European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Multicenter Study
Early versus delayed reduction of cervical spine dislocation with complete motor paralysis: a multicenter study.
Reduction of cervical facet dislocation should be performed as soon as possible to depressurize neuron cells although some randomized control studies defined early reduction as over 24 h after trauma. The purpose of this study was to define the actual time limit for early reduction in patients with complete motor paralysis. ⋯ Our data suggest that early (<6 h) reduction of cervical spine dislocation is associated with favorable neurological outcome as compared with those performed after 6 h.
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To construct and validate a prediction instrument for early identification of patients with a high risk of delayed recovery after whiplash injuries (PPS-WAD) in an insurance company setting. ⋯ Clinical decision rules need validation before they are used in a new setting. An instrument consisting of four questions with an excellent possibility of identifying patients with a high risk of nonrecovery after a whiplash injury in the emergency room was not as useful in an insurance company setting. The importance and type of the risk factors for not recovering probably differ between the settings, as well as the individuals.
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To compare the clinical and radiological outcomes of posterior atlantoaxial fixation and fusion using C1 lateral mass-C2 pedicle screws (screw-rod constructs, SRC) with C1-C2 transarticular screws (TAS). ⋯ Both SRC and TAS produced excellent outcomes for atlantoaxial stabilization. But the volume of bleeding and operation time tended to be better in TAS group compared to SRC group.
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Occult subaxial cervical disco-ligamentous injuries in computer tomography negative trauma patients.
Due to lack of cervical clearance consensus in literature and the devastating consequences of missed cervical injuries, Magnetic resonance imaging (MRI) of the neurologically intact symptomatic patient with negative CT scan is frequently done to rule out disco-ligamentous injuries. This study retrospectively evaluates occult disco-ligamentous injuries detected by MRI in patients with no abnormalities detected by modern multi-detector CT scanning and postulates a new theory of ligamentous stability of cervical spine. ⋯ CT scans alone may be inadequate for clearing occult disco-ligamentous injuries of the subaxial cervical spine in trauma. Denis three-column stability theory may be beneficial in determining stability and guiding treatment along with the SLIC system for occult discoligamentous injuries of the subaxial cervical spine.
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The purpose of this study was to present a series of adolescent patients with cervical facet dislocations to identify the mechanism of injury, severity of neurological injury and rate of neurological recovery. ⋯ Over half of children with this injury in our study had a complete SCI with no recovery. We believe that the adolescent spine is more resilient to injury, thus requiring a high-energy injury to cause a dislocation, but resulting in a high rate of SCI with a low rate of neurological recovery, and a low rate of cervical disc herniation.