managing unstable Hangman’s fractures.

Transverse Lag Screw Fixation in Midline Mandibulotomy

2000 ◽  
Vol 109 (3) ◽  
pp. 334-339 ◽  
Author(s):  
Joseph M. Serletti ◽  
John U. Coniglio ◽  
Salvatore J. Pacella ◽  
John D. Norante
Keyword(s):  
Reliable Method ◽  
Screw Fixation ◽  
Postoperative Radiotherapy ◽  
Major Complication ◽  
Recurrent Tumor ◽  
Minor Complication ◽  
Anterior Cortex ◽  
Lag Screw ◽  
The Mean

Vertical midline mandibulotomy has provided a relatively simple and efficient means of obtaining access to intraoral tumors that are too large or too posterior to be removed transorally. Midline mandibulotomy has had the advantage of nerve and muscle preservation and places the osteotomy outside the typical field of radiotherapy, in contrast to lateral and paramedian osteotomies. Plate and screw fixation has been the usual means of osteosynthesis for these mandibulotomies; however, plate contouring over the symphyseal surface has been a time-consuming process. Unless the plate was contoured exactly, mandibular malalignment and malocclusion in dentulous patients has occurred. Use of parallel transverse lag screws has become a popular method of osteosynthesis for parasymphyseal fractures, and we have extended their use for mandibulotomy fixation. This paper reports our clinical experience with transverse lag screw fixation of midline mandibulotomies in 9 patients from 1994 to 1997. There were 7 men and 2 women with a mean age of 56 (range 35 to 71 years). The pathological diagnosis in all patients was squamous cell carcinoma; 8 cases were primary, and 1 patient presented with recurrent tumor. No tumors involved the mandibular periosteum. One patient had had previous radiotherapy, and 3 patients underwent postoperative radiotherapy. The mean follow-up has been 17 months (range 9 to 27). There was 1 minor complication and 1 major complication related to our technique. The major complication was a delayed nonunion of the mandibulotomy. This occurred because the 2 parallel screws were placed too close to one another, and this placement resulted in a delayed sagittal fracture of the anterior cortex and subsequent nonunion. Transverse lag screw fixation has not affected occlusion in our dentulous patients. Speech and diet were normal in the majority of our patients. Transverse lag screw fixation of the midline mandibulotomy has been a relatively safe, rapid, and reliable method for tumor access and postextirpation mandibular stabilization and has significant advantages over other current methods of mandibulotomy and fixation.

scholarly journals Olfactory ensheathing cell transplantation for chronic spinal cord injury: A long-term follow-up study

2021 ◽  
Vol 9 (2) ◽  
pp. 94-105
Author(s):  
Naifeng Kuang ◽  
Xiaoyu Wang ◽  
Yuexia Chen ◽  
Guifeng Liu ◽  
Fan’e Kong ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Autonomic Function ◽  
Spinal Injury ◽  
International Standards ◽  
Olfactory Ensheathing Cell ◽  
Cord Injury ◽  
Long Term Follow Up

Spinal cord injury is a serious disabling condition. Transplantation of olfactory ensheathing cells (OECs) is one of the most promising treatments for spinal cord injury (SCI). Thirty-nine patients with chronic SCI received OEC transplantation and completed long-term follow-up, with a minimum follow-up of 7 years. We assessed sensorimotor function with the American Spinal Injury Association (ASIA) Impairment Scale (AIS) and autonomic nervous function by the International Standards to document remaining Autonomic Function after Spinal Cord Injury (ISAFSCI), and sympathetic skin responses (SSR). The scores of each group were significantly higher after OECs transplantation than before treatment. SSR latencies were shorter and response amplitudes increased after treatment. Long-term follow-up showed further improvement only in motor function and autonomic function compared with 3 months postoperatively. No complications occurred in any patient during long-term follow-up. The results indicate that the transplantation of OECs in spinal cord restored function without serious side effects.

Neurological prognosis after traumatic quadriplegia

1979 ◽  
Vol 50 (5) ◽  
pp. 611-616 ◽  
Author(s):  
Frederick M. Maynard ◽  
Glenn G. Reynolds ◽  
Steven Fountain ◽  
Conal Wilmot ◽  
Richard Hamilton
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Injury ◽  
Head Injuries ◽  
Gunshot Wounds ◽  
Neurological Impairment ◽  
Treatment Protocols ◽  
Content Type ◽  
Cord Injury

✓ Between January, 1974, and December, 1976, 123 patients with traumatic quadriplegia were admitted to the California Regional Spinal Cord Injury Care System. The spinal cord injury resulted from gunshot wounds in five, from a stab wound in one, from neck injuries with no bone damage seen on x-ray studies in 10, and from fracture dislocations of the cervical spine in 107. One-year follow-up information was available on 114 patients. Neurological impairment using the Frankel classification system was compared at 72 hours postinjury to the 1-year follow-up examination. Fifty of 62 patients with complete injury at 72 hours were unchanged at 1 year. Five of these 62 patients had developed motor useful function in the legs or became ambulatory by 1 year, but all had sustained serious head injuries at the time of their trauma making initial neurological assessment unreliable. Ten percent of all cases had combined head injury impairing consciousness. Among 103 cognitively intact patients, none with complete injury at 72 hours were walking at 1 year. Of patients with sensory incomplete function at 72 hours postinjury, 47% were walking at 1 year; 87% of patients with motor incomplete function at 72 hours postinjury were walking at 1 year. Spinal surgery during the first 4 weeks postinjury did not improve neurological recovery. A method of analyzing neurological and functional outcomes of spinal cord injury is presented in order to more accurately evaluate the results of future treatment protocols for acute spinal injury.

Long-Term Follow-up of Patients with Spinal Cord Injury

2005 ◽  
Vol 19 (4) ◽  
pp. 332-337 ◽  
Author(s):  
Figen Yilmaz ◽  
Fusun Sahin ◽  
Semra Aktug ◽  
Banu Kuran ◽  
Adem Yilmaz
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Injury ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
American Spinal Injury Association ◽  
Cord Injury ◽  
Long Term Follow Up

Objective. The aim of this study was to evaluate the motor, sensory, and functional recovery in patients with spinal cord injury (SCI). Methods. Forty-one patients with SCI participated in this study. Twenty patients were evaluated after discharge. Each patient was evaluated by the American Spinal Injury Association (ASIA) impairment scale and the Functional Independence Measure (FIM) at admission, before discharge, and at least at 6 months after discharge. Friedman, Dunn, and Mann-Whitney U tests were used for statistical analysis. Results. There were 17 male and 3 female patients. Seven patients had complete SCI, and 13 patients had incomplete SCI. The evaluation of motor, sensory, and FIM scores at admission showed significant improvement in all of the patients during the follow-up period (P < 0.0001). Five incompletely injured cases improved with regard to ASIA staging. Motor and FIM scores significantly increased at follow-up for converted and unconverted patients. All parameters increased at follow-up in patients who were complete and incomplete. Motor scores significantly increased at discharge and at follow-up. FIM scores also increased significantly at follow-up in incomplete patients. Conclusion. Motor, sensory, and FIM scores increased in patients with SCI after a follow-up period of 18 months. Improvement to a higher ASIA stage could be accomplished by 25% of the patients. Although both complete and incomplete patients recovered significantly at the follow-up period, only incompletely injured cases could convert to a higher ASIA stage.

scholarly journals Depression, Social Support, and Coping Strategies in Individuals with Spinal Injury Depression with Spinal Injury Patients

2021 ◽  
Vol 73 (8) ◽  
pp. 518-525
Author(s):  
Nopchanok Sukprasert ◽  
Cholavech Chavasiri ◽  
Srinual Chavasiri
Keyword(s):  
Social Support ◽  
Spinal Cord ◽  
Coping Strategies ◽  
Spinal Injury ◽  
Depression Scale ◽  
Negatively Associated ◽  
The Social ◽  
Cord Injury ◽  
Prevalence Of Depression

Objective: To investigate the prevalence of and factors associated with depression, the social support received by, and the coping strategies used by spinal cord injury (SCI) patients.Materials and Methods:  SCI patients who received follow-up evaluation at the Siriraj Hospital during 2016 to 2018. The instruments used included a general information, the Zung Self-Rating Depression Scale(Thai version), the Social Provisions Scale, and the Spinal Cord Lesion-Related Coping Strategies Questionnaire (Thai version).Results: Eighty-six SCI patients (age: 43.1±15.7 years, 66.3% male) were included, and 59.3%  had some level of permanent impairment. The prevalence of depression was 55.8%. Depression was found to be negatively associated with all social support domains. Regarding coping, depression was shown to be negatively associated with the acceptance strategy, but positively associated with the social reliance strategy. Multivariate analysis by multiple logistic regression showed  level of impairment (p=0.005), guidance provision (p=0.040), fighting spirit strategy (p=0.031), and the social reliance strategy (p=0.032) to be independently associated with depression.Conclusion: The prevalence of depression among SCI was 55.8%. The results revealed the types of social support received, and the coping strategies used by SCI patients after hospital discharge. These findings will improve follow-up care and patient quality of life.

scholarly journals Traumatic Spinal Cord Injury: Long-Term Motor, Sensory, and Urinary Outcomes

2017 ◽  
Vol 11 (3) ◽  
pp. 412-418 ◽  
Author(s):  
Rouzbeh Motiei-Langroudi ◽  
Homa Sadeghian
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Injury ◽  
Treatment Protocol ◽  
Spinal Column ◽  
Surgical Approaches ◽  
Trauma Mechanism ◽  
Cord Injury

<sec><title>Study Design</title><p>Retrospective study.</p></sec><sec><title>Purpose</title><p>To evaluate how motor, sensory, and urinary outcomes of spinal cord injury (SCI) patients were influenced in the long term.</p></sec><sec><title>Overview of Literature</title><p>SCI is a potentially disabling and devastating neurological outcome that can occur because of spinal column fractures. Most studies have not evaluated or have failed to show the influence of different surgical approaches and other parameters on neurological recovery.</p></sec><sec><title>Methods</title><p>A thorough history regarding sensory, motor, and urinary complaints was taken from 103 patients with SCI due to vertebral fracture; patients were followed by a thorough neurological examination. Subsequently, all medical records of patients, including neurological state after trauma, trauma mechanism, treatment protocol, surgical protocol, and imaging findings, were evaluated.</p></sec><sec><title>Results</title><p>Of the 103 patients, 73.8% were survivors of a major earthquake and 26.2% were victims of vehicle accidents; 92.2% patients were surgically treated, while 7.8% underwent conservative management. The mean follow-up duration was 10.3 years. In follow-up visits, 67.0%, 12.6%, 13.6%, and 6.8% patients showed no, partial, substantial, and complete motor improvement, respectively; 68.0%, 26.2%, and 5.8% showed no, mild, and substantial sensory improvement, respectively; and 73.8%, 17.5%, and 8.7% showed no, substantial, and complete urinary improvement, respectively. Logistic regression analysis showed that sex, age at injury time, follow-up duration, trauma mechanism, and stem cell therapy had no effect on motor, sensory, and urinary improvement. Higher initial scores on the American Spinal Injury Association (ASIA) classification, lumbar fracture level, and performance of laminectomy improved motor outcome; higher initial ASIA scores improved urinary and sensory outcomes.</p></sec><sec><title>Conclusions</title><p>The initial ASIA score is the most important factor for prognosticating motor, sensory, and urinary improvement in SCI patients. Lumbar (L3–L5) and thoracic (T1–T10) fractures have the best and worst prognosis, respectively, in terms of motor recovery. Laminectomy during surgery improves motor function.</p></sec>

scholarly journals The Effect of Surgical Intervention for Delayed Cervical Central Cord Syndrome

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Yanan Liu ◽  
Zongyi Wang ◽  
Shaofeng Yang ◽  
Huilin Yang ◽  
Jun Zou
Keyword(s):  
Surgical Intervention ◽  
Spinal Injury ◽  
American Spinal Injury Association ◽  
Japanese Orthopedic Association ◽  
Sf 36 ◽  
Cord Injury ◽  
Central Cord Syndrome ◽  
Time Point ◽  
The Ideal

The authors retrospectively studied 11 patients with delayed cervical central cord syndrome (CCS) to investigate the efficacy of the surgical intervention on treatment for delayed CCS. The American Spinal Injury Association (ASIA) motor scores, Japanese Orthopedic Association (JOA) scores, SF-36 scores, and neurologic status were analyzed preoperatively and at each time point of postoperative follow-up. The results show that patients with reversible spinal cord injury caused by delayed central cord syndrome can recover significantly after surgical intervention. Therefore, we suggest that surgical intervention is still the ideal choice for delayed cervical central cord syndrome.

Sign in / Sign up

Export Citation Format

Share Document