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The Journal of the American Academy of... Jan 2018Skiing and snowboarding have increased in popularity since the 1960s. Both sports are responsible for a substantial number of musculoskeletal injuries treated annually... (Review)
Review
Skiing and snowboarding have increased in popularity since the 1960s. Both sports are responsible for a substantial number of musculoskeletal injuries treated annually by orthopaedic surgeons. Specific injury patterns and mechanisms associated with skiing and snowboarding have been identified. No anatomic location is exempt from injury, including the head, spine, pelvis, and upper and lower extremities. In these sports, characteristic injury mechanisms often are related to the position of the limbs during injury, the athlete's expertise level, and equipment design. Controversy exists about the effectiveness of knee bracing and wrist guards in reducing the incidence of these injuries. Understanding these injury patterns, proper training, and the use of injury prevention measures, such as protective equipment, may reduce the overall incidence of these potentially debilitating injuries.
Topics: Craniocerebral Trauma; Equipment Design; Humans; Incidence; Lower Extremity; Protective Clothing; Skiing; Spinal Injuries; Sports Equipment; Upper Extremity
PubMed: 29206691
DOI: 10.5435/JAAOS-D-16-00832 -
Handbook of Clinical Neurology 2018Cervical spine trauma is a relatively rare but catastrophic event in sports. These critical situations depend on sports medicine personnel understanding every aspect of... (Review)
Review
Cervical spine trauma is a relatively rare but catastrophic event in sports. These critical situations depend on sports medicine personnel understanding every aspect of sideline care to ensure a safe and successful evaluation. This involves thorough preparation, vigilant observation of the sporting event to detect the possible mechanism of injury, and initiation of the appropriate action plan when a potentially catastrophic injury is suspected. Sideline management of cervical spine trauma requires the appropriate primary survey, with spine stabilization if necessary, secondary survey for concomitant injury, and, potentially, initiation of full spine stabilization with a spine board. In this chapter, our primary focus is discussion of the sideline evaluation of cervical spine trauma, and sideline practices designed to stabilize the athlete and minimize risk for further injury.
Topics: Athletic Injuries; Humans; Spinal Injuries
PubMed: 30482362
DOI: 10.1016/B978-0-444-63954-7.00032-X -
Der Radiologe Aug 2021Injuries of the cervical spine are quite common with an incidence of more than 3% in trauma patients. The incidence is even higher in elderly patients. Cervical spine... (Review)
Review
BACKGROUND
Injuries of the cervical spine are quite common with an incidence of more than 3% in trauma patients. The incidence is even higher in elderly patients. Cervical spine injuries might induce severe neurological deficits. Therefore, they must be quickly and adequately diagnosed and treated. Depending on the pattern of injury, conservative or surgical treatment is indicated.
OBJECTIVE
The authors describe the different surgical strategies and treatment options based on the pattern of injury. Typical surgical methods are illustrated by case presentations.
CONCLUSION
Cervical spine injuries should be treated in a trauma centre with extensive expertise in spine surgery. The immobilisation and gentle transportation is important already at the scene of the accident. Nowadays, there are excellent surgical options and strategies available as well as excellent intensive care therapy. These possibilities lead to rapid and good stabilisation of cervical spine injuries and the posttraumatic morbidity and mortality can be reduced significantly especially in elderly patients.
Topics: Aged; Cervical Vertebrae; Humans; Incidence; Retrospective Studies; Spinal Cord Injuries; Spinal Injuries
PubMed: 34244812
DOI: 10.1007/s00117-021-00881-9 -
Scandinavian Journal of Trauma,... Jul 2019Alpine winter sports have become increasingly popular over recent decades, with a similar increase in accident incidence. This review provides an overview of the most... (Review)
Review
INTRODUCTION
Alpine winter sports have become increasingly popular over recent decades, with a similar increase in accident incidence. This review provides an overview of the most recent literature concerning spinal injury epidemiology, mechanisms, patterns and prevention strategies in the context of alpine winter sports.
MATERIAL AND METHODS
The PubMed, Cochrane Library, and EMBASE databases were searched using the keywords spine injury, alpine injury, spine fracture, skiing injuries, snowboard injuries. 64 published studies in English and German met a priori inclusion criteria and were reviewed in detail by the authors.
RESULTS
There are various mechanisms of injury in alpine winter sports (high speed falls in skiing, jumping failure in snowboarding) whilst regionality and injury severity are broadly similar. The thoracolumbar spine is the most common region for spinal injury. Spinal cord injury is relatively rare, usually accompanying distraction and rotation type fractures and is most commonly localised to the cervical spine. Disc injuries seem to occur more commonly in alpine winter sport athletes than in the general population.
DISCUSSION
Despite awareness of increasing rates and risks of spinal injuries in alpine winter sports, there has been little success in injury prevention.
Topics: Athletic Injuries; Global Health; Humans; Incidence; Male; Seasons; Spinal Injuries
PubMed: 31324221
DOI: 10.1186/s13049-019-0645-z -
Clinical Radiology Dec 2021The cervical spine is part of the axial skeleton and is responsible for protecting vital structures, such as the spinal cord and the vertebral arteries and veins.... (Review)
Review
The cervical spine is part of the axial skeleton and is responsible for protecting vital structures, such as the spinal cord and the vertebral arteries and veins. Traumatic injury to the cervical spine occurs in approximately 3% of blunt trauma injuries, and approximately 80% are below the level of C2. The AO Spine society divides the spine into four segments: the upper cervical spine (C0-C2), subaxial spine (C3-C7), thoracolumbar spine, and sacral spine. Various classifications have been proposed for the subaxial segment since that of Allen and Ferguson in 1982; however, none is universally accepted, and treatment remains controversial. The complex anatomy and biomechanics of the subaxial spine and the lack of a widely accepted classification system make these injuries difficult to evaluate on imaging. The Subaxial Injury Classification System (SLIC) uses fracture morphology, the integrity of discoligamentous complex, and neurological status to score the patient and determine between operative and non-operative management; however, other factors may influence management, such as time for immobilisation, osteoporosis, surgeon's experience, and hospital circumstances. SLIC classifies fracture morphology in a crescent order of severity based on Allen and Ferguson's classification. Compression fractures are the simpler ones, while both distraction injuries and translation/rotation are severe injuries, which are always associated with some degree of discoligamentous complex (DLC) injury. This article will review the indications for imaging, the basis of the SLIC classification, the different types of fracture morphology, evaluation of the DLC, and other features important in decision making in subaxial spine trauma.
Topics: Cervical Vertebrae; Humans; Magnetic Resonance Imaging; Spinal Injuries; Tomography, X-Ray Computed
PubMed: 34579865
DOI: 10.1016/j.crad.2021.09.006 -
European Spine Journal : Official... Jan 2023Thoracolumbar spine injury is frequently seen with high-energy trauma but dislocation fractures are relatively rare in spinal trauma, which is often neurologically... (Observational Study)
Observational Study
PURPOSE
Thoracolumbar spine injury is frequently seen with high-energy trauma but dislocation fractures are relatively rare in spinal trauma, which is often neurologically severe and requires urgent treatment. Therefore, it is essential to understand other concomitant injuries when treating dislocation fractures. The purpose of this study is to determine the differences in clinical features between thoracolumbar spine injury without dislocation and thoracolumbar dislocation fracture.
METHODS
We conducted an observational study using the Japan Trauma Data Bank (2004-2019). A total of 734 dislocation fractures (Type C) and 32,382 thoracolumbar spine injuries without dislocation (Non-type C) were included in the study. The patient background, injury mechanism, and major complications in both groups were compared. In addition, multivariate analysis of predictors of the diagnosis of dislocation fracture using logistic regression analysis were performed.
RESULTS
Items significantly more frequent in Type C than in Non-type C were males, hypotension, bradycardia, percentage of complete paralysis, falling objects, pincer pressure, accidents during sports, and thoracic artery injury (P < 0.001); items significantly more frequent in Non-type C than in Type C were falls and traffic accidents, head injury, and pelvic trauma (P < 0.001). Logistic regression analysis showed that younger age, male, complete paralysis, bradycardia, and hypotension were associated with dislocation fracture.
CONCLUSION
Five associated factors were identified in the development of thoracolumbar dislocation fractures.
LEVEL OF EVIDENCE
III.
Topics: Humans; Male; Female; Spinal Fractures; Bradycardia; Thoracic Vertebrae; Lumbar Vertebrae; Spinal Injuries; Fracture Dislocation; Joint Dislocations; Paralysis
PubMed: 36469132
DOI: 10.1007/s00586-022-07478-3 -
Magnetic Resonance Imaging Clinics of... Aug 2016The article summarizes classification schemes of spinal trauma and rules to decide on proper imaging modality after a spinal trauma. High-risk factors that recommend... (Review)
Review
The article summarizes classification schemes of spinal trauma and rules to decide on proper imaging modality after a spinal trauma. High-risk factors that recommend imaging are, for instance, age 65 years or older, a dangerous trauma mechanism, and paresthesia in the extremities. More recent classification schemes include evaluation of the posterior ligamentous complex, for which MR imaging is the best modality, and to give therapeutic recommendations for conservative or surgical management. MR imaging is the imaging method of choice when spinal cord injury, cord compression, or ligamentous injury is suspected. MR imaging is the method of choice to depict epidural or intramedullary hemorrhage and sequelae of spinal trauma.
Topics: Humans; Magnetic Resonance Imaging; Neuroimaging; Spinal Injuries; Spine
PubMed: 27417400
DOI: 10.1016/j.mric.2016.04.004 -
Pediatric Radiology May 2021There is growing evidence of spine injury in abusive head trauma (AHT). Historically, spine injury was considered rare in AHT because of a lack of attributable clinical... (Review)
Review
There is growing evidence of spine injury in abusive head trauma (AHT). Historically, spine injury was considered rare in AHT because of a lack of attributable clinical symptoms or signs and a lack of advanced imaging. Increased use of MRI in AHT has been instrumental in helping identify evidence of ligamentous injuries of the spine. These findings can be difficult to identify on autopsy because of the size and location of the ligaments. Because spinal injury in AHT mostly involves ligamentous and soft tissues and only rarely involves bony fractures, more than 90% of the injury findings are missed on CT or radiography of the spine. Investigation of these findings and the injury patterns should lead to a better understanding of the mechanism of spinal injury. In this pictorial review, we describe the various manifestations of spinal ligamentous injury in AHT, as seen on MRI, in children younger than 48 months.
Topics: Child; Child Abuse; Craniocerebral Trauma; Humans; Infant; Ligaments; Magnetic Resonance Imaging; Spinal Injuries; Spine
PubMed: 33999239
DOI: 10.1007/s00247-020-04922-8 -
The Spine Journal : Official Journal of... Sep 2015Spinal gunshot injuries (spinal GSIs) are a major cause of morbidity and mortality in both military and civilian populations. These injuries are likely to be encountered... (Review)
Review
BACKGROUND CONTEXT
Spinal gunshot injuries (spinal GSIs) are a major cause of morbidity and mortality in both military and civilian populations. These injuries are likely to be encountered by spine care professionals in many treatment settings. A paucity of resources is available to summarize current knowledge of spinal GSI evaluation and management.
PURPOSE
The aim was to summarize the ballistics, epidemiology, evaluation, treatment, and outcomes of spinal GSI among civilian and military populations.
STUDY DESIGN
This was a review of the current literature reporting spinal GSI management.
METHODS
MEDLINE (PubMed) was queried for recent studies and case reports of spinal GSI evaluation and management.
RESULTS
Spinal GSI now comprise the third most common cause of spinal injury. Firearms that produce spinal GSI can be divided into categories of high- and low-energy depending on the initial velocity of the projectile. Neural and mechanical spinal damage varies with these types and results from several factors including direct impact, concussion waves, tissue cavitation, and thermal energy. Management of spinal GSI also depends on several factors including neurologic function and change over time, spinal stability, missile tract through the body, and concomitant injury. Surgical treatment is typically indicated for progressive neurologic changes, spinal instability, persistent cerebrospinal fluid leak, and infection. Surgical treatment for GSI affecting T12 and caudal often has a better outcome than for those cranial to T12. Surgical exploration and removal of missile fragments in the spinal canal are typically indicated for incomplete or worsening neurologic injury.
CONCLUSIONS
Treatment of spinal GSI requires a multidisciplinary approach with the goal of maintaining or restoring spinal stability and neurologic function and minimizing complications. Concomitant injuries and complications after spinal GSI can present immediate and ongoing challenges to the medical, surgical and rehabilitative care of the patient.
Topics: Humans; Spinal Injuries; Wounds, Gunshot
PubMed: 26070284
DOI: 10.1016/j.spinee.2015.06.007 -
Emergency Medicine Practice Oct 2021The majority of the nearly 18,000 new cases of spinal cord injury in the United States each year involve the cervical spine. Although the morbidity, mortality, and... (Review)
Review
The majority of the nearly 18,000 new cases of spinal cord injury in the United States each year involve the cervical spine. Although the morbidity, mortality, and healthcare costs associated with these injuries is very high, quality evidence to guide emergency management is limited. Recent changes to guidelines have called into question decades of practice, including prehospital spinal immobilization protocols, timing of surgery, and pharmacotherapy. A systematic approach to the diagnosis and management of the spine-injured patient is outlined in this review, with a focus on recent updates and management of emergent complications.
Topics: Cervical Vertebrae; Emergency Medical Services; Emergency Service, Hospital; Humans; Immobilization; Spinal Cord Injuries; Spinal Injuries; United States
PubMed: 34533917
DOI: No ID Found