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Handbook of Clinical Neurology 2018The cervical spine functions to position the head while maintaining stability and protecting the spinal cord. The anatomy of the cervical spine dictates the amount of... (Review)
Review
The cervical spine functions to position the head while maintaining stability and protecting the spinal cord. The anatomy of the cervical spine dictates the amount of physiologic motion at each level. Knowledge of the normal biomechanical anatomy of the cervical spine is imperative to the understanding of the biomechanics of injury to the cervical spine. There are a variety of reproducible injury patterns based on the direction and magnitude of force applied to the cervical spine. Knowledge of these forces can allow an understanding of the mechanical and neurologic stability of the cervical spine and can also help guide treatment options. It is also important to understand the mechanism of injury and injured cervical structures based on radiographic findings, as often patients will present with neurologic examinations that also reflect noncervical spine-related injuries. The goal of this chapter is to present a review of the normal biomechanics of the cervical spine, in addition to presenting different injury patterns of the cervical spine from the minor to life-threatening, with the goal of maximizing postinjury function by ensuring proper treatment protocols are followed.
Topics: Biomechanical Phenomena; Cervical Vertebrae; Humans; Spinal Injuries
PubMed: 30482361
DOI: 10.1016/B978-0-444-63954-7.00031-8 -
Clinics in Sports Medicine Jul 2021Spinal injury and back pain are a common problem facing patients seeking medical care including athletes, which can lead to significant disability, medical costs, and... (Review)
Review
Spinal injury and back pain are a common problem facing patients seeking medical care including athletes, which can lead to significant disability, medical costs, and impaired performance for these patients. Rehabilitation including core muscle stabilization, Kinesio taping, and flexibility have been shown to help with treatment and prevention. Critical factors such as equipment, technique, and rule changes can also be an important part of spine injury prevention.
Topics: Athletic Injuries; Athletic Tape; Humans; Low Back Pain; Spinal Injuries
PubMed: 34051938
DOI: 10.1016/j.csm.2021.03.001 -
Primary Care Mar 2020Neck injuries are relatively uncommon but have the potential to cause serious and permanent disability. In athletes, injuries are most common in contact sports, and... (Review)
Review
Neck injuries are relatively uncommon but have the potential to cause serious and permanent disability. In athletes, injuries are most common in contact sports, and occur with direct axial loading with a forward-flexed neck. Soft tissue and peripheral nerve injuries are typically minor and self-limiting, with excellent recovery potential and return to activities based on symptoms. Concern for devastating spinal cord injuries has led to routine immobilization using spine boards and hard cervical collars. This approach may provide more harm than benefit when applied universally, and a more commonsense protocol can be used to better address potential neck injuries.
Topics: Athletic Injuries; Cervical Vertebrae; Humans; Neck; Neck Injuries; Orthotic Devices; Return to Sport; Spinal Cord Injuries; Spinal Injuries
PubMed: 32014132
DOI: 10.1016/j.pop.2019.10.009 -
Neurosurgery Clinics of North America Jan 2017Useful thoracolumbar injury classifications allow for meaningful and concise communication between surgeons, trainees, and researchers. Although many have been proposed,... (Review)
Review
Useful thoracolumbar injury classifications allow for meaningful and concise communication between surgeons, trainees, and researchers. Although many have been proposed, none have been able to obtain universal acceptance. Historically, classifications focused only on the osseous injuries; more recent classifications focused on the injury morphology and other critical determinants of treatment, including the posterior ligamentous complex integrity and the patient's neurologic status. This review details the important historic classifications and reviews more contemporary thoracolumbar injury classifications, such as the Thoracolumbar Injury Classification System and the AOSpine Thoracolumbar Injury Classification System.
Topics: Humans; Lumbar Vertebrae; Spinal Injuries; Thoracic Vertebrae
PubMed: 27886879
DOI: 10.1016/j.nec.2016.07.007 -
Injury May 2019"Blobbing" is a modern outdoor activity where a participant sits on the end of a partially inflated air bag ("blobber") and is launched into the water when another...
INTRODUCTION
"Blobbing" is a modern outdoor activity where a participant sits on the end of a partially inflated air bag ("blobber") and is launched into the water when another participant jumps onto the air bag from a platform on the opposite side ("jumper"). This is the first study to evaluate the injury patterns associated with blobbing.
PATIENTS AND METHODS
A retrospective data analysis was conducted based on 86 patients who sustained blobbing injuries between January 2011 and December 2016. The date of birth, gender, day of injury, diagnosis, body region of trauma, and treatment were recorded for the patients. Treatment was subclassified into conservative or surgical treatment. The position of the participant was recorded as either a jumper or a blobber.
RESULTS
One-third of the patients sustained a spine injury, which was the most common body part injured. The most frequent type of injury was cervical spine distortion. All shoulder (n = 9), elbow (n = 3), hand (n = 2), knee (n = 3), and foot (n = 12) injuries occurred in jumpers, whereas all ear (n = 6) and lung (n = 5) injuries occurred in blobbers. Head (n = 5) and spine (n = 33) injuries were distributed in jumpers and blobbers. Sixty-nine patients were treated with conservative treatment. Three ankle fractures and two spine fractures were treated with immediate surgical treatment. Twelve patients were treated with conservative treatment but were referred for potential surgery at their hospital at home.
CONCLUSION
Both jumpers and blobbers were prone to injuries. More severe injuries with the potential for surgical treatment occurred in jumpers, presumably because of bad landings. This analysis of the injury patterns in blobbers might lead to the introduction of protective gear and changes in the behavior of participants in order to reduce the risk of injury.
Topics: Accident Prevention; Accidental Falls; Adolescent; Adult; Athletic Injuries; Child; Craniocerebral Trauma; Extremities; Female; Fractures, Bone; Humans; Male; Middle Aged; Retrospective Studies; Risk Factors; Severity of Illness Index; Spinal Injuries; Young Adult
PubMed: 30773215
DOI: 10.1016/j.injury.2019.02.007 -
Radiologic Clinics of North America Jul 2019Every year in North America, approximately 3 million patients are evaluated for spinal injury. Of blunt trauma patients presenting to the emergency department, 3% to 4%... (Review)
Review
Every year in North America, approximately 3 million patients are evaluated for spinal injury. Of blunt trauma patients presenting to the emergency department, 3% to 4% will have a cervical spine injury, and up to 18% will suffer a thoracolumbar spine injury. Failure to identify an unstable spine injury can lead to devastating outcomes.
Topics: Humans; Magnetic Resonance Imaging; Spinal Injuries; Spine; Tomography, X-Ray Computed
PubMed: 31076031
DOI: 10.1016/j.rcl.2019.02.007 -
The Orthopedic Clinics of North America Oct 2021Craniocervical injuries (CCJs) account for 10% to 30% of all cervical spine trauma. An increasing number of patients are surviving these injuries due to advancements in... (Review)
Review
Craniocervical injuries (CCJs) account for 10% to 30% of all cervical spine trauma. An increasing number of patients are surviving these injuries due to advancements in automobile technology, resuscitation techniques, and diagnostic modalities. The leading injury mechanisms are motor vehicle crashes, falls from height, and sports-related events. Current treatment with urgent rigid posterior fixation of the occiput to the cervical spine has resulted in a substantial reduction in management delays expedites treatment of CCJ injuries. Within CCJ injuries, there is a spectrum of instability, ranging from isolated nondisplaced occipital condyle fractures treated nonoperatively to highly unstable injuries with severely distracted craniocervical dissociation. Despite the evolution of understanding and improvement in the management of cases regarding catastrophic failure to diagnose, subsequent neurologic deterioration still occurs even in experienced trauma centers. The purpose of this article is to review the injuries that occur at the CCJ with the accompanying anatomy, presentation, imaging, classification, management, and outcomes.
Topics: Atlanto-Axial Joint; Atlanto-Occipital Joint; Axis, Cervical Vertebra; Cervical Atlas; Cervical Vertebrae; Humans; Joint Dislocations; Occipital Bone; Spinal Fractures; Spinal Injuries; Trauma, Nervous System
PubMed: 34538354
DOI: 10.1016/j.ocl.2021.05.013 -
La Radiologia Medica Jan 2023Spinal trauma is an important cause of disability worldwide. Injury to the cervical spine (CS) occurs frequently after major trauma. 5-10% of patients with blunt trauma... (Review)
Review
Spinal trauma is an important cause of disability worldwide. Injury to the cervical spine (CS) occurs frequently after major trauma. 5-10% of patients with blunt trauma have a cervical spine injury. The cervical spine accounts for ~ 50% of all spinal injuries. Determination of CS stability is a common challenge in the acute care setting of patients with trauma. Several issues, indeed, are of particular concern: who needs CS imaging; what imaging should be obtained; when should computed tomography (CT), magnetic resonance imaging (MRI), or flexion/extension (F/E) radiographs be obtained; and how is significant ligamentous injury excluded in the comatose patient. CT and MRI both have roles to play. This article aims to present the different imaging to frame techniques to be used with greater precision in the acute event also for the purpose of planning the next therapeutic process. An overview of the applicability of the same methods in forensic pathology is also provided highlighting possible future biomarker to ease in diagnosis of acute TBI.
Topics: Humans; Spinal Injuries; Tomography, X-Ray Computed; Radiography; Magnetic Resonance Imaging; Wounds, Nonpenetrating; Cervical Vertebrae
PubMed: 36719553
DOI: 10.1007/s11547-022-01578-2 -
Pediatric Clinics of North America Aug 2021Complaints related to the neck are common following mild pediatric trauma. Although significant cervical spine injuries are most often seen and evaluated in the... (Review)
Review
Complaints related to the neck are common following mild pediatric trauma. Although significant cervical spine injuries are most often seen and evaluated in the emergency room or inpatient setting, the primary care provider is faced with the evaluation of lower acuity complaints. We provide a review to assist with the efficient evaluation of these patients to facilitate decisions regarding return to play, the need for imaging, and need for referral to subspecialty providers.
Topics: Adolescent; Athletic Injuries; Cervical Vertebrae; Child; Evidence-Based Medicine; Humans; Postoperative Period; Risk Factors; Spinal Injuries; Wounds, Nonpenetrating
PubMed: 34247715
DOI: 10.1016/j.pcl.2021.04.012 -
Neurosurgery Nov 2016: Imaging with computed tomography and magnetic resonance imaging is fundamental to the evaluation of traumatic spinal injury. Specifically, neuroradiologic techniques... (Review)
Review
UNLABELLED
: Imaging with computed tomography and magnetic resonance imaging is fundamental to the evaluation of traumatic spinal injury. Specifically, neuroradiologic techniques show the exact location of injury, evaluate the stability of the spine, and determine neural element compromise. This review focuses on the complementary role of different radiologic modalities in the diagnosis of patients with traumatic injuries of the spine. The role of imaging in spinal trauma classifications will be addressed. The importance of magnetic resonance imaging in the assessment of soft tissue injury, particularly of the spinal cord, will be discussed. Last, the increasing role of advanced imaging techniques for prognostication of the traumatic spine will be explored.
ABBREVIATIONS
ADC, apparent diffusion coefficientALL, anterior longitudinal ligamentAS, ankylosing spondylitisASIA, American Spine Injury AssociationCTA, computed tomography angiographyCVJ, craniovertebral junctionDISH, diffuse idiopathic skeletal hyperostosisDTI, diffusion tensor imagingFA, fractional anisotropyMDCT, multidetector computed tomographyMRA, magnetic resonance angiographySCI, spinal cord injurySTIR, short tau inversion recoveryVAI, vertebral artery injury.
Topics: Humans; Magnetic Resonance Imaging; Multidetector Computed Tomography; Spinal Cord; Spinal Cord Injuries; Spinal Injuries; Spine; Tomography, X-Ray Computed
PubMed: 27404215
DOI: 10.1227/NEU.0000000000001336