Articles: spinal-injuries-diagnostic-imaging.
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Intensive care medicine · May 2012
ReviewClinical review: Spinal imaging for the adult obtunded blunt trauma patient: update from 2004.
Controversy exists over how to 'clear' (we mean enable the clinician to safely remove spinal precautions based on imaging and/or clinical examination) the spine of significant unstable injury among clinically unevaluable obtunded blunt trauma patients (OBTPs). This review provides a clinically relevant update of the available evidence since our last review and practice recommendations in 2004. ⋯ Given the variability of screening performance it remains acceptable for clinicians to clear the spine of OBTPs using MDCT alone or MDCT followed by MRI, with implications to either approach. Ongoing research is needed and suggestions are made regarding this. It is essential clinicians and institutions audit their data to determine their likely screening performances in practice.
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Acta neurochirurgica · Oct 2010
Blunt craniocervical artery injury in cervical spine lesions: the value of CT angiography.
The awareness of traumatic craniocervical artery injuries has increased over the last years, and the detection rate varies in published trauma series. These injuries are often associated with cervical spinal and cranial trauma. The purpose of this prospective study was to determine the frequency and injury characteristics of blunt traumatic cervical artery injuries in patients suffering from cervical spine injuries by using a standardized CT angiography (CTA) protocol of the craniocervical vessels. ⋯ Craniocervical vessel injury is a life-threatening and underdiagnosed event in cases of cervical spine injury. CTA of the craniocervical vessels offers a fast, safe, and feasible method for detecting vascular injuries of the craniocervical region and allows prompt further treatment if necessary to reduce the risk of cerebral infarction. CTA of the craniocervical vessels is strongly indicated in cases of cervical spine trauma and in trauma mechanisms involving the cervical spine. Our data underscore the need for screening of blunt carotid and vertebral injury especially in injured cervical spine.
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A case report and literature review of Kümmell's disease. ⋯ Only after an extensive workup, including 3 biopsies of the affected area was the diagnosis of Kümmell's disease considered and surgical treatment performed. CONCLUSION.: Delayed vertebral body collapse, i.e., Kümmell's disease, needs to be considered in any patient with recurrent or worsening spinal symptoms. Under-recognition of this condition leads to delayed diagnosis and treatment.
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Comparative Study
Cervical dynamic screening in spinal clearance: now redundant.
The safest and most effective method of early cervical spine clearance in unconscious patients is the subject of intense debate. We hypothesize that helical computed tomography (CT) is a sufficiently sensitive investigation to render dynamic screening redundant. ⋯ Dynamic screening is a safe procedure but has no real advantage over helical CT. Power's ratio calculation is essential to reduce the chance of a missing an upper cervical injury. The cervical spine can be reliably cleared using helical CT alone.
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To compare the diagnostic value of low-cost computer monitors and a Picture Archiving and Communication System (PACS) workstation for the evaluation of cervical spine fractures in the emergency room. ⋯ Low-cost LCD personal computer monitors may be useful in establishing a diagnosis of cervical spine fractures in the emergency room.