Cervical Spine Clearance in Obtunded Patients After Blunt Traumatic Injury

2015 ◽  
Vol 162 (6) ◽  
pp. 429 ◽  
Author(s):  
Jetan H. Badhiwala ◽  
Chung K. Lai ◽  
Waleed Alhazzani ◽  
Forough Farrokhyar ◽  
Farshad Nassiri ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Traumatic Injury

Multiple subluxations and comminuted fracture of the cervical spine in a sheep

2015 ◽  
Vol 43 (01) ◽  
pp. 44-38
Author(s):  
C.-C. Lin ◽  
K.-S. Chen ◽  
Y.-L. Lin ◽  
J. P.-W. Chan
Keyword(s):  
Cervical Spine ◽  
Pain Perception ◽  
Cervical Vertebrae ◽  
Traumatic Injury ◽  
Spinal Reflexes ◽  
Spine Trauma ◽  
Blunt Force Trauma ◽  
Comminuted Fracture ◽  
History Of ◽  
The Right

SummaryA 5-month-old, 13.5 kg, female Corriedale sheep was referred to the Veterinary Medicine Teaching Hospital, with a history of traumatic injury of the cervical spine followed by non-ambulatoric tetraparesis that occurred 2 weeks before being admitted to the hospital. At admission, malalignment of the cervical spine with the cranial part of the neck deviating to the right was noted. Neurological examinations identified the absence of postural reactions in both forelimbs, mildly decreased spinal reflexes, and normal reaction to pain perception tests. Radiography revealed malalignment of the cervical vertebrae with subluxations at C1–C2 and C2–C3, and a comminuted fracture of the caudal aspect of C2. The sheep was euthanized due to a presumed poor prognosis. Necropsy and histopathological findings confirmed injuries of the cervical spine from C1 to C3, which were consistent with the clinical finding of tetraparesis in this case. This paper presents a rare case of multiple subluxations of the cervical spine caused by blunt force trauma in a young sheep. These results highlight the importance of an astute clinical diagnosis for such an acute cervical spine trauma and the need for prompt surgical correction for similar cases in the future.

Mechanical Properties of Injured Human Cervical Spine Ligaments and Corresponding Effect on Spinal Kinematics

2011 ◽  
Author(s):  
P. Devin Leahy ◽  
Christian M. Puttlitz
Keyword(s):  
Cervical Spine ◽  
Soft Tissue ◽  
Dynamic Range ◽  
Traumatic Injury ◽  
Soft Tissue Injuries ◽  
Neurological Impairment ◽  
Cervical Instability ◽  
Cervical Spine Instability ◽  
Tissue Injuries ◽  
Flexion And Extension

The assessment of cervical spine instability following traumatic injury is controversial [1, 4, 5, 8]. Typical definitions of cervical instability are based on the presence of several key detectable injuries using simple radiographs, computed tomography (CT), and magnetic resonance (MR) imaging. Although these imaging modalities have been shown to be relatively reliable for detection of fractures and very large soft tissue injuries, they are largely deficient for determining the presence of smaller soft tissue injuries, such as hyperstrained ligaments [1, 3]. Soft tissue injuries of this nature may be revealed with dynamic range of motion (ROM) assessment, such as a flexion and extension test with radiography. However, these tests are currently inadequate for determining the existence of specific injuries. Cervical soft tissue injuries demand further analysis, given the risk of severe and permanent neurological impairment that may accompany these injuries [2, 5].

scholarly journals Posterior fusion of the subaxial cervical spine: indications and techniques

2001 ◽  
Vol 10 (4) ◽  
pp. 1-8 ◽  
Author(s):  
James K. Liu ◽  
Kaushik Das
Keyword(s):  
Cervical Spine ◽  
Traumatic Injury ◽  
Spinal Instrumentation ◽  
Posterior Fusion ◽  
Neoplastic Disease ◽  
Cervical Instability ◽  
Biomechanical Stability ◽  
Subaxial Cervical Spine ◽  
Fixation Devices ◽  
Stabilization Procedure

The biomechanical stability of the subaxial cervical spine (C3–7) can be compromised by numerous pathological processes, and the restoration of stability may ultimately require fusion and placement of rigid internal fixation devices. A posterior fusion and stabilization procedure is often used to treat cervical instability secondary to traumatic injury, rheumatoid arthritis, ankylosing spondylitis, neoplastic disease, infections, and previous laminectomy. Numerous techniques and advances in spinal instrumentation have evolved over the last 30 years. The authors review the indications and the various methods for stabilizing and fusing the subaxial cervical spine via posterior approaches.

scholarly journals Complications of Halo Vest Orthosis: A Narrative Study

2021 ◽  
Vol 7 (3) ◽  
pp. 131-138
Author(s):  
Ali Babashahi ◽  
◽  
Majid Rezvani ◽  
Majid Vatankhah ◽  
Navid Kalani ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Traumatic Injury ◽  
Cervical Spine Fracture ◽  
Halo Vest ◽  
Narrative Study ◽  
Beneficial Effects ◽  
Starting Point ◽  
Pin Site ◽  
Immobilization Device ◽  
Unstable Cervical Spine

Background and Aim: Perry and Nickel introduced the halo vest in 1959. It is the most common immobilization device for the unstable cervical spine. In the literature review, most articles review the beneficial effects of the halo vest, and a few report its complications. This study aims to evaluate the complications associated with halo orthosis. Methods and Materials/Patients: This is a narrative study about halo vest complications. To provide up-to-date information, we reviewed the articles written about halo complications. All relevant articles were retrieved from Google Scholar, Medline, PubMed, etc., using the keywords of “halo vest orthosis”, “unstable cervical spine fracture”, “halo vest complications”, “halo vest immobilization”, “pin-site-related complications”, and “vest-related complications”. Afterward, we reviewed and critically analyzed the articles. Results: At first, the halo vest was used for postoperative paralyzed poliomyelitis patients, and later, it was also used for traumatic injury of the cervical spine or postoperatively in cervical spine reconstructive surgery. Compared to other orthoses, the halo vest provides a more effective external fixation and maintains normal anatomic alignment of the cervical spine without impacting jaw motion and resulting in eating problems. However, it has many temporary complications. To prevent halo vest complications, experienced people should apply it, and the patients should be regularly followed up for early detection and treatment of complications. Conclusion: Our review is the starting point for the evaluation and investigation of halo vest complications. Because of the high incidence of pin loosening and infection, it is better to evaluate the design and application of halo pin. Since the initial design of the halo vest, only its superstructure has been redesigned without any significant change in other parts of it.

scholarly journals Cervical Spinal Cord, Root, and Bony Spine Injuries

2011 ◽  
Vol 114 (4) ◽  
pp. 782-795 ◽  
Author(s):  
Bradley J. Hindman ◽  
John P. Palecek ◽  
Karen L. Posner ◽  
Vincent C. Traynelis ◽  
Lorri A. Lee ◽  
...  
Keyword(s):  
Cervical Spine ◽  
General Anesthesia ◽  
Cervical Spinal Cord ◽  
Traumatic Injury ◽  
Cervical Cord ◽  
Cervical Injury ◽  
Claims Database ◽  
Cord Injury ◽  
Spine Injuries ◽  
Closed Claims

Background The aim of this study was to characterize cervical cord, root, and bony spine claims in the American Society of Anesthesiologists Closed Claims database to formulate hypotheses regarding mechanisms of injury. Methods All general anesthesia claims (1970-2007) in the Closed Claims database were searched to identify cervical injuries. Three independent teams, each consisting of an anesthesiologist and neurosurgeon, used a standardized review form to extract data from claim summaries and judge probable contributors to injury. Results Cervical injury claims (n = 48; mean ± SD age 47 ± 15 yr; 73% male) comprised less than 1% of all general anesthesia claims. When compared with other general anesthesia claims (19%), cervical injury claims were more often permanent and disabling (69%; P < 0.001). In addition, cord injuries (n = 37) were more severe than root and/or bony spine injuries (n = 10; P < 0.001), typically resulting in quadriplegia. Although anatomic abnormalities (e.g., cervical stenosis) were often present, cord injuries usually occurred in the absence of traumatic injury (81%) or cervical spine instability (76%). Cord injury occurred with cervical spine (65%) and noncervical spine (35%) procedures. Twenty-four percent of cord injuries were associated with the sitting position. Probable contributors to cord injury included anatomic abnormalities (81%), direct surgical complications (24% [38%, cervical spine procedures]), preprocedural symptomatic cord injury (19%), intraoperative head/neck position (19%), and airway management (11%). Conclusion Most cervical cord injuries occurred in the absence of traumatic injury, instability, and airway difficulties. Cervical spine procedures and/or sitting procedures appear to predominate. In the absence of instability, cervical spondylosis was the most common factor associated with cord injury.

Increased rates of fibromyalgia following cervical spine injury. A Controlled study of 161 cases of traumatic injury

1997 ◽  
Vol 40 (3) ◽  
pp. 446-452 ◽  
Author(s):  
Dan Buskila ◽  
Lily Neumann ◽  
Genady Vaisberg ◽  
Daphna Alkalay ◽  
Frederick Wolfe
Keyword(s):  
Cervical Spine ◽  
Cervical Spine Injury ◽  
Traumatic Injury ◽  
Controlled Study ◽  
Spine Injury

scholarly journals The state of the sagittal balance of the injured cervical spine depending on the nature of the damage to the subaxial level

TRAUMA ◽  
2021 ◽  
Vol 22 (3) ◽  
pp. 48-57
Author(s):  
O.S. Nekhlopochyn ◽  
V.V. Verbov
Keyword(s):  
Cervical Spine ◽  
Sagittal Balance ◽  
Traumatic Injury ◽  
The State ◽  
Sagittal Profile ◽  
Spine Injury ◽  
Cervical Lordosis ◽  
Subaxial Cervical Spine ◽  
Wide Range ◽  
Type Of Injury

Background. Three main interrelated principles form the basis for modern surgery of traumatic cervical spine injuries, namely decompression, reconstruction and stabilization. Restoration of the sagittal profile is one of the basic tasks of the reconstructive stage. Currently, there are no clear recommendations for surgical management in traumatic injuries depending on the degree of deformation, and the state of sagittal balance of the injured cervical spine in the preoperative period has practically not been studied. The purpose of the work is to study the state of the sagittal profile and the degree of segmental deformation of the cervical spine following traumatic injury at the subaxial level, to determine the relationship between them and the type of injury. Materials and methods. We performed a retrospective analysis of X-ray data from 140 patients with subaxial cervical spine traumatic injury who were hospitalized at the Department of Spinal Cord Pathology of the Romodanov Neurosurgery Institute of the National Academy of Medical Sciences of Ukraine in the period from 2008 to 2018. We calculated indicators of segmental kyphosis and general cervical lordosis and determined the type of damage according to AO Spine Subaxial Cervical Spine Injury Classification System. Results. We found that the type of the damage affects the degree of segmental deformation (p < 0.001). Type A1, A2 and C injuries show the maximum kyphotic angulation: 13.51° (8.18; 20.07), 21.8° (20.12; 22.96) and 20.01° (17.52; 21.99), respectively. Injuries of type A2 and C statistically significantly differ from other types of lesions. We registered maximum values of deviations from the normal sagittal circuit in patients with injuries types A2 and C: ‒26.77° (‒32.78; ‒20.91) and ‒26.70° (‒36.30; ‒16.77), respectively. The parameters of segmental kyphosis and general cervical lordosis reveal high interdependence (r2 = 0.766, p < 0.001). We found maximum correlation in type A3, A4 and B3 injuries: ‒0.93, ‒0.91 and ‒0.97, respectively (p < 0.001). And types A1 and A2 injuries demonstrated statistically insignificant relationship (p > 0.05). Conclusions. The results show that traumatic injury of the subaxial cervical spine is characterized by a wide range of kyphotic segmental angulation values, which is largely determined by the type of injury. General cervical lordosis tends to flatten in most cases, but the degree of physiological curvature loss correlates with local deformation to some extent.

scholarly journals Traumatic injury of the transverse atlantal ligament

2018 ◽  
Vol 20 (3) ◽  
pp. 351-355
Author(s):  
Fabrizio Borges Scardino ◽  
Ricardo Vieira Botelho
Keyword(s):  
Cervical Spine ◽  
Traumatic Injury ◽  
Ligament Injury ◽  
Bony Injury ◽  
Mri Study ◽  
C2 Fixation ◽  
Atlantodental Interval ◽  
Conventional Radiology ◽  
Flexion And Extension ◽  
Transverse Atlantal Ligament

Introduction. In some cases C2 may suffer only rotational dislocation around its own axis (dens), causing no increase in the atlantodental interval (ADI), making it difficult to diagnose the instability in static radiographies. Objective. To report a case of atlanto-axial traumatic subluxation, without bony injury or displacement, in which the diagnosis cannot be achieved through conventional radiology and computed tomography, and discuss the types of transverse ligament injuries, its diagnosis, the instability and their treatment. Methods.A 61-year-old man, victim of head (occipital), complaining neck. Static radiographies and CT scan of cervical spine were performed, demonstrating no abnormalities. Flexion and extension cervical radiography revealed an increase of ADI in flexion, indicating instability and damage to the transverse atlantal ligament (TAL). The MRI of the cervical spine demonstrated the discontinuity of the TAL, configuring an injury to the structure of the ligament. The patient underwent to early surgery with C1-C2 fixation using the Goel-Harms’technique. Results. The diagnosis could be revealed only in dynamic radiographs or MRI study. The patient presented complete improvement of symptoms. Conclusions. The use of cervical dynamic radiography and / or magnetic resonance imaging allowed the diagnosis of instability and visualization of the TAL injury, avoiding the lack of diagnosis with its consequences. The MRI allows a direct view of the ligament injury, their classification and the prognostic evaluation of the injury, guiding the therapy, surgical or conservative.

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