scholarly journals History of posterior thoracic instrumentation

2004 ◽  
Vol 16 (1) ◽  
pp. 1-4 ◽  
Author(s):  
Harshpal Singh ◽  
Scott Y. Rahimi ◽  
David J. Yeh ◽  
David Floyd
Keyword(s):  
Multiple Stressors ◽  
Spinal Injury ◽  
Posterior Instrumentation ◽  
Spinal Instrumentation ◽  
Spinal Column ◽  
Spinal Fractures ◽  
Thoracic Spinal ◽  
History Of ◽  
Central Meaning ◽  
Historical Treatment

The term “backbone” appears in many expressions used in modern day society. In any scenario, it has one central meaning: stability. Best defined as a foundation that is able to sustain multiple stressors without adversely affecting integrity, the commonly and appropriately termed backbone of humans is the spinal column. As the central focus of stability in our species, the spine is subject to a great degree of trauma and mechanical forces. A variety of methods have been developed throughout history in the treatment of spinal column injury. Initial treatment involved the use of simple traction devices for the reduction of spinal fractures; these have evolved to include the current insertion of spinal instrumentation. The authors review the historical treatment and development of posterior instrumentation for thoracic spinal injury.

scholarly journals Aortic Impingement in Displaced Traumatic Spine Fracture with Complete Spinal Cord Transection: A Case Report

2021 ◽  
pp. 1-7
Author(s):  
Asma Anan Mohammed ◽  
Fatima R. Shulaiba ◽  
Mina Hikmat Ismaeal Alhety ◽  
Hayder Saleh Abdul Hadi Al Saadi ◽  
Bilal El Yafawi
Keyword(s):  
Causes Of Death ◽  
Spinal Injury ◽  
Spinal Fractures ◽  
Clinical Problem ◽  
Aortic Injury ◽  
Thoracic Spinal ◽  
Thoracic Aortic Injury ◽  
Type C ◽  
Primary Focus ◽  
Lumbar Fractures

Aortic impingement associated with traumatic thoracic spinal fractures is a rare and potentially lethal complication that creates management challenges in an already complex clinical problem. Traumatic aortic injury is one of the leading causes of death in blunt trauma. Magerl divided thoracic and lumbar fractures into 3 categories; the primary focus of this report, type C fractures, describes rotational injury and is one of the less common types, especially associated with aortic impingement as such. In this case, a young man was admitted following a near-fatal fall resulting in blunt force trauma to the midthoracic region. Emergency CT revealed a type C complete transection at the level of T11 and a grade I aortic injury. Definitive fixation of the spinal injury was delayed in favor of preventing further vascular injury by prioritizing the securing of hemodynamic stability. In traumatic thoracolumbar injuries, blunt traumatic aortic injury is often managed conservatively. However, blunt thoracic aortic injury is one of the leading causes of death from trauma, and each case requires its own case-by-case multidisciplinary management. In this occasion, management of the vascular insult was paramount to ensuring patient survival and favorable outcome.

scholarly journals Biomechanical Evaluation of the MACSTL Internal Fixator for Thoracic Spinal Stabilisation

2008 ◽  
Vol 77 (1) ◽  
pp. 97-102 ◽  
Author(s):  
R. Veselý ◽  
Z. Florián ◽  
P. Wendsche ◽  
J. Tošovský
Keyword(s):  
Thoracic Spine ◽  
Spinal Column ◽  
Spinal Fractures ◽  
Internal Fixator ◽  
Additional Advantage ◽  
System A ◽  
Thoracic Spinal ◽  
Mechanical Study ◽  
Surgical Tactics ◽  
The Stability

Unstable fractures of the thoracic spine in humans represent a serious social and economic issue. They may lead to persistent consequences and chronic disease. The anatomical and biomechanical characteristics of the thoracic spine are different from all the other spinal parts due to its higher mobility. The vertebrae of the chest area are less mobile, conferring a higher degree of rigidity to the spine. To destabilize this relatively rigid system, a considerable force is necessary. The treatment of unstable spinal fractures is solely surgical. The decompression of the spinal canal with reposition and stabilisation of the fracture is indicated urgently. This intervention is performed mostly from the posterior approach in the first phase. However, the anterior spinal column is the structure responsible for the stability of the spine. Therefore, the recent advances in spine surgery focus on this area of expertise. For this reason, we carried out a bio-mechanical study aimed at assessing the effectiveness of two surgical tactics used. The study consisted of comparative experiments performed by computer-aided device on segments of pig cadavers (n = 5). The experiment involved a comparison of segments of the thoracic spine under the following conditions: an anatomically intact segment, a spine segment with an artificially created anterior instability, and a segment with an applied internal fixator. The experiment compared the mechanical characteristics of these segments. The experiment has demonstrated that after application of the internal fixator used for stabilisation of the injured anterior spinal column at defined pre-loading of 200 N, the stability of damaged spinal segment in torsion increased twofold. It was also verified that sufficient stability can be ensured using the Modular Anterior Construct System (MACSTL) implant for ventral stabilisation of thoracic spine unstable injuries. Endoscopic application of this implant represents an additional advantage of this surgical procedure.

scholarly journals A retrospective study of surgical treatment of spinal injuries with rehabilitation program

2011 ◽  
Vol 1 (1) ◽  
pp. 18-22
Author(s):  
Dijana Avdić ◽  
Amila Jaganjac ◽  
Bakir Katana ◽  
Samir Bojičić
Keyword(s):  
Traffic Accidents ◽  
Physical Therapists ◽  
Spinal Injury ◽  
Spinal Column ◽  
Spinal Fractures ◽  
Rehabilitation Program ◽  
Spinal Injuries ◽  
Team Approach ◽  
Therapy Program ◽  
The Difference

Introduction: Traumatic injuries of the spinal column are among the most devastating injuries in orthopedics. The primary goals of rehabilitation of these injuries are prevention of secondary complications, maximizing physical functioning and reintegration into the community. Rehabilitation after spinal injury reqires multidisciplinary team approach. Team members include, but are not limited to, physical therapists, occupational therapists, nurses, psychologists, health care managers and social workers, with each member having role and responsibility in their area of expertise. This study aimed to determine the difference in the occurrence of spinal injuries according to gender, age, cause of injury, neurological phenomenon in injured patients, the treatment and physical procedures used in the early stages of rehabilitation.Methods: The study was conducted as a retrospective and comparative at the Department of Orthopedics and Traumatology of Clinical Center University of Sarajevo. Medical records of 100 patients, treated at from January 1st 2007 till June 30th 2008, were processed and data about outpatient protocols and surgery protocols analyzed.Results: The results obtained from the data showed greater proportion of women (56%) compared to men (44%). Most patients were in the age group between 41 and 60. Injuries were most often due to falls from height and make 32%, fall from a tree 25%, traffic accidents 12% (²=17.94, p=0.0061). 88% of patients were without neurologic events, while the neurological disturbances occurred 12% (χ²=3.397, p=0.3343). 56% of patients with spinal injuries were treated surgically, while 41% were treated conservatively (χ ²=7.264, p= 0.00153). 73% patient had physical therapy program of early rehabilitation exercises, with at least at least only a massage in 4% of patients X² = 6.573, p = 0.04270).Conclusion: The adoption of national protocols is necessary for future treatment of patients with spinal fractures.

Primary Melanocytoma of the Lower Thoracic Spinal Cord: Case report and review of the literature

2019 ◽  
Vol 8 (1) ◽  
pp. 5
Author(s):  
Dimitrios Panagopoulos
Keyword(s):  
Total Resection ◽  
Thoracic Spinal Cord ◽  
Meningeal Melanocytoma ◽  
Melanocytic Tumors ◽  
Thoracic Spinal ◽  
Thoracolumbar Region ◽  
Rare Benign Tumor ◽  
Mri Scans ◽  
History Of ◽  
The Central Nervous System

Background: Meningeal melanocytoma is a rare benign tumor, most frequently located in the posterior fossa and spinal canal. Our objective is to illustrate a case of this tumor that originated in the thoracolumbar area of the spine and had an uneventful clinical course after total resection. Case description: We present the case of a 59 years old woman who presented with a medical history of ongoing neurological deterioration due to spastic paresis of the lower extremities. MRI of the thoracolumbar region identified a melanocytic melanoma as the underlying cause. Conclusions: Melanocytic tumors of the central nervous system have a typical appearance on MRI scans, varying with the content and distribution of melanin. However, the differential diagnosis between malignant melanoma and melanocytoma still depends on pathological criteria. Spinal meningeal melanocytoma has a benign course, and it is amenable for gross total resection. The outcome is favorable following complete resection.

A Rare Case of Spinal Leprosy Mimicking Spinal Tuberculosis

2019 ◽  
pp. 33
Author(s):  
K Thuraikumar ◽  
V Naveen ◽  
Mustaqim A ◽  
Arieff AA ◽  
K Shri ◽  
...  
Keyword(s):  
Back Pain ◽  
Soft Tissue ◽  
Histopathological Examination ◽  
Posterior Instrumentation ◽  
Spinal Tuberculosis ◽  
Previous History ◽  
Skin Lesions ◽  
Titanium Implants ◽  
Paravertebral Abscess ◽  
History Of

Introduction: Spinal tuberculosis is the most common manifestation of extrapulmonar y tuberculosis. A combination of leprosy and tuberculosis is a rare entity.Case report: A 44-year-old male patient working as a laborer presented to our hospital with complaints of severe back pain and swelling over the back, difficulty in walking, associated with constitutional symptoms. On admission, he was febrile and had leukocytosis. Initial spine X-ray showed end plate destruction and increase in soft tissue shadow at the level of T8-T9. CT spine revealed thoracic paravertebral collection extending from T7 to T9 levels, suggest ive of tuberculous spondylitis with cold abscess. Patient refused a transpedicular biopsy and was started on anti-tubercular therapy. Two weeks after commencement of treatment, he developed worsening back pain and weakness of the lower extremities. MRI spine showed a paravertebral abscess and posterior soft tissue edema involving level of T7 to T11. Patient underwent a posterior decompression, debridement and posterior instrumentation. He was discharged well, there was improvement of his lower limb power. Upon clinic review, he complained of multiple hyperpigmented, painless, nonpruritic skin lesions over the trunk and back. No previous history of eczema, psoriasis and Tinea corporis. Given the history of allergy, initial impression was hypersensitivity reaction towards the titanium implants, and he was started on anti-histamines. However, there was no improvements seen. Histopathological examination of skin lesions revealed presence of granuloma within the dermis layer, composed of epitheloid, histiocytes, lymphocytes and plasma cells. Wade-Fite stain for Mycobacterium leprae is positive. Slit skin smear shows multibacillary leprosy. Patient was started on multidrug therapy (rifampicin, clofazimine and dapsone) for 1 year. He has recovered well.International Journal of Human and Health Sciences Supplementary Issue: 2019 Page: 33

scholarly journals Just the Facts: Risk stratifying non-traumatic back pain for spinal epidural abscess in the emergency department

CJEM ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 753-755
Author(s):  
Zoe Polsky ◽  
Shawn K. Dowling ◽  
W. Bradley Jacobs
Keyword(s):  
Emergency Department ◽  
Back Pain ◽  
Epidural Abscess ◽  
Spinal Epidural Abscess ◽  
Thoracic Spinal ◽  
Life Threatening ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Whole Spine ◽  
Spinal Epidural

A 65-year-old male with a history of hypertension presents to the emergency department (ED) with new onset of non-traumatic back pain. The patient is investigated for life-threatening diagnoses and screened for “red flag symptoms,” including fever, neurologic abnormalities, bowel/bladder symptoms, and a history of injectiondrug use (IVDU). The patient is treated symptomatically and discharged home but represents to the ED three additional times, each time with new and progressive symptoms. At the time of admission, he is unable to ambulate, has perineal anesthesia, and 500 cc of urinary retention. Whole spine magnetic resonance imaging (MRI) confirms a thoracic spinal epidural abscess. This case, and many like it, prompts the questions: when should emergency physicians consider the diagnosis of a spinal epidural abscess, and what is the appropriate evaluation of these patients in the ED? (Figure 1).

scholarly journals Butterfly vertebra: a case report

2017 ◽  
Vol 31 (1) ◽  
pp. 80-84 ◽  
Author(s):  
D. Adam ◽  
D. Iftimie ◽  
Gina Burduşa ◽  
Cristiana Moisescu
Keyword(s):  
Vertebral Fracture ◽  
Diagnostic Procedures ◽  
Spinal Pain ◽  
Benign Condition ◽  
Thoracic Spinal ◽  
Schmorl’S Nodes ◽  
History Of ◽  
Epidural Fat ◽  
Vertebral Bodies ◽  
Local Examination

Abstract Background and importance: Butterfly vertebra is an uncommon congenital spinal anomaly, which can be easily mistaken for vertebral fracture, infection or tumor. Clinical presentation: We report the case of a 20-year-old male patient with a 3-year history of intermittent mid-thoracic spinal pain. Local examination showed a mild thoracic kyphoscoliosis. Neurological examination was normal. Computer tomography revealed the presence of a T6 butterfly vertebra associated with morphological anomalies in adjacent vertebral bodies and T6-T9 Schmorl’s nodes. MRI scan confirmed the diagnosis and additionally showed a mild spinal stenosis caused by apparent posterior epidural fat hypertrophy. The patient was treated with painkillers and physical therapy. Conclusion: Butterfly vertebra is a benign condition. Once diagnosed, additional diagnostic procedures are not necessary. Neurosurgeons must be aware of this congenital anomaly that should not be confused with a vertebral fracture.

Bilateral isolated C5 paralysis of the shoulder: Atypical presentation of a transdiscal C4-C5 cervical spine fracture

2021 ◽  
Vol 14 (3) ◽  
pp. e236323
Author(s):  
Elisa Mareddu ◽  
Aurélien Traverso ◽  
Pietro Laudato ◽  
Stefan Bauer
Keyword(s):  
Cervical Spine ◽  
Spinal Injury ◽  
Spinal Fractures ◽  
Low Energy ◽  
Cervical Spine Fracture ◽  
Atypical Presentation ◽  
American Spinal Injury Association ◽  
Initial Imaging ◽  
Clinical Awareness ◽  
Diagnostic Index

After a low-energy fall, an 83-year-old man presented with bilateral weakness of the upper arms without loss of sensation associated with a rigid cervical spine (ankylosing spinal disorder, ASD). Because of an atypical presentation during history, examination and initial imaging, a late diagnosis of a transdiscal C4-C5 fracture was made by dynamic radiographs. Anterior cervical discectomy and fusion were performed with delay. Strength improved from grade C to D (American Spinal Injury Association classification) after surgery. To our knowledge, this is the first description of a bilateral, isolated upper limb C5 paralysis without any loss of sensation caused by a transdiscal C4-C5 fracture. A high clinical and diagnostic index of suspicion is mandatory to make the diagnosis. We present three clinical ‘Awareness Criteria’ (1: recognition of ASD; 2: high index of fracture suspicion; 3: necessary imaging) helping clinicians to safely and promptly diagnose occult spinal fractures in ASD.

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