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At least 1,045 records · Page 58Linked to original sources
PubMed1995

Penetrating spinal injury inflicted by screwdriver: unusual morphological findings.

A 50-year-old female victim died of recurrent pulmonary embolism, 3 months after having received multiple screwdriver stab wounds in the neck and upper spine. Autopsy showed that one stab had penetrated the middle part of the cervical spinal cord and thus caused an incomplete tetraplegia. In the region of the healed spinal cord and the affected meninges, a considerable amount of hair and textile fibres surrounded by foreign body giant cells and elastic fibres of spinal ligament were found, all of which had been carried into the stab canal by the blunt tip of the screwdriver. In addition to the primary clinical findings, this unusual transportation of matter into the depth of the stab canal allowed identification of the murder weapon.

Journal Article↗
PubMed1991

Mid-ileal stricture and spinal injury sustained by a 7 year old child restrained by a lap seat belt involved in a motor vehicle accident.

Lap belts are a feature of the middle seat occupant in the rear seat of most Australian family cars. Without the provision of a child harness, they are inadequate to restrain children under eight years of age. We report a motor vehicle accident involving a seven year old child wearing an adult lap belt which resulted in an ileal stricture and a potentially unstable distraction injury of the lumbar spine.

Accidents, Traffic↗
PubMed2006

Timing of thoracic and lumbar fracture fixation in spinal injuries: a systematic review of neurological and clinical outcome.

A systematic review of all available evidence on the timing of surgical fixation for thoracic and lumbar fractures with respect to clinical and neurological outcome was designed. The purpose of this review is to clarify some of the controversy about the timing of surgical fracture fixation in spinal trauma. Better neurological outcome, shorter hospital stay and fewer complications have been reported after early fracture fixation. But there are also studies showing no difference in neurological outcome when compared to late treatment. Mortality is another controversial point since a recent report of higher mortality in early treated patients. A systematic review of the literature was preformed. Ten articles were included. Early fracture fixation is associated with less complications, shorter hospital and ICU stay. The effect of early treatment on the neurological outcome remains unclear due to the contradictory results of the included studies. Early thoracic and lumbar fracture fixation results in improvement of clinical outcome, but the effect on neurological outcome remains controversial.

Fracture Fixation, Internal↗
PubMed1988

[Acute management of spinal injuries. The cervical spine, conservative therapy].

Stable injuries of the cervical spine can be treated with a cervical collar. Unstable injuries that do not require repositioning can be immobilized with a Minerva plaster cast. Crutchfield's extension is used for extension of short duration during repositioning before setting a cast or performing surgery and for long-term extension in cases of transverse lesions of the spinal cord. The Halo apparatus is especially suitable for treatment requiring extension of long duration when there are no symptoms of transverse lesions of the spinal cord.

Atlanto-Axial Joint↗
PubMed1993

[Unstable spinal injuries in craniocerebral trauma].

Estimates of the incidence of injury to the cervical spine among patients suffering blunt trauma to the head vary widely. In an attempt to quantify the risk, the records of 593 consecutive patients with blunt craniocerebral injuries admitted to our trauma center in 1991 were reviewed. The overall incidence of cervical spine injuries was 5.8% and for the unstable cervical spine injuries 2.9%. In the management of head trauma with associated cervical spine injuries realignment and immobilisation of the spine and surgery of the head were carried out as first step, followed by decompression and stabilisation of the affected segment in the same session. In patients with altered consciousness a loss of cooperation is always present and an early spinal stabilisation for the optimal treatment in the intensive care unit and in the wake-up-phase is important.

Adult↗
PubMedDate not supplied

[Use of transpedicular fixation in treatment of thoraco-lumbar spinal injuries].

In Orthopaedic University Department in Lublin in years 1993-1998 39 patients with thoraco-lumbar spine injuries were treated including 34 fractures and 5 luxations. All of them were treated by surgery. Complete neurological palsy (Frankel A) occurred in 16 patients. Grade E on Frankel scale e.g. no neurological symptoms was in 2 cases. The operations consisted of wide laminectomy with interpedicular joints resection. It gave chance to mobilise the dural sac with its contents. In this situation it was possible to remodel the anterior wall of spinal canal by removal of fractured bony pieces from vertebral body or fibroid remnants of damaged disc. Injured segments of the spine were stabilized by Kluger's fixateur. In 20 cases reduction of vertebral body fracture and filting of bone loss by autogenic spongiosa grafts from iliac crest as proposed by Daniaux was done. In 6 patients posterior interbody spondylodesis was done also with iliac crest grafts. In 9 patients who had only reduction of injured segments, without vertebral body reconstruction and spondylodesis loss of correction occurred after fixateur removal. In 3 patients fatigue break of screws or stabilizing rods developed. It happened 12-16 months after surgical procedure. In patients with primary complete neurological palsy from the level of injury (Frankel A) no symptoms of function improvement appeared higher than one grade in Frankel's scale.

Adolescent↗
PubMed1992

Treatment of lower cervical spinal injuries--C3 to C7.

Injuries of the lower cervical spine are categorized according to the morbid anatomy of the lesion. Most often, such injuries are successfully treated by surgery through a posterior approach. After anatomic restoration, internal fixation with plates and screws provides for stability and arthrodesis. Of 221 cases of lower cervical spine injuries, posterior stabilization was accomplished in 89%. There was no secondary displacement in 85% of cases.

Cervical Vertebrae↗
PubMed1990

[Use of demineralized bone sawdust in the treatment of spinal injuries].

The experimental investigation for the purpose of studying the possibility of intervertebral osseous adhesion formation when demineralized osseous sawdust is introduced in the intervertebral disk in case of penetrating fractures of bodies of vertebra has been carried out. In 70% of cases the osseous adhesion is formed at the level of disks which demineralized osseous sawdust was introduced to (adhesion was formed, mainly, as perifocal osseous stratifications). Osseous adhesion, in case of introduction of lekozim to the damaged disk, was noted in 20% of cases (1 animal). Osteogenesis in disks was absent in all observations in the control group. When used in clinics in 12 patients with injuries of vertebral column in 63.6% of them perivertebral osseous connection has been formed during 8-12 months.

Animals↗
PubMed1990

[Computerized tomography of spinal injuries].

The authors have presented their experience of computer roentgen tomography application in 127 patients with complicated and noncomplicated spine damages, attained during 1987-89 in the clinic of the Byelorussian research institute of traumatology and orthopaedics. Computer tomography examinations allowed to determine spine fractures in 12 patients for the first time, reveal additional damages of the spine frontal sections in 35 patients and of the rear support complex in 30 patients. The causes of neurological disorders have been defined more precisely in 74 observations. Computer tomography possibilities as to the spine and spinal cord damage diagnosis are represented in the offered observations with demonstration of pictures obtained with/without subarachnoid space contrasting, in different hardness modes, formed according to the assigned programs.

Cervical Vertebrae↗
PubMedDate not supplied

[Conservative treatment of spinal injuries yesterday and today].

Since 60 years fractures of the spine are reduced by longitudinal traction and hyperlordosis and then immobilized in a plaster jacket followed by an intensive exercise programme. This type of treatment was originated by Davis, Watson-Johnes and Lorenz Böhler. Inspite of the increase of operative stabilizations this method of treatment is still valid.

Casts, Surgical↗
PubMed2005

Penetrating spinal injury with wooden fragments causing cauda equina syndrome: case report and literature review.

STUDY DESIGN: Case report. OBJECTIVE: To report an unusual case of cauda equina syndrome following penetrating injury to the lumbar spine by wooden fragments and to stress the importance of early magnetic resonance imaging (MRI) in similar cases. SUMMARY OF BACKGROUND DATA: A 22-year-old girl accidentally landed on wooden bannister and sustained a laceration to her back. She complained of back pain but had fully intact neurological function. The laceration in her back was explored and four large wooden pieces were removed. However 72 h later, she developed cauda equina syndrome. MRI demonstrated the presence of a foreign body between second and third lumbar spinal levels following which she underwent emergency decompressive laminectomy and the removal of the multiple wooden fragments that had penetrated the dura. RESULTS: Post-operatively motor function in her lower limbs returned to normal but she continued to require a catheter for incontinence. At review 6 months later, she was mobilising independently but the incontinence remained unchanged. CONCLUSION: There are no reported cases in the literature of wooden fragments penetrating the dura from the back with or without the progression to cauda equina syndrome. The need for a high degree of suspicion and an early MRI scan to localise any embedded wooden fragments that may be separate from the site of laceration is emphasized even if initial neurology is intact.

Adult↗
PubMed1999

Value of homonymous and heteronymous monosynaptic reflexes in the diagnosis and follow-up of cervical spinal injuries.

Needle electromyographic examination constitutes the only neurophysiological test used routinely to assess the integrity of proximal nerve pathways. A heteronymous reflex, with a latency consistent with a monosynaptic pathway, can be evoked in the contracting biceps brachii muscle by stimulation of the median nerve at the elbow. This reflex response provides a complementary technique to the biceps and supinator jerks for accessing the C(5)/C(6)motoneuron pool because its afferent limb involves the median nerve and the C(5)/C(6)posterior roots. Three cases are described to illustrate the clinical value of this heteronymous monosynaptic reflex of biceps brachii and of conventional H reflexes in the diagnosis and follow-up of lesions involving the C(5)/C(6)segments. Reflex function can be assessed for most spinal segments innervating the upper and lower limbs, thus allowing both objective confirmation of the clinical findings and documentation of changes over time. Copyright 1999 Harcourt Publishers Ltd.

Journal Article↗
PubMed1990

[Posterior stabilization of complicated spinal injuries with titanium plates].

Decompressive operations due to the complicated damages of thoracal and lumbar parts of the spine aggravate its instability. Existing constructions for inner momentary stabilization of spine are not effectual enough. On the basis of biomechanical and clinical investigations individuality modelled titanium plates with multilevel fixation by means of polymeric materials are proposed. They ensure situationally strong spine stabilization. It is possible to regulate operation mode of the plates: contraction, distraction, neutral stabilization and their combinations.

Accidental Falls↗