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PubMed · 15427752

Cervical disk protrusion.

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E NEUWIRTH. 1950. Cervical disk protrusion.. https://pubmed.ncbi.nlm.nih.gov/15427752/

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Measurement techniques for lower cervical spine injuries: consensus statement of the Spine Trauma Study Group.

STUDY DESIGN: Literature review. OBJECTIVES: It was the purpose of the Spine Trauma Study Group to compile a collection of clinically useful imaging methods used in lower cervical spine trauma and to describe in detail how these measurements should be made. SUMMARY OF BACKGROUND DATA: Injury detection, description, and treatment decision-making rely on accurate imaging of the lower cervical spine. However, a standard set of imaging measurement techniques for this region does not exist. While most clinicians have developed their own methods of describing radiographic pathology, this variability often leads to confusion in developing an agreed on classification system and limits treatment recommendations. METHODS: The available literature concerning measurement of injury characteristics after lower cervical trauma was reviewed. Consensus of the most potentially useful measurement methods among the surgeon members of the Spine Trauma Study Group was achieved. RESULTS: These measurements included the following: kyphosis (Cobb angle and posterior vertebral body tangent methods); vertebral body translation; vertebral body height loss; maximal spinal canal compromise and spinal cord compression; facet fracture fragment size; and percentage facet subluxation. CONCLUSIONS: A consistent and standard measurement technique among clinicians with regards to imaging of lower cervical spine trauma should positively influence treatment outcome. However, it is through prospective study that the clinical significance of these recommendations will be scientifically established.

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Predicting neurologic recovery in cervical spinal cord injury with postoperative MR imaging.

STUDY DESIGN: Prospective, nonrandomized, observational cohort study. OBJECTIVES: To determine whether the presence of spinal cord hemorrhage and length of hematoma on magnetic resonance imaging (MRI) is predictive of recovery in cervical spinal cord injury (SCI). SUMMARY OF BACKGROUND DATA: A clear picture of the location, extent, and severity of traumatic cervical cord injury can be obtained with MRI. Several prognostic studies looked for an association between the degree of SCI, as depicted by MRI, and neurologic outcome. Up to now, an association between the length of hemorrhage and the extent of SCI and motor recovery could not be demonstrated. METHODS: Twenty-nine patients with acute traumatic cervical spinal cord injury underwent surgery within 2 to 9 hours. MRI was performed within 2 weeks of injury. Neurologic impairment was classified using the ASIA classification. The effects of hemorrhage and length of hematoma on changes in the neurologic impairment were assessed at time of MRI and at median follow-up in 35 months (range, 24-65 months). RESULTS: Patients with hemorrhage were much more likely to have a complete injury at time of follow-up (odds ratio = 2.33, 95% confidence interval, 1.42-3.82). Patients admitted with complete SCI, ASIA A, showed a median length of hematoma of 10.5 mm and a median length of edema of 66.5 mm and no change at follow-up. Patients with incomplete SCI showed a median length of hematoma of 4 mm and small edema. Presence of hemorrhage less than 4 mm was associated with good prognosis. CONCLUSION: This study indicates that presence of hemorrhage of less than 4 mm was not associated with complete SCI and showed good prognosis.

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Methodological quality and outcomes of studies addressing manual cervical spine examinations: a review.

The aims of this review were, first to rate the methodological quality of studies which investigate the reliability of manual tests for cervical spine dysfunctions by applying a new quality assessment tool; secondly to compare the outcomes of these studies. The literature search included databases of CINAHL, MEDLINE, AMED, AMI, and SPORT DISCUS, the Cochrane Library, the Physiotherapy Evidence Database (PEDro), the National Library of Medicine (PubMed), Factiva, the EBSCOT HOST Research Database, online journal databases of ELSEVIER Science periodicals, LIPPINCOTT WILLIAMS & WILKINS, ELSEVIER Science @ Direct, THIEME ONLINE, and BLACKWELL SYNERGY. The application of the Quality Assessment of Diagnostic Accuracy Studies tool (QUADAS) to the 15 studies which met the inclusion criteria showed methodological weaknesses such as not considering an independent reference standard, or a representative study population. The studies demonstrated methodological strength in describing selection criteria and in interpreting results. The studies' outcomes make the claim to be able to detect segmental cervical dysfunction based on a manual assessment only questionable. Further improvements in quality, uniform study designs, and a valid reference standard would be necessary in order to obtain more reliable data in the future.

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