Radiological Risk Factors for Neurological Deficits After Traumatic Mid and Low Lumbar Fractures

Study Design. Retrospective study. Objective. We identified radiological risk factors for neurological deficits in mid and low lumbar spinal fractures. Summary of Background Data. Although numerous studies have focused on radiological risk factors for neurological deficits in spinal cord injury or thoracolumbar junction area fractures, few have examined mid and low lumbar fractures at the cauda equina level. Methods. We retrospectively reviewed 71 consecutive patients who suffered acute traumatic mid and low lumbar fractures (L2–L5) corresponding to the cauda equina level, as confirmed on magnetic resonance imaging. We defined a neurological deficit as present if the patient had any sensory or motor deficit in the lower extremity or autonomic system at the initial assessment. Various computed tomography parameters of canal stenosis, vertebral body compression, sagittal alignment, interpedicular distance, and presence of vertical laminar fractures were analyzed as independent risk factors to predict neurological deficits using multivariate logistic regression analyses. Results. At the initial assessment, 31 patients had neurological deficits. Fracture level, AO fracture type, canal encroachment ratio, vertebral compression ratio, interpedicular distance ratio, and presence of a vertical laminar fracture were significantly associated with the presence of neurological deficits (all P 
Source: Spine - Category: Orthopaedics Tags: DIAGNOSTICS Source Type: research

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CONCLUSIONS: Our data suggest a relevant gap between recommendations and clinical routine for time to some assessments after spinal cord injury. Within the framework of a quality improvement project, the next steps should be to build a national and international consensus on specific time frames for examinations and assessments in patients with a newly acquired spinal cord injury and thereafter, to develop an institutional implementation strategy.    . PMID: 32730632 [PubMed - in process]
Source: Swiss Medical Weekly - Category: General Medicine Authors: Tags: Swiss Med Wkly Source Type: research
Retrospective review The degree of spinal cord compression and bony spinal canal stenosis are risk factors for the occurrence of spinal cord injury (SCI) without major fracture or dislocation, but they do not affect the severity of neurological symptoms. However, whether a relatively large spinal cord for the dural sac influences the severity of symptoms in SCI cases is unknown. The purpose of this study was to verify the influence of spinal cord size relative to dural sac on the severity of paralysis in elderly patients with cervical SCI caused by minor trauma. Subjects were 50 elderly patients with SCI caused by falls...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
This study aimed to evaluate the frequency of os odontoideum in Turkish cases by sagittal/coronal cervical magnetic resonance imaging (MRI) and computed tomography (CT) and analyze the relationship with age, gender and related symptoms.MethodsThe incidence of os odontoideum was retrospectively diagnosed by sagittal/coronal cervical CT and MRI out of 16,122 subjects aged 20 –70 years (mean 46) in the period between 2014 and 2018. The relationship of os odontoideum with age, gender, and symptoms was recorded.ResultsThe statistical analysis of the study was performed by theχ² test and two-way mixed ANOVA. ...
Source: Surgical and Radiologic Anatomy - Category: Anatomy Source Type: research
Cervical spondylotic myelopathy (CSM) is a neurologic condition that develops insidiously over time as degenerative changes of the spine result in compression of the cord and nearby structures. It is the most common form of spinal cord injury in adults; yet, its diagnosis is often delayed. The purpose of this article is to review the pathophysiology, natural history, diagnosis, and management of CSM with a focus on the recommended timeline for physicians suspecting CSM to refer patients to a spine surgeon. Various processes underlie spondylotic changes of the canal and are separated into static and dynamic factors. Not all...
Source: Journal of the American Board of Family Medicine - Category: Primary Care Authors: Tags: Clinical Review Source Type: research
Conclusion: It appears that obtaining an MRI in addition to a CT before spine surgery for FD is essential mandatory, as it changed the treatment option in nearly 60% of cases. PMID: 31893140 [PubMed]
Source: Surgical Neurology International - Category: Neurosurgery Tags: Surg Neurol Int Source Type: research
Conclusion: ASA occlusion was not observed in CCM patients with spinal canal sagittal diameter compression of more than 80%. PMID: 31791211 [PubMed - as supplied by publisher]
Source: Journal of Spinal Cord Medicine - Category: Orthopaedics Tags: J Spinal Cord Med Source Type: research
We present a case of a 66-year-old man with no pertinent past medical history, who presented with progressive quadriparesis and gait ataxia over last 6 months (Nurick's grade 2). Neurological exam revealed pattern suggestive of high-cervical myelopathy with no evidence of cranial nerve paresis. Magnetic resonance imaging (MRI) of his CVJ revealed a large pannus behind the dens with severe spinal cord compression, mild contrast enhancement was noted posterior to the pannus, likely from the ligamentous structures; pannus was hypointense on both T1- and T2-weighted images. Further, a computerized tomography (CT) scan did not ...
Source: Journal of Neurological Surgery Part B: Skull Base - Category: Neurosurgery Authors: Tags: Skull Base: Operative Videos Source Type: research
ConclusionGreater the rostrocaudal LOE, worse is the neurology at presentation, and it is associated with poor neurological recovery at follow-up.Graphic abstractThese slides can be retrieved under Electronic Supplementary Material.
Source: European Spine Journal - Category: Orthopaedics Source Type: research
AbstractPurposeThe Spinal Cord Society constituted a panel tasked with reviewing the literature on the radiological evaluation of spinal trauma with or without spinal cord injury and recommend a protocol. This position statement provides recommendations for the use of each modality, i.e., radiographs (X-rays), computed tomography (CT), magnetic resonance imaging (MRI), as well as vascular imaging, and makes suggestions on identifying or clearing spinal injury in trauma patients.MethodsPubMed was searched for the corresponding keywords from January 1, 1980, to August 1, 2017. A MEDLINE search was subsequently undertaken aft...
Source: European Spine Journal - Category: Orthopaedics Source Type: research
We present a case of a 17-year-old boy who suffered a severe head trauma during a car accident. He had prolonged confinement in the supine position because of ongoing coma. The SMAS developed due to a progressive weight lost. Upper gastrointestinal Barium contrast study, fibroesophagogastroduodenoscopy (FEGDS), abdomen computed tomography scan (CT) were not specific and only, magnetic resonance imaging (MRI) findings suggested diagnosis of SMAS. As there was no response to the conservative treatment, surgical intervention of duodenojejunostomy was performed. The postoperative period was successful.
Source: Journal of Pediatric Surgery Case Reports - Category: Surgery Source Type: research
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