Respiratory complications in traumatic quadriplegia

1973 ◽  
Vol 39 (5) ◽  
pp. 596-600 ◽  
Author(s):  
Raymond Bellamy ◽  
Fredrick W. Pitts ◽  
E. Shannon Stauffer

✓ A 20-year series of 531 patients with cervical spine fractures or dislocations is reviewed, and the records of 54 quadriplegic patients are analyzed in detail. Tracheostomy, surgery, overhydration, advanced age, severity of neurological injury, and corticosteroid therapy are discussed as factors in pulmonary complications.

1970 ◽  
Vol 33 (1) ◽  
pp. 54-59 ◽  
Author(s):  
John D. Loeser

✓ Therapy of cervical spine fractures is reviewed from the time of the Egyptians (4000 B.C.) to the present day. Immobilization has been practiced for slightly more than a century; devices for exerting traction upon the skull have been in use for 37 years. The Renaissance surgeon, Fabricus Hildanus, designed a tool for exerting traction upon the cervical vertebrae, but this method did not become popular. Until the 20th century, few physicians considered the therapy of this common injury.


Author(s):  
Calan Mathieson ◽  
Chris Barrett ◽  
Likhith Alakandy

The management of cervical spine fractures is a complex and fascinating topic. A multitude of descriptive terminologies and classification systems have been developed over the years in an attempt to better understand this heterogenous group of patients. Despite this however, there is often little consensus with regards to the best way to manage this population. This chapter will predominantly discuss the decision-making process involved in the management of cervical spine fractures. The goal of the spine surgeon in managing patients with acute cervical spine injury is to prevent secondary neurological injury, deformity, and pain by re-establishing stability if necessary. Assessing how to achieve this goal can be very challenging. The surgeon will be faced with many questions. Which patients should undergo surgical intervention? Which operation will best stabilize the spine? Which patients should be treated with a collar or a halo vest? Does the injury require reduction with traction initially? There are also questions of timing. When should the surgeon plan the proposed procedure?


2002 ◽  
Vol 97 (1) ◽  
pp. 113-117 ◽  
Author(s):  
Kevin L. Stevenson ◽  
Matthew Wetzel ◽  
Ian F. Pollack

✓ Delayed complications associated with sublaminar and interspinous wiring in the pediatric cervical spine are rare. The authors present a case of delayed complication in which a cervical fusion wire migrated into the cerebellum, causing subsequent cerebellar abscess 2 years after posterior cervical arthrodesis. A craniotomy was required to remove the wire and drain the abscess. Despite their history of safety and successful fusion, procedures involving sublaminar and interspinous wiring carry a risk of neurological injury secondary to wire migration. A thorough neuroimaging evaluation is required in patients who have undergone fusion and who have neurological complaints to detect late instrumentation-related sequelae.


1994 ◽  
Vol 81 (6) ◽  
pp. 932-933 ◽  
Author(s):  
J. Bob Blacklock

✓ Sublaminar cables have been used to stabilize bone grafts for arthrodesis in the cervical spine in recent years. Previous accounts of their use have indicated no instances of breakage or neurological injury. This report is of a delayed cable fracture that resulted in penetration of the dura with neurological injury in a patient who had undergone atlantoaxial fusion for rheumatoid subluxation. The cable fracture occurred in the epidural space beneath the attempted arthrodesis and resulted in uncoiling of the cable, which penetrated the spinal canal and caused a one-sided sensory deficit.


1979 ◽  
Vol 50 (5) ◽  
pp. 603-610 ◽  
Author(s):  
Paul R. Cooper ◽  
Kenneth R. Maravilla ◽  
Frederick H. Sklar ◽  
Sarah F. Moody ◽  
W. Kemp Clark

✓ Thirty-three patients with a spectrum of cervical spine fractures or subluxations were treated with immobilization by a halo apparatus. All spines were assumed to be unstable because of the nature of the fracture or because of a subluxation noted on spine films. Treatment consisted of immobilization and fracture reduction followed by application of a halo plaster cast or molded halo plastic vest. Patient acceptance was high. Complications were few and minor. No patient experienced neurological deterioration during treatment. Reduction was well maintained during an average halo immobilization period of over 3 months. Use of the halo resulted in healing of bone and ligament and restoration of stability in 85% of the patients. Halo immobilization was efficacious in the treatment of odontoid and hangman's fractures as well as complex fractures involving multiple areas of a single vertebra. It was also used successfully as an adjunct to posterior cervical fusion. Although several patients with subluxations or angulation without bone injury were treated successfully, two of the four therapy failures occurred in this group of patients, and the halo must be used with caution in this clinical setting. Contraindications to the use of the halo include complete cervical spinal cord injury with anesthetic skin, tomographic and/or myelographic evidence of disc or bone within the spinal canal, and unsatisfactorily reduced subluxations. The halo has provided more effective and reliable immobilization than other orthoses. It is an acceptable alternative to cervical fusion for the achievement of stability in a wide variety of cervical spine fractures and dislocations avoiding both the short-term and perhaps long-term complications of spinal fusion.


1990 ◽  
Vol 9 (1) ◽  
pp. 13-29 ◽  
Author(s):  
Michael R. Marks ◽  
Gordon R. Reli ◽  
Francis R.S. Roumphrey

2010 ◽  
Vol 92 (3) ◽  
pp. 567-574 ◽  
Author(s):  
Mitchel B Harris ◽  
William M Reichmann ◽  
Christopher M Bono ◽  
Kim Bouchard ◽  
Kelly L Corbett ◽  
...  

1991 ◽  
Vol 75 (1) ◽  
pp. 131-133 ◽  
Author(s):  
Leonard F. Hirsh ◽  
Luis E. Duarte ◽  
Eric H. Wolfson ◽  
Wilhelm Gerhard

✓ Isolated cervical spinous process fractures are common, but are usually considered to be inconsequential. Although such fractures may produce pain, complete recovery without residual symptoms is expected after conservative treatment, and neurological injury does not usually occur. The case of a patient with a persistently symptomatic C-2 spinous process fracture that required surgical treatment for pain relief is reported. A review of the pertinent literature illustrates with unusual clarity the interactions of social, political, and economic forces associated with this medical condition.


2002 ◽  
Vol 96 (1) ◽  
pp. 122-126 ◽  
Author(s):  
Tateru Shiraishi

✓ The author describes a new technique for exposure of the cervical spine laminae in which the attachments of the semispinalis cervicis and multifidus muscles to the spinous processes are left untouched. It provides a conservative exposure through which a diverse range of posterior cervical surgeries can be performed. In contrast to conventional cervical approaches, none of the muscular attachments to the spinous processes is compromised. In this paper the author describes the technical details and discusses the applications of the procedure.


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