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At least 91 records · Page 5Linked to original sources
PubMed2005

Functional outcome 5 years after non-operative treatment of type A spinal fractures.

This study was conducted to study the functional outcome after non-operative treatment of type A thoracolumbar spinal fractures without neurological deficit. Functional outcome was determined following the International Classification of Functioning, Disability and Health, measuring restrictions in body function and structure, restrictions in activities, and restrictions in participation/quality of life. All patients were treated non-operatively for a type A thoracolumbar (Th11-L4) spinal fracture at the University Hospital Groningen, The Netherlands. Thirty-three of the eighty-one selected patients agreed to participate in the study (response-rate 41%). Respondents were older than non-respondents (mean 50.5 years vs. 39.2 years), but did not differ from each other concerning injury-related variables. Patients with a neurological deficit were excluded. Treatment consisted either of mobilisation without brace, or of bedrest followed by wearing a brace. Restrictions in body function and structure were measured by physical tests (dynamic lifting test and bicycle ergometry test); restrictions in activities were measured by means of questionnaires, the Roland Morris Disability Questionnaire (RMDQ) and Visual Analogue Scale Spine Score (VAS). Restrictions in participation/quality of life were assessed with the Short Form 36 (SF-36) and by means of return to work status. Thirty-seven per cent of the patients were not able to perform the dynamic lifting test within normal range. In the ergometry test, 40.9% of the patients performed below the lowest normal value, 36.4% of the patients achieved a high VO(2)-max. Mean RMDQ-score was 5.2, the mean VAS-score was 79. No significant differences between patients and healthy subjects were found in SF-36 scores, neither were differences found between braced and unbraced patients in any of the outcome measures. Concerning the return to work status, 10% of the subjects had stopped working and received social security benefits, 24% had arranged changes in their work and 14% had changed their job. We conclude that patients do reasonably well 5 years after non-operative treatment of a thoracolumbar fracture, although outcome is diverse in the different categories and physical functioning seems restricted in a considerable number of patients.

Adult↗
PubMedDate not supplied

Imaging a spinal fracture in a Kohaku Koi (Cyprinus carpio): techniques and case history report.

An ornamental pet fish was diagnosed with a spinal fracture and subluxation involving truncal vertebrae 5 and 6 (T5-T6) using conventional radiography, nuclear scintigraphy, and computed tomography. Attempts to evaluate the dynamic nature of the lesion using conventional fluoroscopy in the unanesthetized, moving patient were unsuccessful. Adaptation of imaging techniques to accommodate a fish patient was not difficult and diagnostic images were obtained. The use of multiple imaging techniques was useful in the diagnosis and determination of the treatment plan of the spinal fracture in this patient.

Animals↗
PubMed1984

Radiographic assessment of Harrington rod instrumentation for spinal fractures.

The surgical procedure for Harrington stabilization of spinal fractures is described. A retrospective review was carried out on 36 patients who underwent Harrington instrumentation for spinal trauma. The group comprised 21 burst fractures, 11 fracture-dislocations and four wedge-compression fractures. Satisfactory reduction was achieved in 13 patients, unsatisfactory reduction in 19 patients, and no reduction in four patients. Loss of reduction later occurred in seven of the patients with satisfactory initial reduction. Further loss of reduction also developed in nine patients in the remaining group without satisfactory reduction initially. Radiographically demonstrable causes for loss of reduction included technical errors allowing slippage of the hooks, improper placement of the hooks, and laminar fractures.

Fracture Fixation, Internal↗
PubMed1990

[Acute surgical treatment of spinal fracture with medullary involvement].

Two case histories are presented to illustrate the possibility of decisive improvement in the neurological sequelae after spinal fractures with spinal stenosis by means of rapid operative decompression and stabilisation. The importance of rapid transfer of patients of this type to centres where therapeutic decisions can be taken on the basis of several possible therapeutic methods, including the above-mentioned, is emphasized.

Accidents, Occupational↗
PubMed1979

Computed tomography of spinal fractures.

Computed tomography (CT) has aided significantly in the diagnosis and management of spinal fractures. The examination is easy, relatively quick, and avoids potentially harmful manipulation. The diagnostic advantages of CT include precise anatomic delineation and indication of extent of fractures, assessment of spinal stenosis, and demonstration of associated peraspinal lesions.

Adult↗
PubMed1985

Deep venous thrombosis and pulmonary embolism in patients with acute spinal cord injury: a comparison with nonparalyzed patients immobilized due to spinal fractures.

The occurrence of deep venous thrombosis (DVT) was studied in the series of 23 consecutive patients with acute spinal cord injury and 14 immobilized patients with spinal fractures without paralysis. The incidence of DVT in paralyzed patients was 100% as detected by the 125I-labeled fibrinogen test and confirmed by contrast venography, and 64% as detected by repeated clinical examinations and confirmed by contrast venography. The respective incidence of DVT in nonparalyzed patients with spinal fractures was 0%. The diagnosis of DVT was reached earlier with the radiofibrinogen test than with the clinical followup (5 days vs. 25 days). Two of the 23 paralyzed patients (9%) developed nonfatal clinical pulmonary embolism (PE). There were no differences in the values of routine coagulation tests. The result justifies prophylactic anticoagulant therapy in all cases of spinal cord injury during the acute post-traumatic phase.

Adolescent↗
PubMed1991

Spinal fractures associated with ejection from jet aircraft: two case reports and a review.

Virtually any A&E department in the UK may see aircrew who have ejected. The case histories of two pilots who ejected and sustained spinal fractures are presented. Both had minimal back symptoms and walked from the site of landing. All ejectees should be considered to have a spinal fracture until proven otherwise radiographically. Other injuries that these patients may sustain during ejection are also discussed.

Acceleration↗
PubMed1994

Child abuse presenting as a thoracolumbar spinal fracture dislocation: a case report.

A child sustained a traumatic thoracolumbar spinal fracture--dislocation with cord compression. A court confirmed the diagnosis of child abuse. There was no history of trauma, and the diagnosis of child abuse was missed by the physicians who first saw the child. Spinal injuries in child abuse are uncommon. They may be symptomatic or asymptomatic, stable or unstable, or occur with or without bony changes on the x-rays. Injuries without a history of trauma may be overlooked if asymptomatic. Radiologic skeletal surveys in suspected abuse should include a minimum of two views of the spine even if the child has no symptoms referrable to the spine. Conversely, a traumatic cause should be considered whenever there is spinal cord injury without vertebral injury. Having a high index of suspicion for abuse while remembering that pediatric spinal injuries may occur in the context of normal x-rays will decrease the likelihood of missed diagnosis, repeated abuse, or complications from delayed immobilization of unstable injuries.

Child Abuse↗
PubMed1992

[A method for in vivo measurements of implants used in the reconstruction of spinal fractures].

Little is known about the forces and moments acting on the spinal column during various movements and activities, and thus about the loading of implants used in the treatment of spinal fractures. A measuring method using an external fixation device was developed to determine the in vivo loading of spinal implants. On the basis of these data the forces acting on the spine can be calculated. The present paper describes this measuring method as applied to the fixation device, and initial experience with this device in a first application is presented.

Biomechanical Phenomena↗
PubMed2002

Thoracolumbar spinal fractures: segmental range of motion after dorsal spondylodesis in 82 patients: a prospective study.

In order to study the effect of dorsal spondylodesis on intervertebral movement in patients treated for thoracolumbar fractures, we measured the sagittal range of motion (ROM) in the segments above and below the fractured vertebral body 2 years after operation. Between 1991 and 1996, 82 consecutive patients with a fracture of the thoracolumbar spine (T12, L1, L2 and L3) were treated operatively with open reduction and stabilisation using an internal fixator, combined with transpedicular cancellous bone graft and dorsal spondylodesis. Eighteen T12, 42 L1, 17 L2 and 5 L3 fractures were included. The range of motion of two segments above and two segments below fracture level was measured. This was done on plain flexion and extension radiographs. The data were compared to normal values and to the zero distribution with the Kolmogorov-Smimov test. At all fracture levels the ROM of the segment adjacent to the disturbed endplate of the fractured body was zero (K-S test). All other evaluated segments showed significant loss of ROM (P<0.05) compared to normal values, except segment L1-L2 in L3 fractures (P=0.058). Dorsal spondylodesis at the level of the disturbed endplate in thoracolumbar spinal fractures leads to immobility in this segment, measured on flexion-extension radiographs 2 years after primary operative treatment. More than 50% loss of motion in the two adjacent levels is equivalent to complete loss of ROM in a second segment.

Adult↗
PubMed1990

25-Hydroxycholecalciferol and insulin-like growth factor I are determinants of serum concentration of osteocalcin in elderly subjects with and without spinal fractures.

Osteocalcin is one of the major proteins in the osseous matrix. To evaluate the determinants and thus the physiological control of osteocalcin production in normal and osteoporotic subjects, the serum levels of osteocalcin, 25-hydroxycholecalciferol (25-OH-D3), and insulin-like growth factor I (IGFI) were measured by radioimmunoassay in 44 subjects over 60 years old. Circulating osteocalcin, 25-OH-D3, and IGFI were 0.28 +/- 0.10 nmol/L (1.65 +/- 0.96 ng/mL), 70.5 +/- 25.1 nmol/L (28.3 +/- 10.1 ng/mL), and 23.8 +/- 12.0 nmol/L in 27 healthy controls respectively, as compared with 0.09 +/- 0.09 nmol/L (0.52 +/- 0.52 ng/mL), 48.2 +/- 19.9 nmol/L (19.35 +/- 7.91 ng/mL), and 16.56 +/- 6.96 nmol/L in 17 patients with spinal fractures. Significant correlation was found between osteocalcin and 25-OH-D3 level, as well as between osteocalcin and IGFI. The results show that IGFI and 25-OH-D3 are important determinants for serum concentration of osteocalcin in elderly subjects with and without spinal fractures.

Aged↗