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PubMedDate not supplied

[Early radiological assessment of spinal injuries. Indication for additional imaging procedures].

UNLABELLED: The question of the best radiological diagnostic pathway to explore the acute spinal trauma is discussed. METHOD: the current state of knowledge is given, based on bibliography and the authors experience. RESULTS: Standard-radiography allows fast orientation. CT ist the best procedure for high resolution imaging of bony structures and MRI is best suited for soft tissue and medullar lesions. Ligamentous lesions are still explored with functional X-ray studies, but ligament rupture can be visualized directly by MRI. CONCLUSIONS: Standard-radiography must precede all further studies. In patients without neurological deficit: CT is indicated if standard radiography suspects a bony lesion. MRI is indicated, if there is a discrepancy between a normal radiography and severe complaints of the patient. functional radiographies are indicated if ligamentous damage is suspected, but MRI can directly visualize ligament rupture. In patients with a radicular lesion, CT is indicated. In patients with a medullar or central radicular lesion, MRI or Myelo-CT are indicated.

Adult↗
PubMed1989

[Computed tomography of spinal injuries].

Computed tomography images are free of superpositional effects. Therefore, today CT represents the most effective method of evaluating spinal fractures. Clear imaging of the vertebral elements provides a sufficient analysis of stability in most cases. Moreover, in the polytraumatized patient, every region of the body can be evaluated without new positioning. Thus, the sequence of therapy may become obvious within a reasonable amount of time. The 3-column theory has proved to be very effective for evaluation of the remaining stability in spinal fractures.

Fractures, Bone↗
PubMedDate not supplied

Impaired awareness of deficits and treatment adherence among people with traumatic brain injury or spinal cord injury.

OBJECTIVE: To examine the relation between impaired awareness of deficits (IAD) and treatment adherence and to verify previous findings regarding the types of disabilities that people with traumatic brain injury (TBI) tend to underestimate. DESIGN: Cross-sectional study. PARTICIPANTS: Twenty-four persons with moderate to severe TBI and 16 persons with traumatic spinal cord injury (SCI) admitted to an inpatient neurorehabilitation program. MAIN OUTCOME MEASURES: IAD assessed using the short version of the Problem Checklist of the Head Injury Family Interview and treatment adherence using the Medical Regimen Adherence Scale. RESULTS: Presence of IAD is linked with poor adherence. Patients with TBI significantly underestimate their emotional/behavioural and cognitive disabilities, but accurately assess their physical disabilities, whereas patients with SCI accurately assess all spheres. Patients with TBI are significantly less aware of their disabilities compared with the patients with SCI as expected. CONCLUSIONS: These results confirm IAD's link to treatment adherence, and support the observation that IAD is a common clinical feature of brain injury that should be carefully considered when making prognoses and developing and applying interventions with this population.

Adult↗
PubMed1986

[Computerized tomography in the acute diagnosis of spinal injuries].

Additional to conventional x-ray examinations, high-resolution CT has a greater impact on the diagnostic evaluation of severe spine injuries. It allows exact judgment of the condition of vertebral arch, articular processes, joints and spinal axis and therefore a better delineation of the stability or instability of spinal fractures. Intraspinal fracture of spinal stenosis and intra or paraspinal soft tissues lesions are much more easily detected. For this reasons CT-evaluation of severe spinal traumata permits earlier, much more precise and in many cases successful therapy.

Adolescent↗