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At least 865 records · Page 48Linked to original sources
PubMed1992

Double-level spinal injury resulting in "en bloc" dislocation of the lumbar spine. A case report.

We report the case of a 21-year-old man with a unilateral lumbosacral dislocation together with a fracture of L1 resulting in "en bloc" dislocation, which is difficult to classify from an anatomopathological and biomechanical point of view. Unilateral lumbosacral dislocation is likewise an infrequent injury with less than 10 cases previously reported. Its association results in an anterior displacement to the left of the whole lumbar spine. To our knowledge, this displacement "en bloc" of the lumbar spine represents a rotatory dislocation of the same, an injury which we have not seen described until now in the literature.

Adult↗
PubMed1992

[Classification and surgical indications in spinal injuries].

A simple and precise classification of vertebral injuries is the key to correct treatment, depending on the differentiation of temporary or permanent instability. This aim is met by a classification presented by Magerl, Harms, Gertzbein et al. It is based on three main types according to the pathomechanics consisting of several subgroups with morphological aspects. In the neurological field, indications for surgical treatment are absolute after a free interval or rapid rising of the level of lesion. In vertebral injuries operative indications are found in possibly permanent instabilities or kyphotic deformities. Some indications depend on the patient himself, especially age and psychosis.

Humans↗
PubMed2004

Engineering novel spinal circuits to promote recovery after spinal injury.

We have developed an innovative way to establish a functional bridge around a spinal lesion. We disconnected the T13 nerve from its muscle targets, leaving the proximal end intact. The cut end was inserted either into an intact spinal cord, to assess regeneration of T13 axons into the cord and synapse formation with spinal neurons, or caudal to a hemisection at L2/3, to assess restoration of function below the injury. Four to 28 weeks later, anterograde tracers indicated that axons from the inserted T13 nerve regenerated into the ventral horn, the intermediate zone, and dorsal horn base, both in intact and hemisected animals. Antibodies to cholinergic markers showed that many regenerating axons were from T13 motoneurons. Electrical stimulation of the T13 nerve proximal to the insertion site 4 weeks or more after insertion into the intact cord evoked local field potentials in the intermediate zone and ventral horn, which is where T13 axons terminated. Stimulation of T13 in 71% of the animals (8 hemisected, 7 intact) evoked contraction of the back or leg muscles, depending on the level of insertion. Animals in which T13 was inserted caudal to hemisection had significantly less spasticity and muscle wasting and greater mobility at the hip, knee, ankle, and digits in the ipsilateral hindlimb than did animals with a hemisection only. Thus, T13 motor axons form novel synapses with lumbosacral motor circuits. Because the T13 motor neurons retain their connections to the brain, these novel circuits might restore voluntary control to muscles paralyzed below a spinal lesion.

Animals↗
PubMed2000

[What must the family practitioner know about spinal injuries].

Spine injuries in a general practitioner's environment are mainly related to osteoporosis fractures in the elderly as well as cervical spine injuries in the elderly especially fractures of the odontoid process that need to be excluded if there is any suspicion. For osteoporotic spine fractures the invention of vertebroplasty offers a new treatment option and therefore patients should be transferred to a spine surgeon for further evaluation. The fracture of the odontoid process can end up in a non-union problem if not treated early; therefore this injury must be excluded in patients after sustaining any head contusion and complaints of neck pain afterwards.

Emergencies↗
PubMed1984

Atropine toxicity in acute cervical spinal injury.

A patient with a C.3/C.4 fracture dislocation resulting in an incomplete tetraplegia was treated with Cimetidine 400 mg bd to prevent gastrointestinal bleeding and 0.6 mg of atropine 6 hourly. He developed symptoms of atropine poisoning in the form of hallucinations, confusion and dilated pupils when the total dosage of atropine was 2.8 mg. This is far below the toxic levels normally considered necessary to produce atropine poisoning. The patient recovered. In view of the fact that this combination of drugs may be used in spinal units to prevent gastrointestinal bleeding and bradycardia, this experience is reported.

Adult↗
PubMed1998

[Thoraco-lumbar spinal injuries--surgical indications and timing].

In thoracolumbar spine injuries, the indication for operative treatment and the time of operation are defined basically by the injury-pattern and by complicating neurological deficits. Immediate decompression is crucial in cases with worsening or secondarily occurring neurological involvements; incomplete paraplegia calls for undelayed decompression. Since accompanying neurological impairment usually represents high-grade instability of the spine, decompression includes fusion of the unstable motion segments. Both stability and shape of the spine determine the functional and subjective result within certain limits of tolerance. Therefore, clear indications for operative treatment exist for the following situations: no reduction possible in a closed manner, conservative fixation unpromising after closed reduction, restoration of stability uncertain in mainly ligamentous injuries. In addition, significant kyphotic and/or scoliotic deformities also require operative correction for satisfying results. An individual evaluation of both the benefit and the risk of all available therapeutic options is needed for every single case of only relative indication for operative measures. The accurate analysis of the injury-pattern determining stability and chances of healing as well as the knowledge of the efficiency of the planned therapy are prerequisites for a differentiated indication.

Humans↗