scholarly journals Epidemiology of Cervical Spine Injuries in The Emergency Department at The University Hospital of The West Indies, Jamaica and The Use of Clinical Decision Rules, A Retrospective Review.

2021 ◽  
Author(s):  
Olsheath Bowen (First Author) ◽  
C Walters ◽  
Eric Wilson Williams ◽  
Leohrandra Graham ◽  
Jean Williams-Johnson (last author)
Keyword(s):  
Cervical Spine ◽  
Motor Vehicle ◽  
Decision Rules ◽  
University Hospital ◽  
The West ◽  
Cervical Spine Injuries ◽  
Vehicle Collision ◽  
Spine Injuries ◽  
The University ◽  
Clinical Rules

Abstract Background: Cervical spine injuries are myriad and ubiquitous, however the related demographic information has not been documented for the Jamaican or Caribbean population. These injuries can be life threatening and so it is important for the Emergency Physician to adhere to guidelines which direct management decisions including the need for imaging. This study therefore is an effort to report on the epidemiology of patients with cervical spine injuries presenting to the Emergency Department (ED) at the University Hospital of the West Indies (UHWI) and the use of clinical rules in the diagnosis of these injuries.This was a retrospective study. The log books from the ED at the UHWI were used to identify patients presenting with possible cervical spine injuries from January 1, 2013 to December 31, 2016. Inclusion/exclusion criteria were applied to select study patients. Demographical and clinical information was collected and evaluated.Results: 1,380 charts were identified as possible subjects. Of these, 887 charts were located and 806 (90.9%) were eligible. Ages ranged from 16 to 101 years with an average of 37.5 years. The majority of subjects were male, with a male to female ratio of 3:1. The main causes of these injuries were motor-vehicle collision (46.4%), motor-bike collision (23.8%) and fall from elevation (13.1%). Cervical spine injuries were identified in 20 (2.48%) subjects where motor-vehicle collision (45%) and motor-bike collisions (25%) were the main cause for injuries. Documentation of clinical rules applied to determine the need for radiological testing were present for 37.7% of the study population (NEXUS 36.2%, CCR 0.4% and combination 1.1%)Conclusion: The main source of injuries was due to road traffic accidents. This suggests more needs to be done regarding road safety. There is also room for improvement as it relates to the use of decision rules which may reduce the occurrence of unnecessary imaging.

Detection of Cervical Spine Injuries in Alert, Asymptomatic Geriatric Blunt Trauma Patients: Who Benefits from Radiologic Imaging?

2006 ◽  
Vol 72 (9) ◽  
pp. 773-777 ◽  
Author(s):  
Adrian W. Ong ◽  
Aurelio Rodriguez ◽  
Robert Kelly ◽  
Vicente Cortes ◽  
Jack Protetch ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cervical Spine ◽  
Blunt Trauma ◽  
Cervical Spine Injury ◽  
Motor Vehicle ◽  
Spine Injury ◽  
Trauma Patients ◽  
Cervical Spine Injuries ◽  
Spine Injuries ◽  
Anatomic Locations

There are differing recommendations in the literature regarding cervical spine imaging in alert, asymptomatic geriatric patients. Previous studies also have not used computed tomography routinely. Given that cervical radiographs may miss up to 60 per cent of fractures, the incidence of cervical spine injuries in this population and its implications for clinical management are unclear. We conducted a retrospective study of blunt trauma patients 65 years and older who were alert, asymptomatic, hemodynamically stable, and had normal neurologic examinations. For inclusion, patients were required to have undergone computed tomography and plain radiographs. The presence and anatomic location of potentially distracting injuries or pain were recorded. Two hundred seventy-four patients were included, with a mean age of 76 ± 10 years. The main mechanisms of injury were falls (51%) and motor vehicle crashes (41%). Nine of 274 (3%) patients had cervical spine injuries. The presence of potentially distracting injuries above the clavicles was associated with cervical injury when compared with patients with distracting injuries in other anatomic locations or no distracting injuries (8/115 vs 1/159, P = 0.03). There was no association of cervical spine injury with age greater or less than 75 years or with mechanism of injury. The overall incidence of cervical spine injury in the alert, asymptomatic geriatric population is low. The risk is increased with a potentially distracting injury above the clavicles. Patients with distracting injuries in other anatomic locations or no distracting injuries may not need routine cervical imaging.

Management of cervical spine injuries in young children: lessons learned

2009 ◽  
Vol 4 (1) ◽  
pp. 64-73 ◽  
Author(s):  
Jodi L. Smith ◽  
Laurie L. Ackerman
Keyword(s):  
Cervical Spine ◽  
Young Children ◽  
Motor Vehicle ◽  
Public Awareness ◽  
Lessons Learned ◽  
Infants And Children ◽  
Cervical Spine Injuries ◽  
Spine Injuries ◽  
Car Safety ◽  
Safety Seat

Previous studies have shown that the correct use of car safety seats can protect infants and children from vehicular injury. Although child passenger devices are increasingly used in the US, motor vehicle crashes continue to be the leading cause of death and acquired disability in infants and children younger than 14 years of age. These events are likely related, at least in part, to the high percentage of children who are unrestrained or improperly restrained. The authors present 2 cases of severe cervical spine trauma in young children restrained in car safety seats during a motor vehicle crash: 1) a previously healthy 14-month-old girl who was improperly restrained in a forward-facing booster seat secured to the vehicle by a lap belt, and 2) a previously healthy 30-month-old girl who was a rear seat passenger restrained in a car safety seat. This study points out the unique challenges encountered in treating cervical spine injuries in infants and young children, as well as the lessons learned, and emphasizes the significance of continuing efforts to increase family and public awareness regarding the importance of appropriate child safety seat selection and use.

Effect of age on cervical spine injuries in children after motor vehicle collisions: effectiveness of restraint devices

2004 ◽  
Vol 39 (3) ◽  
pp. 483-486 ◽  
Author(s):  
Brian S Zuckerbraun ◽  
Katie Morrison ◽  
Barbara Gaines ◽  
Henri R Ford ◽  
David J Hackam
Keyword(s):  
Cervical Spine ◽  
Motor Vehicle ◽  
Motor Vehicle Collisions ◽  
Vehicle Collisions ◽  
Cervical Spine Injuries ◽  
Spine Injuries ◽  
Effect Of Age

scholarly journals Chronic Neck Pain Associated with an Old Odontoid Fracture: A Rare Presentation

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Mauricio Avila-Guerra
Keyword(s):  
Cervical Spine ◽  
Neurological Deficit ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Odontoid Fracture ◽  
Motor Vehicles ◽  
Rare Presentation ◽  
Cervical Spine Injuries ◽  
Wide Range ◽  
Spine Injuries

Cervical spine injuries represent a minority of injury cases in motor vehicles accidents but are a real threat to a patient’s life. In the wide range of cervical spine injuries, odontoid (dens) fractures represent the most common findings. These fractures are more usually found in the elderly population due to the changes associated with age. Neurological deficit is not frequently found in these injuries. The following is a case presentation of a chronic odontoid fracture with neurological deficit in a young man that was discovered 23 years after he sustained a motor vehicle accident.

scholarly journals Pediatric subaxial cervical spine injuries: origins, management, and outcome in 51 patients

2006 ◽  
Vol 20 (2) ◽  
pp. 1-7 ◽  
Author(s):  
Seref Dogan ◽  
Sam Safavi-Abbasi ◽  
Nicholas Theodore ◽  
Eric Horn ◽  
Harold L. Rekate ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Spinal Cord Injuries ◽  
Motor Vehicle ◽  
Fracture Dislocation ◽  
Cervical Spine Injuries ◽  
Factors Affecting ◽  
Vehicle Accidents ◽  
Subaxial Cervical Spine ◽  
Cervical Orthosis ◽  
Spine Injuries

Object In this study the authors evaluated the mechanisms and patterns of injury and the factors affecting management and outcome of pediatric subaxial cervical spine injuries (C3–7). Methods Fifty-one pediatric patients (38 boys and 13 girls; mean age 12.4 years, range 10 months–16 years) with subaxial cervical spine injuries were reviewed retrospectively. Motor vehicle accidents (MVAs) were the most common cause of injury. Overall, 12% presented with a dislocation, 63% with a fracture, 19% with a fracture–dislocation, and 6% with a ligamentous injury. The most frequently injured level was C6–7 (33%); C3–4 (6%) was least frequently involved. Sixty-four percent of patients were neurologically intact, 16% had incomplete spinal cord injuries (SCIs), 14% had complete SCIs, and three patients (6%) died after admission and before assessment. Treatment was conservative in 64%: seven (13%) wore a halo vest and 26 (51%) wore a rigid cervical orthosis. Surgery was performed in the other 18 patients (36%), with the breakdown as follows: 15 (30%) underwent an anterior approach, two (4%) had posterior approaches, and one (2%) had a combined approach. Postoperatively, four patients (8%) who had a neurological deficit improved. The overall mortality rate was 8%; all deaths were related to MVAs. There were no surgery-related deaths or complications. Conclusions Subaxial cervical spine injuries are common in children 9 to 16 years of age, and occur principally between C-5 and C-7. Multilevel injury is more common in children 8 years of age and older than in younger children and infants. Most patients with subaxial cervical spine injuries can be treated conservatively. Both anterior and posterior approaches are safe and effective.

Cervical Spine Injuries Associated With the Incorrect Use of Airbags in Motor Vehicle Collisions

Spine ◽  
2008 ◽  
Vol 33 (6) ◽  
pp. 631-634 ◽  
Author(s):  
William F. Donaldson ◽  
Stephen E. Hanks ◽  
Ahmad Nassr ◽  
Molly T. Vogt ◽  
Joon Y. Lee
Keyword(s):  
Cervical Spine ◽  
Motor Vehicle ◽  
Motor Vehicle Collisions ◽  
Vehicle Collisions ◽  
Cervical Spine Injuries ◽  
Spine Injuries

Cervical spine injuries from motor vehicle accidents

2003 ◽  
Author(s):  
N. Yoganandan ◽  
D.J. Maiman ◽  
F.A. Pintar ◽  
A. Sances
Keyword(s):  
Cervical Spine ◽  
Motor Vehicle ◽  
Motor Vehicle Accidents ◽  
Cervical Spine Injuries ◽  
Vehicle Accidents ◽  
Spine Injuries

scholarly journals Profile of Traumatic Cervical Spine Injuries in Assiut University Hospital

2020 ◽  
Vol 35 (1) ◽  
pp. 53-60
Author(s):  
Mohammed El-Beshbeshy ◽  
Mohamed Hassan ◽  
Al Moataz El-Sabrout ◽  
Mohammad El-Sharkawi
Keyword(s):  
Cervical Spine ◽  
University Hospital ◽  
Cervical Spine Injuries ◽  
Spine Injuries

Atlas Fractures

Neurosurgery ◽  
2010 ◽  
Vol 66 (suppl_3) ◽  
pp. A60-A67 ◽  
Author(s):  
Udaya K. Kakarla ◽  
Steve W. Chang ◽  
Nicholas Theodore ◽  
Volker K. H. Sonntag
Keyword(s):  
Cervical Spine ◽  
Motor Vehicle ◽  
Transverse Ligament ◽  
Cervical Spine Injuries ◽  
Burst Fractures ◽  
Bony Avulsion ◽  
Flexion Extension ◽  
Spine Injuries ◽  
Surgical Fixation ◽  
Atlas Fractures

Abstract OBJECTIVE To provide a comprehensive review of the biomechanics, pathophysiology, and clinical management of atlas fractures. METHODS Selected literature review. RESULTS Atlas fractures account for 25% of craniocervical injuries, 3% to 13% of cervical spine injuries, and 1% to 3% of all spinal injuries. Motor vehicle accidents account for 80% to 85% of atlas fractures, and the mechanism of injury is axial loading. Isolated atlas fractures are more common; however, 40% to 44% of atlas fractures have concomitant axis fractures. Fractures of isolated anterior or posterior arches are more common and typically seen with concomitant spine fractures. Isolated burst fractures are the second most common type and rarely cause neurological injury. Treatment of atlas fractures is based on whether they occur in isolation or in combination with other cervical spine injuries and on the integrity of the transverse ligament, which is best assessed with high-resolution magnetic resonance imaging. Isolated atlas fractures without injury of the transverse ligament or associated with bony avulsion of the transverse ligament can be treated with halo-brace immobilization and should be followed for instability with flexion-extension radiography. Surgical fixation is recommended for nonbony avulsion of the transverse ligament or if instability is present. The type of surgical fixation is determined by the concomitant craniocervical injuries if present. CONCLUSION Atlas fractures can be treated with halo-brace immobilization with acceptable outcomes. The role of surgical fixation, especially for atlas burst fractures, requires further study for clarification.

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