Acute traumatic spinal injury following bicycle accidents : a report of three cases
|
|
- Noreen French
- 8 years ago
- Views:
Transcription
1 Acta Orthop. Belg., 2012, 78, CASE REPORT Acute traumatic spinal injury following bicycle accidents : a report of three cases Niall P. MCGOlDRICK, Connor GREEN, Neil BURKE, Keith SyNNOTT From the National Spinal Injuries Unit, Mater Misericordiae University Hospital, Dublin, Ireland Although the vast majority of injuries suffered while cycling are minor, acute spinal injuries have been reported. We describe three cases of acute spinal injury occurring while cycling. All three patients reported being thrown over the handlebars, while travelling downhill at speed. Two of the cases resulted in profound neurological deficit. These cases show that there is a spectrum of spinal injury due to bicycle accidents, ranging from no neurological deficit to profound insult, and from high cervical injury to mid-thoracic spinal injury. In cases of bicycle accidents, increased awareness of the possibility of such spinal injury is advisable. Keywords : bicycle accident ; spinal cord injury ; spinal trauma. The first patient is a 30 year-old gentleman who lost control of his bicycle at speed during an adventure race downhill over mountainous terrain, and was thrown over the handlebars. He landed head first in a ditch approximately six feet below road surface level. He was wearing a helmet. On initial assessment by paramedics he was found to have no motor or sensory function from level T6 and below. His helmet was found in multiple fragments. He was transferred to the nearest emergency department on full spinal precaution for further management. On arrival his Glasgow Coma Score (GCS) was 15 out of 15. He was hypertensive with a blood pressure of 174/96 mmhg and hypothermic with a temperature of 34.2 C. His blood investigation revealed a haemoglobin of 14.0 g/dl, and his white cell count was /l. He had no prior past medical history. Examination by the orthopaedic INTRODUCTION The vast majority of injuries sustained while cycling are considered minor in nature (9). More serious injuries can occur. We present three cases of acute spinal injury which occurred following cycling accidents. In two cases, profound neurological deficit was the result. Case 1 CASE REPORTS Niall McGoldrick, MB BCh BAO, Orthopaedic Senior House Officer. Connor Green, MRCSI, Orthopaedic Specialist Registrar. Neil Burke, MRCSI, Orthopaedic Registrar. Keith Synnott, FRCSI, Consultant Orthopaedic & Spine Surgeon. National Spinal Injuries Unit, Department of Trauma & Orthopaedic Surgery, Mater Misericordiae University Hospital, Dublin, Ireland. Correspondence : Dr Niall McGoldrick, Department of Trauma & Orthopaedic Surgery, Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland. niallmcg@gmail.com 2012, Acta Orthopædica Belgica. No benefits or funds were received in support of this study
2 410 N. MC GOlDRICK, C. GREEN, N. BURKE, K. SyNNOTT Fig. 1. Transverse cut through CT showing 100% antero - listhesis of T4 on T5, with associated manubrium injury (Case 1). team revealed tenderness to palpation over C7 and T2. Plain film imaging and Computed Tomography (CT) imaging of his whole spine was requested. CT revealed a four-column spinal injury involving profound fracture-dislocation of T4 on T5 with an associated displaced manubrium fracture (Figs. 1 & 2). He also suffered a mediastinal haematoma (aorta intact), fractures of the first and second ribs on the left side, and second rib on the right side, mid-shaft fracture of his left clavicle, moderate left pulmonary contusion, and an undisplaced fracture of the left base of skull at the level of the foramen magnum. No intra-abdominal injury was noted. The patient was transferred to a tertiary level specialist spinal injury unit for operative management. The following day he underwent posterior decompression and stabilisation from T1 to T8. In view of this gentleman s lung parenchymal injury and concern for possible cardiac contusion, a decision was made to achieve fixation of this Type C injury by posterior approach. This decision was made in conjunction with Cardiothoracic and Anaesthetic services. His spinal cord was found transected at level T4-T5. He spent six days in a High Dependency Unit before transfer back to the ward. His post-operative American Spinal Injury Association Score was T4 ASIA A Spinal Cord Injury. Fig. 2. Reconstructed CT demonstrating extensive fracture dislocation at level T4-T5 (Case 2). Case 2 A 59-year-old gentleman walked into his local Emergency Department complaining only of neck pain several hours following a mountain-bike accident. He reported losing control of his bicycle travelling downhill at speed and was thrown head first over the handlebars. His impact with the ground was sufficiently forceful to split his helmet into two pieces. On arrival his GCS was 15 out of 15, and his observations were stable. He had no neurological deficit. CT and subsequent Magnetic Resonance Imaging (MRI) confirmed wedge compression fractures at T1 and T2, a left facet dislocation of C6 on C7, and fracture of C7 left facet. The anterior and posterior longitudinal ligaments were disrupted at the level of C7-T1 (Fig. 3). He underwent posterior cervical decompression and fusion C4-T4 the following day. His post-operative period was uneventful. He mobilised without
3 ACUTE TRAUMATIC SPINAl INjURy FOllOWING BICyClE ACCIDENTS 411 Fig. 3. MRI demonstrating disruption of anterior and posterior longitudinal ligaments at C7-T1 level (Case 2). difficulty on day 1 post-op, and was discharged home on his third post-operative day. Case 3 A 61-year-old gentleman sustained catastrophic cervical spine injury when the front wheel forks of his intermediate performance carbon fibre racing bicycle reportedly collapsed, throwing him forward over the handlebars. At the time he was applying brakes to slow down as he reached the bottom of a gentle hill (with approximately 15 incline). He was travelling at approximately 20 mph. He impacted onto the tarmacadam road surface head first, sustaining a hyperextension injury to his cervical spine. He reported no loss of consciousness as he recalls telling a friend following behind not to move him as he had sustained a neck injury. He was unable to move both arms and legs at the scene. His helmet was broken in two pieces. Paramedics on the scene record a GCS 13 out of 15. His heart rate was 69 bpm, and he was hypertensive with a blood pressure of 151/101. Plain film, Computed Tomography and Magnetic Resonance Imaging of his cervical spine demonstrated bilateral lamina fracture at C5, Fig. 4. Plain film lateral cervical spine performed on arrival in the Emergency Department (Case 3). bilateral lamina and pedicle fracture at C6, bilateral jumped facets at C5-C6 level, and fracture of spinous processes from C2-C6 (Figs. 4-6). Haematoma was identified within the spinal cord, and anterior to the vertebral bodies leading to tracheal compromise. He required emergency tracheostomy, and sedation in the Intensive Care Unit. His other injuries included a fracture of his left clavicle, and abrasions to his shins and back. Once stable, he was transferred to a tertiary level specialist spinal injury unit for operative management. He underwent anterior decompression and fusion C5-C6. Intra-operatively, his spinal cord was found transected and herniating through the disc space at this level. His neurological injury was classified as C2 ASIA A spinal cord injury, with motor preservation on right side at C5 level. DISCUSSION Bicycle riding remains an ever popular sport across all age groups. Although most injuries
4 412 N. MC GOlDRICK, C. GREEN, N. BURKE, K. SyNNOTT Fig. 5. CT showing the jumped facets at C5-C6 (Case 3) Fig. 6. MRI demonstrating significant disruption at C5-C6 level with signal change in the cord at this level (Case 3). reported are usually minor in nature (9), more devastating spinal injuries can be the result. Where spinal injury occurs, the mechanism is usually a forward fall over the handlebars (7), and usually while moving downhill (8). Overall, males are more commonly injured than females (1,10). Carmont observes however that the most serious injuries are more common in women, since females tend to be lighter than males, and thus more easily thrown over the handlebars (4). Falls where the rider impacts the ground with the top of their head may lead to flexion injury of the cervical spine, while landing on the face could lead to hyperextension injury (2). Kim et al report that the cervical spine is the most common site of spinal injury, and cord injury is a feature in 24% of cases (6). A number of risk factors for bicycle-related injury have been identified including slippery road surface, the cyclists poor assessment of the situation, and excessive speed (5). In our report, all three riders were male. All three describe being thrown over the handlebars, though in one case mechanical malfunction may have been to blame. All three were travelling downhill. The terrain involved was variable ranging from smooth tarmacadam to mountainous. Two of our patients suffered spinal cord injury and subsequent neurological impairment. In both cases, the cord was found transected at time of surgery. A limited number of case reports of spinal trauma following bicycle accidents have been described before (3). To our knowledge this represents the first time three cases of spinal trauma related to bicycle accidents have been described in an Irish context. We also note the spectrum of injury that can occur from these accidents. Two of the three patients in this report suffered neurological deficit. One patient however escaped with no neurological injury at all. In case one, the level of injury was mid-thoracic. In cases two and three, the cervical spine was involved, though at varying levels. This serves to remind that bicycle-related spinal injury is not just limited to the cervical spine, and that there exists a spectrum of spinal injury associated with bicycle accidents. Regard to this important consideration is advisable in initial management and treatment of patients with suspected spinal trauma following bicycle accidents.
5 ACUTE TRAUMATIC SPINAl INjURy FOllOWING BICyClE ACCIDENTS 413 REFERENCES 1. Aitken SA, Blant LC, Court-Brown CM. Recreational mountain biking injuries. Emerg Med J 2011 ; 28 : Allen BL Jr, Ferguson RL, Lehmann TR, O Brien RP. A mechanistic classification of closed, indirect fractures and dislocations of the lower cervical spine. Spine 1982 ; 7 : Aspingi S, Dussa CU, Soni BM. Acute cervical spine injuries in mountain biking. Am J Sports Med 2006 ; 34 : Carmont MR. Mountain-biking injuries : a review. Brit Med Bull 2008 ; 85 : Gaulrapp H, Weber A, Rosemeyer B. Injuries in mountain biking. Knee Surg Sports Traumatol Arthrosc 2001 ; 9 : Kim PT, Jangra D, Ritchie AH et al. Mountain biking injuries requiring trauma centre admission. J Trauma 2006 ; 60 : Kronisch RL, Chow TK, Simon LM et al. Acute injuries in off-road bicycle racing. Am J Sports Med 1996 ; 24 : Kronisch RL, Pfeiffer RP. Mountain biking injuries : an update. Sports Med 2002 ; Pfeiffer RP. Off-road bicycle racing injuries the NORBA Pro/Elite category : care and prevention. Clin Sports Med 1994 ; 13 : Thompson MJ & Rivara FP. Bicycle-related injuries. Am Fam Physician 2001 ; 63 :
.org. Fractures of the Thoracic and Lumbar Spine. Cause. Description
Fractures of the Thoracic and Lumbar Spine Page ( 1 ) Spinal fractures can vary widely in severity. While some fractures are very serious injuries that require emergency treatment, other fractures can
More informationEvaluation and Treatment of Spine Fractures. Lara C. Portmann, MSN, ACNP-BC
Evaluation and Treatment of Spine Fractures Lara C. Portmann, MSN, ACNP-BC Nurse Practitioner, Neurosurgery, Trauma Services, Intermountain Medical Center; Salt Lake City, Utah Objectives: Identify the
More informationUpper Cervical Spine - Occult Injury and Trigger for CT Exam
Upper Cervical Spine - Occult Injury and Trigger for CT Exam Bakman M, Chan K, Bang C, Basu A, Seo G, Monu JUV Department of Imaging Sciences University of Rochester Medical Center, Rochester, NY Introduction
More informationThoracolumbar Fratures R1: 胡 家 瑞 指 导 老 师 : 吴 轲 主 任
Thoracolumbar Fratures R1: 胡 家 瑞 指 导 老 师 : 吴 轲 主 任 Patient Data Name: 苏 XX Gender: Female Age:47 years old Admission date: 2010.06.09 Chief complaint Fell down from 4-54 5 meter tree and lead to lumbosacral
More informationThoracolumbar Spine Fractures. Outline. Outline. Holmes Criteria. Disclosure:
Thoracolumbar Spine Fractures C. Craig Blackmore, MD, MPH Department of Radiology Virginia Mason Medical Center Affiliate Professor, University of Washington Disclosure: Book Royalties, Springer-Verlag
More informationCervical-Spine Injuries: Catastrophic Injury to Neck Sprain. Seth Cheatham, MD
Cervical-Spine Injuries: Catastrophic Injury to Neck Sprain Seth Cheatham, MD 236 Seth A. Cheatham, MD VCU Sports Medicine I have no financial disclosures Contact sports, specifically football, places
More informationVivian Gonzalez Gillian Lieberman, MD. January 2002. Lumbar Spine Trauma. Vivian Gonzalez, Harvard Medical School Year III Gillian Lieberman, MD
January 2002 Lumbar Spine Trauma Vivian Gonzalez, Harvard Medical School Year III Agenda Anatomy and Biomechanics of Lumbar Spine Three-Column Concept Classification of Fractures Our Patient Imaging Modalities
More information1 REVISOR 5223.0070. (4) Pain associated with rigidity (loss of motion or postural abnormality) or
1 REVISOR 5223.0070 5223.0070 MUSCULOSKELETAL SCHEDULE; BACK. Subpart 1. Lumbar spine. The spine rating is inclusive of leg symptoms except for gross motor weakness, bladder or bowel dysfunction, or sexual
More informationIf you or a loved one have suffered because of a negligent error during spinal surgery, you will be going through a difficult time.
If you or a loved one have suffered because of a negligent error during spinal surgery, you will be going through a difficult time. You may be worried about your future, both in respect of finances and
More informationSpine Trauma: When to Transfer. Alexander Ching, MD Director, Orthopaedic Spine Trauma OHSU
Spine Trauma: When to Transfer Alexander Ching, MD Director, Orthopaedic Spine Trauma OHSU Disclosures Depuy Spine Consultant (teaching and courses) Department education and research funds Atlas Spine
More informationIII./8.4.2: Spinal trauma. III./8.4.2.1 Injury of the spinal cord
III./8.4.2: Spinal trauma Introduction Causes: motor vehicle accidents, falls, sport injuries, industrial accidents The prevalence of spinal column trauma is 64/100,000, associated with neurological dysfunction
More informationTemple Physical Therapy
Temple Physical Therapy A General Overview of Common Neck Injuries For current information on Temple Physical Therapy related news and for a healthy and safe return to work, sport and recreation Like Us
More informationWHIPLASH INJURIES By Prof RP Grabe, Department of Orthopaedics, University of Pretoria
1 WHIPLASH INJURIES By Prof RP Grabe, Department of Orthopaedics, University of Pretoria In a recent publication in Spine the Quebec task force mentions that very little is available in the literature
More informationBODY BODY PEDICLE PEDICLE TRANSVERSE TRANSVERSE PROCESS PROCESS
Learning Objective Radiology Anatomy of the Spine and Upper Extremity Identify anatomic structures of the spine and upper extremities on standard radiographic and cross-sectional images Timothy J. Mosher,
More informationSpine University s Guide to Kinetic MRIs Detect Disc Herniations
Spine University s Guide to Kinetic MRIs Detect Disc Herniations 2 Introduction Traditionally, doctors use a procedure called magnetic resonance imaging (MRI) to diagnose disc injuries. Kinetic magnetic
More informationMaricopa Integrated Health System: Administrative Policy & Procedure
Maricopa Integrated Health System: Administrative Policy & Procedure Effective Date: 03/05 Reviewed Dates: 09/05, 9/08 Revision Dates: Policy #: 64500 S Policy Title: Cervical & Total Spine Clearance and
More informationCervical Spine Imaging
March 20, 2006 Cervical Spine Imaging Johannes Kratz, Harvard Medical School Year IV 1 Overview Background Clinical Cases Diagnostic Tests and a Decision-Tree Algorithm Examples of Cervical Spine Evaluations
More informationReturn to same game if sx s resolve within 15 minutes. Return to next game if sx s resolve within one week Return to Competition
Assessment Skills of the Spine on the Field and in the Clinic Ron Burke, MD Cervical Spine Injuries Sprains and strains Stingers Transient quadriparesis Cervical Spine Injuries Result in critical loss
More information.org. Ankle Fractures (Broken Ankle) Anatomy
Ankle Fractures (Broken Ankle) Page ( 1 ) A broken ankle is also known as an ankle fracture. This means that one or more of the bones that make up the ankle joint are broken. A fractured ankle can range
More informationA Patient s Guide to Diffuse Idiopathic Skeletal Hyperostosis (DISH)
A Patient s Guide to Diffuse Idiopathic Skeletal Hyperostosis (DISH) Introduction Diffuse Idiopathic Skeletal Hyperostosis (DISH) is a phenomenon that more commonly affects older males. It is associated
More informationDoes the pain radiating down your legs, buttocks or lower back prevent you from walking long distances?
Does the pain radiating down your legs, buttocks or lower back prevent you from walking long distances? Do you experience weakness, tingling, numbness, stiffness, or cramping in your legs, buttocks or
More informationClinical guidance for MRI referral
MRI for cervical radiculopathy Referral by a medical practitioner (excluding a specialist or consultant physician) for a scan of spine for a patient 16 years or older for suspected: cervical radiculopathy
More informationMountain biking injuries: a review
Published Online February 21, 2008 Mountain biking injuries: a review Michael R. Carmont The Hartshill Orthopaedic Surgical Unit, The University Hospital of North Staffordshire, Stoke-on-Trent ST4 6QG,
More informationAbstract. Introduction. Case Report. imedpub Journals http://www.imedpub.com/
Case Report imedpub Journals http://www.imedpub.com/ Unusual 2-Stages Posterior Approach Surgical Treatment for Complete Fracture Dislocation of the Upper Thoracic Spine without Neurologic Deficit: A Case
More informationSpinal Cord Injury. North American Spine Society Public Education Series
Spinal Cord Injury North American Spine Society Public Education Series What Is a Spinal Cord Injury? A spinal cord injury is a condition that results from damage or trauma to the nerve tissue of the spine.
More informationObjectives. Spinal Fractures: Classification Diagnosis and Treatment. Level of Fracture. Neuro exam Muscle Grading
Objectives Spinal Fractures: Classification Diagnosis and Treatment Johannes Bernbeck,, MD Review and apply the understanding of incidence and etiology of VCF. Examine conservative and operative management
More information6.0 Management of Head Injuries for Maxillofacial SHOs
6.0 Management of Head Injuries for Maxillofacial SHOs As a Maxillofacial SHO you are not required to manage established head injury, however an awareness of the process is essential when dealing with
More informationTraumatic injuries SPINAL CORD. Causes of Traumatic SCI SYMPTOMS. Spinal Cord trauma can be caused by:
Traumatic injuries SPINAL CORD Jennie Trkulja RN, BScN, ENC (c) Causes of Traumatic SCI Spinal Cord trauma can be caused by: MVC (most injuries) Gunshots Falls Stabbings Assaults Industrial accidents Sports
More informationSurgery for cervical disc prolapse or cervical osteophyte
Mr Paul S. D Urso MBBS(Hons), PhD, FRACS Neurosurgeon Provider Nº: 081161DY Epworth Centre Suite 6.1 32 Erin Street Richmond 3121 Tel: 03 9421 5844 Fax: 03 9421 4186 AH: 03 9483 4040 email: paul@pauldurso.com
More informationMagnetic Resonance Imaging
Magnetic Resonance Imaging North American Spine Society Public Education Series What Is Magnetic Resonance Imaging (MRI)? Magnetic resonance imaging (MRI) is a valuable diagnostic study that has been used
More informationCategory Health: Hospital; accident and emergency; clinical treatment; diagnosis
Scottish Parliament Region: South of Scotland Case 201100366: Ayrshire and Arran NHS Board Summary of Investigation Category Health: Hospital; accident and emergency; clinical treatment; diagnosis Overview
More informationSpinal Fractures Classification System
Spinal Fractures Classification System an AOSpine Knowledge Forum initiative Cervical Spine Fractures Thoracolumbar Spine Fractures Sacral Spine Fractures AOSpine the leading global academic community
More informationThe Anatomy of Spinal Cord Injury (SCI)
The Anatomy of Spinal Cord Injury (SCI) What is the Spinal Cord? The spinal cord is that part of your central nervous system that transmits messages between your brain and your body. The spinal cord has
More informationAssessment & Treatment of Fractures and Dislocations of the Thoracic and Lumbar Spine. Brian Drew, MD
Assessment & Treatment of Fractures and Dislocations of the Thoracic and Lumbar Spine Brian Drew, MD Introduction Mechanism of injuries to the thoracolumbar spine Assessment of spinal stability Treatment
More informationCervical Spine Injuries in Hockey. Joel L. Boyd, MD Minnesota Wild
Cervical Spine Injuries in Hockey Joel L. Boyd, MD Minnesota Wild DISCLOSURES Case example: Hey, doc. My neck hurts. 30 yo NFL lineman involved in head-tohead collision during a preseason game Player continued
More informationHEAD INJURIES Table 1
NEISS HORSE RELATED EMERGENCY ROOM ADMISSIONS HEAD INJURY Edited 5-31-08 Word count 3,694 Characters 17,297 The first part of the report concerned the National Electronic Injury Surveillance System (NEISS)
More informationUpper thoracic spinal fractures in trauma patients Ð a diagnostic pitfall
Injury, Int. J. Care Injured 31 (2000) 219±223 www.elsevier.com/locate/injury Upper thoracic spinal fractures in trauma patients Ð a diagnostic pitfall Edwin J.R. van Beek a, d, *, Henk D. Been b, Kees-Jan
More informationHyperextension Injuries Thoracic Spine Joseph Junewick, MD FACR
Hyperextension Injuries Thoracic Spine Joseph Junewick, MD FACR 10/29/2010 History 3 year old restrained passenger involved in motor vehicle accident. Diagnosis Hyperextension Injuries Thoracic Spine Additional
More informationContact your Doctor or Nurse for more information.
A spinal cord injury is damage to your spinal cord that affects your movement, feeling, or the way your organs work. The injury can happen by cutting, stretching, or swelling of the spinal cord. Injury
More informationProposal 1. I. M. Writer 520 Safe Drive St. Anytown, Anystate, USA 01000 (555) 555-1212. October 13, 2004
Proposal 1 Cover letter I. M. Writer 520 Safe Drive St. Anytown, Anystate, USA 01000 (555) 555-1212 October 13, 2004 Mr. David Decider Director, Policy Branch Department of Highways 759 Main Rd. E. Suite
More informationSpinal Cord Injury Education. An Overview for Patients, Families, and Caregivers
Spinal Cord Injury Education An Overview for Patients, Families, and Caregivers Spinal Cord Anatomy A major component of the Central Nervous System (CNS) It is 15 to 16 inches long, and weighs 1 to 2 ounces
More informationContents. Introduction 1. Anatomy of the Spine 1. 2. Spinal Imaging 7. 3. Spinal Biomechanics 23. 4. History and Physical Examination of the Spine 33
Contents Introduction 1. Anatomy of the Spine 1 Vertebrae 1 Ligaments 3 Intervertebral Disk 4 Intervertebral Foramen 5 2. Spinal Imaging 7 Imaging Modalities 7 Conventional Radiographs 7 Myelography 9
More informationThe Petrylaw Lawsuits Settlements and Injury Settlement Report
The Petrylaw Lawsuits Settlements and Injury Settlement Report TRAUMATIC BRAIN INJURIES How Minnesota Juries Decide the Value of Pain and Suffering in Brain Injury Cases The Petrylaw Lawsuits Settlements
More informationX Stop Spinal Stenosis Decompression
X Stop Spinal Stenosis Decompression Am I a candidate for X Stop spinal surgery? You may be a candidate for the X Stop spinal surgery if you have primarily leg pain rather than mostly back pain and your
More informationNeck Injuries and Disorders
Neck Injuries and Disorders Introduction Any part of your neck can be affected by neck problems. These affect the muscles, bones, joints, tendons, ligaments or nerves in the neck. There are many common
More informationInstability concept. Symposium- Cervical Spine. Barcelona, February 2014
Instability concept Guillem Saló Bru, MD, Phd AOSpine Principles Symposium- Cervical Spine Orthopaedic Depatment. Spine Unit. Hospital del Mar. Barcelona. Associated Professor UAB Barcelona, February 2014
More informationClearing the C Spine
1. Introduction 2. Clinical Presentation 3. History 4. Physical Exam 5. Diagnosis 6. Investigations 7. Evaluation 8. Management 9. Reference 10. Acknowledgents Clearing the C Spine 1. Introduction: Injury
More informationLow Back Injury in the Industrial Athlete: An Anatomic Approach
Low Back Injury in the Industrial Athlete: An Anatomic Approach Earl J. Craig, M.D. Assistant Professor Indiana University School of Medicine Department of Physical Medicine and Rehabilitation Epidemiology
More informationCase Report Chronic Neck Pain Associated with an Old Odontoid Fracture: A Rare Presentation
Case Reports in Emergency Medicine Volume 2013, Article ID 372723, 4 pages http://dx.doi.org/10.1155/2013/372723 Case Report Chronic Neck Pain Associated with an Old Odontoid Fracture: A Rare Presentation
More informationCase Studies Updated 10.24.11
S O L U T I O N S Case Studies Updated 10.24.11 Hill DT Solutions Cervical Decompression Case Study An 18-year-old male involved in a motor vehicle accident in which his SUV was totaled suffering from
More informationCompression Fractures
September 2006 Compression Fractures Eleanor Adams Harvard Medical School Year IV Overview Spine Anatomy Thoracolumbar Fractures Cases Compression Fractures, Ddx Radiologic Tests of Choice Treatment Options
More informationSpine and Spinal Cord Injuries. William Schecter, MD
Spine and Spinal Cord Injuries William Schecter, MD Anatomy of the Spine http://education.yahoo.com/reference/gray/fig/387.html Anatomy of the spine 7 cervical vertebrae 12 thoracic vertebrae 5 lumbar
More informationPreventing & Treating Low Back Pain
Preventing & Treating Low Back Pain An Introduction to Low Back Pain Low back pain is the number two reason that Americans see a health care practitioner second only to colds and flu. While most people
More informationPatient Information. Anterior Cervical Discectomy and Fusion Surgery (ACDF).
Patient Information. Anterior Cervical Discectomy and Fusion Surgery (ACDF). Understanding your spine Disc Between each pair of vertebrae there is a disc that acts as a cushion to protect the vertebra,
More informationAnatomy and Terminology of the Spine. Bones of the Spine (Vertebrae)
Anatomy and Terminology of the Spine The spine, also called the spinal column, vertebral column or backbone, consists of bones, intervertebral discs, ligaments, and joints. In addition, the spine serves
More informationSPINE ANATOMY AND PROCEDURES. Tulsa Spine & Specialty Hospital 6901 S. Olympia Avenue Tulsa, Oklahoma 74132
SPINE ANATOMY AND PROCEDURES Tulsa Spine & Specialty Hospital 6901 S. Olympia Avenue Tulsa, Oklahoma 74132 SPINE ANATOMY The spine consists of 33 bones called vertebrae. The top 7 are cervical, or neck
More information.org. Cervical Spondylosis (Arthritis of the Neck) Anatomy. Cause
Cervical Spondylosis (Arthritis of the Neck) Page ( 1 ) Neck pain can be caused by many things but is most often related to getting older. Like the rest of the body, the disks and joints in the neck (cervical
More informationMEDICAL MALPRACTICE CASE RESULTS
CASE RESULTS INFORMATION Please note that every case is different and these verdicts and settlements, while accurate, do not represent what we may obtain for you in your case. Nor does it mean that we
More informationCycling-related Traumatic Brain Injury 2011
Cycling-related Traumatic Brain Injury 2011 The Chinese University of Hong Kong Division of Neurosurgery, Department of Surgery Accident & Emergency Medicine Academic Unit Jockey Club School of Public
More informationSPINE SURGERY - LUMBAR DECOMPRESSION
SPINE SURGERY - LUMBAR DECOMPRESSION Information Leaflet Your Health. Our Priority. Page 2 of 7 Introduction This booklet has been compiled by the physiotherapy department to help you understand lumbar
More informationGilbert Varela, M.D., Inc 5232 E. Beverly Boulevard Los Angeles, California 90022 Phone: (323) 724-6911 Fax: (323) 724-6915
Gilbert Varela, M.D., Inc 5232 E. Beverly Boulevard Los Angeles, California 90022 Phone: (323) 724-6911 Fax: (323) 724-6915 September 10, 2007 Law offices of xxxxxxxxx Santa Monica, CA 90405 REGARDING:
More informationB U R T & D A V I E S PERSONAL INJURY LAWYERS
TRANSPORT ACCIDENT LAW - TRAUMATIC BRAIN INJURY Traumatic Brain Injury ( TBI ) is a common injury in transport accidents. TBI s are probably the most commonly undiagnosed injuries in a hospital setting.
More informationWhiplash injuries can be visible by functional magnetic resonance imaging. Pain Research and Management Autumn 2006; Vol. 11, No. 3, pp.
Whiplash injuries can be visible by functional magnetic resonance imaging 1 Bengt H Johansson, MD FROM ABSTRACT: Pain Research and Management Autumn 2006; Vol. 11, No. 3, pp. 197-199 Whiplash trauma can
More informationWhiplash and Whiplash- Associated Disorders
Whiplash and Whiplash- Associated Disorders North American Spine Society Public Education Series What Is Whiplash? The term whiplash might be confusing because it describes both a mechanism of injury and
More informationDUKE ORTHOPAEDIC SURGERY GOALS AND OBJECTIVES SPINE SERVICE
GOALS AND OBJECTIVES PATIENT CARE Able to perform a complete musculoskeletal and neurologic examination on the patient including cervical spine, thoracic spine, and lumbar spine. The neurologic examination
More informationAdvances In Spine Care. James D. Bruffey M.D. Scripps Clinic Division of Orthopaedic Surgery Section of Spinal Surgery
Advances In Spine Care James D. Bruffey M.D. Scripps Clinic Division of Orthopaedic Surgery Section of Spinal Surgery Introduction The Spine - A common source of problems Back pain is the #2 presenting
More informationWhiplash Associated Disorder
Whiplash Associated Disorder The pathology Whiplash is a mechanism of injury, consisting of acceleration-deceleration forces to the neck. Mechanism: Hyperflexion/extension injury Stationary vehicle hit
More informationSpine Injury and Back Pain in Sports
Spine Injury and Back Pain in Sports DAVID W. GRAY, MD 1 Back Pain Increases with Age Girls>Boys in Teenage years Anywhere from 15 to 80% of children and adolescents have back pain depending on the studies
More informationPatient Information. Lateral Lumbar Interbody Fusion Surgery (LLIF).
Patient Information. Lateral Lumbar Interbody Fusion Surgery (LLIF). Understanding your spine Disc Between each pair of vertebrae there is a disc that acts as a cushion to protect the vertebra, allows
More informationSt Vincent s Hospital Sydney Referral to Sacred Heart Rehabilitation Consultation Service Policy Section 1 Policy 32
Subject: Referral to the Sacred Heart Rehabilitation Consultation Service Area: Hospital wide Classification: Operational Relevant to: All clinical staff Implementation date: October 2003 Review Date:
More information.org. Clavicle Fracture (Broken Collarbone) Anatomy. Description. Cause. Symptoms
Clavicle Fracture (Broken Collarbone) Page ( 1 ) A broken collarbone is also known as a clavicle fracture. This is a very common fracture that occurs in people of all ages. Anatomy The collarbone (clavicle)
More informationCycling Injury Prevention Workshop
Cycling Injury Prevention Workshop Focus on Thoracic-Shoulder & Associated Conditions Ian Wee Occupational Therapist / Cycle Coach Chris Thompson Physiotherapist / Cycle Coach/ Exercise Physiologist Workshop
More informationCervical Spine Surgery. Orthopaedic Nursing Seminar. Dr Michelle Atkinson. Friday October 21 st 2011. Cervical Disc Herniation
Cervical Spine Surgery Dr Michelle Atkinson The Sydney and Dalcross Adventist Hospitals Orthopaedic Nursing Seminar Friday October 21 st 2011 Cervical disc herniation The most frequently treated surgical
More informationMinimally Invasive Spine Surgery For Your Patients
Minimally Invasive Spine Surgery For Your Patients Lukas P. Zebala, M.D. Assistant Professor Orthopaedic and Neurological Spine Surgery Department of Orthopaedic Surgery Washington University School of
More informationOrthopaedic Spine Center. Anterior Cervical Discectomy and Fusion (ACDF) Normal Discs
Orthopaedic Spine Center Graham Calvert MD James Woodall MD PhD Anterior Cervical Discectomy and Fusion (ACDF) Normal Discs The cervical spine consists of the bony vertebrae, discs, nerves and other structures.
More informationSPINAL STENOSIS Information for Patients WHAT IS SPINAL STENOSIS?
SPINAL STENOSIS Information for Patients WHAT IS SPINAL STENOSIS? The spinal canal is best imagined as a bony tube through which nerve fibres pass. The tube is interrupted between each pair of adjacent
More informationHead Position and Impact Direction in Whiplash Injuries: Associations with MRI-Verified Lesions of Ligaments and Membranes in the Upper Cervical Spine
Head Position and Impact Direction in Whiplash Injuries: Associations with MRI-Verified Lesions of Ligaments and Membranes in the Upper Cervical Spine 1 Journal of Neurotrauma Volume 22, Number 11, November
More informationWhiplash: a review of a commonly misunderstood injury
1 Whiplash: a review of a commonly misunderstood injury The American Journal of Medicine; Volume 110; 651-656; June 1, 2001 Jason C. Eck, Scott D. Hodges, S. Craig Humphreys This review article has 64
More information(a) Glasgow coma scale less than or equal to thirteen; (b) Loss of consciousness greater than five minutes;
ACTION: Original DATE: 09/11/2014 3:19 PM 4765-14-02 Determination of a trauma victim. Emergency medical service personnel shall use the criteria in this rule, consistent with their certification, to evaluate
More informationIMPAIRMENT RATING 5 TH EDITION MODULE II
IMPAIRMENT RATING 5 TH EDITION MODULE II THE SPINE AND ALTERATION OF MOTION SEGMENT INTEGRITY (AOMSI) PRESENTED BY: RONALD J. WELLIKOFF, D.C., FACC, FICC In conjuction with: The chapter on the spine includes
More informationSpinal Surgery 2. Teaching Aims. Common Spinal Pathologies. Disc Degeneration. Disc Degeneration. Causes of LBP 8/2/13. Common Spinal Conditions
Teaching Aims Spinal Surgery 2 Mr Mushtaque A. Ishaque BSc(Hons) BChir(Cantab) DM FRCS FRCS(Ed) FRCS(Orth) Hunterian Professor at The Royal College of Surgeons of England Consultant Orthopaedic Spinal
More informationPosterior Cervical Decompression
Posterior Cervical Decompression Spinal Unit Tel: 01473 702032 or 702097 Issue 2: January 2009 Following your recent MRI scan and consultation with your spinal surgeon, you have been diagnosed with a
More informationCervical Spinal Injuries
Cervical Spinal Injuries Common mechanism is extension or axial compression with buckling into extension. Structures most often injured are discs & facets. Disc & facet injuries are equally frequent. Major
More informationFunctions of the Brain
Objectives 0 Participants will be able to identify 4 characteristics of a healthy brain. 0 Participants will be able to state the functions of the brain. 0 Participants will be able to identify 3 types
More informationProblems. Knowing. back of the
Introduction Welcome to BodyZone Physiotherapy patient resource about Cervical Spine Problems. Knowing the main parts of your neck and how these parts work is important as you learn to care for your neck
More informationBalloon Kyphoplasty. Balloon Kyphoplasty is a minimally invasive procedure to treat vertebral body compression fractures.
Balloon Kyphoplasty Overview Balloon Kyphoplasty is a minimally invasive procedure to treat vertebral body compression fractures. The technique is designed to: Reduce and stabilise the fracture in a controlled
More informationThoracic Spine Anatomy
A Patient s Guide to Thoracic Spine Anatomy 228 West Main, Suite C Missoula, MT 59802 Phone: info@spineuniversity.com DISCLAIMER: The information in this booklet is compiled from a variety of sources.
More informationUnderstanding. Spinal Cord Injury. Tasha, injured in 1997.
Understanding Spinal Cord Injury Tasha, injured in 1997. What Is Spinal Cord Injury? The spinal cord is the part of the central nervous system that contains the body s longest nerve fibers. It serves as
More informationCombined approach for a locked unilateral facet fracture-dislocation of the cervicothoracic junction
Acta Orthop. Belg., 2008, 74, 875-880 CASE REPORT Combined approach for a locked unilateral facet fracture-dislocation of the cervicothoracic junction Bernhard SCHMIDT-ROHLFING, Matthias NOSSEK, Matthias
More informationIntroduction. signs or symptoms. This approach may uncover subtle signs and symptoms that
Introduction Even with today s understanding of the mechanisms that lead to spinal cord injury in athletics, some are still inclined to present these injuries as freak accidents1,2. The physics and mechanics
More informationAnatomy of the Spine. Figure 1. (left) The spine has three natural curves that form an S-shape; strong muscles keep our spine in alignment.
1 2 Anatomy of the Spine Overview The spine is made of 33 individual bony vertebrae stacked one on top of the other. This spinal column provides the main support for your body, allowing you to stand upright,
More informationInstrumented in situ posterolateral fusion for low-grade lytic spondylolisthesis in adults
Acta Orthop. Belg., 2005, 71, 83-87 ORIGINAL STUDY Instrumented in situ posterolateral fusion for low-grade lytic spondylolisthesis in adults Mohamed A. EL MASRY, Walaa I. EL ASSUITY, Youssry K. EL HAWARY,
More informationSpinal Instability as Defined by the Three-column Spine Concept in Acute Spinal Trauma
Spinal Instability as Defined by the Three-column Spine Concept in Acute Spinal Trauma FRANCIS DENIS, M.D., F.R.C.S.(C.), F.A.C.S.* This article is a presentation of the concept of the three-column spine.
More informationCervical Spine: Postmortem Assessment of Accident Injuries Comparison of Radiographic, MR Imaging, Anatomic, and Pathologic Findings
Cervical Spine: Postmortem Assessment of Accident Injuries Comparison of Radiographic, MR Imaging, Anatomic, and Pathologic Findings 1 Radiology, November, 2001;221:340-346. Axel Stäbler, MD, Jurik Eck,
More informationNonoperative Management of Herniated Cervical Intervertebral Disc With Radiculopathy. Spine Volume 21(16) August 15, 1996, pp 1877-1883
Nonoperative Management of Herniated Cervical Intervertebral Disc With Radiculopathy 1 Spine Volume 21(16) August 15, 1996, pp 1877-1883 Saal, Joel S. MD; Saal, Jeffrey A. MD; Yurth, Elizabeth F. MD FROM
More informationHuman Anatomy & Physiology
PowerPoint Lecture Slides prepared by Barbara Heard, Atlantic Cape Community College Ninth Edition Human Anatomy & Physiology C H A P T E R 7 The Skeleton: Part B Annie Leibovitz/Contact Press Images Vertebral
More informationOn Cervical Zygapophysial Joint Pain After Whiplash. Spine December 1, 2011; Volume 36, Number 25S, pp S194 S199
On Cervical Zygapophysial Joint Pain After Whiplash 1 Spine December 1, 2011; Volume 36, Number 25S, pp S194 S199 Nikolai Bogduk, MD, PhD FROM ABSTRACT Objective To summarize the evidence that implicates
More informationAmerican Heritage Life Insurance Company
Policy GVAP1 pays the following benefits for covered on and off the job accidental injuries that result within 90 days (180 days for Accidental Death or Dismemberment) from the date of the accident. A
More informationSpine Clinic Neurospine Specialists, Orthopaedics and Neurosurgery
Spine Clinic Neurospine Specialists, Orthopaedics and Neurosurgery REVISION SPINE SURGERY Revision surgery is a very complex field which requires experience, training and evaluation in a very individual
More information