Background and Aim: Diagnosing the status of the posterior ligament complex (PLC) plays an essential role in the management of patients with thoracolumbar fractures. In this study, due to the inefficiency of existing imaging modalities in the accurate detection of PLC damage, we investigated the relevance of some imaging parameters to specific guidelines for rapid PLC injury detection. Methods and Materials/Patients: In this study, 50 patients with and 50 patients without PLC injury were included. MRI, CT scan, and radiographic imaging of the thoracolumbar spine (T12-L1) were evaluated. The thoracolumbar injury classification systems such as Denis, TLICS (Thoracolumbar Injury Classification and Scoring System), and McCormack Load Sharing and radiographic parameters such as Superior Inferior Endplate Angle (SIEA), Body Height (BH), Local Kyphosis (LK), Interspinous Distance (ISD), and Interpedicular Distance (IPD) were investigated in these patients for each imaging method. Statistical analysis was performed using SPSS (Version 21). Result: The ISD and LK and BHp (Body Height Posterior) were significant predictors of PLC injury. On radiographs, the mean LK with and without PLC damage was 25.67° and 20.92°, respectively (p<0.001). The ISD difference was 6.75 mm in cases with PLC damage and 2.84 mm in cases with an intact PLC (p<0.0001). In CT images, the mean LK was 25.77° in cases with PLC damage and 18.63° in cases with an intact PLC (p<0.037). The ISD difference was 4.14 mm in patients with PLC damage and 2.19 mm in patients without PLC damage (p<0.002). The BHp difference was 9.44 mm in cases with PLC damage and 11.09 mm in cases without PLC damage (p<0.002). Conclusion: The current study suggests formulating a predictive radiological index to identify PLC injury successfully. These guidelines can be very helpful in emergency room decision-makings, especially when the cost, availability, and time of performing MRI are important concerns in patients with multiple trauma.
Background and Aim: Previous studies have reported the important effect of age, sex, heredity, and occupational status on intervertebral degenerative dick diseases, which are among the most important causes of low back pain. However, their results are not always so conclusive. This study was performed to investigate the demographic characteristics and family history of lumbar problems in patients with lumbar degenerative dick diseases due to causes other than acute trauma. Methods and Materials/Patients: This cross-sectional descriptive study included patients without acute trauma who were candidates for surgery of lumbar degenerative dick diseases from 2017 to 2018 in the only state hospital admitting these patients in Rasht, Iran. The data related to the disease were obtained from the patients' medical records. Their demographic characteristics and family history of lumbar vertebrae diseases in their relatives were collected using a researcher-made questionnaire through face-to-face interview by the researcher. The data were analyzed using SPSS (Version 16). Descriptive statistics and the chi-square test were conducted at a significance level of 0.05. Results: More than half of the patients were in their 4th to 6th decades of life, and the number of men was 1.8 times as women. The frequency of herniated discs was more than that of both spinal canal stenosis and spondylolisthesis, and most people had no history of low back trauma. The duration of disease in 73% of the patients was more than 1 year and the mean duration was about 4.5 years. More than half of the patients reported problems with the lumbar vertebrae in at least 1 of their first-degree relatives. About one-third of the patients reported a history of vertebrae surgery in their first-degree relatives and the maximum number of reported surgeries in 1 family was 5. Most of the patients were low-literate and illiterate, and about one-third of the patients were workers/farmers. More than one-third of them were housewives and the number of patients working in administrative and driving jobs was very low. There was no significant relationship between study variables and the type of degenerative problems of the lumbar vertebrae. Conclusion: These findings showed similarities with previous studies in terms of age groups, occupational status, and a history of family lumbar problems in patients with lumbar degenerative disc diseases.
Background: Appropriate clinical measures to prevent secondary brain damage in traumatic brain injury are of critical importance. Objectives: This study aims to investigate the relationships between serum electrolyte disturbances and Glasgow Coma Scale (GCS) score in patients with Diffuse Axonal Injury (DAI) at the time of admission and discharge. Materials & Methods: In this retrospective cross-sectional study, we evaluated 101 patients with DAI having GCS score <15 admitted to Poursina Hospital in Rasht, Iran from 2019 to 2020. Based on the presence or absence of serum potassium (K), sodium (Na), magnesium (Mg), and zinc (Zn), disturbances on the first day of hospitalization, patients were divided into two study groups of with and without abnormal electrolyte levels. The GCS scores of the two groups at the time of admission and discharge were recorded and the relationship between electrolyte disturbances and GCS score was evaluated. Results: There were no significant differences in the mean GCS score at the time of admission and discharge between patients with and without disturbances in serum Na, K, Zn and Mg levels based on the crude analysis. Regarding the simultaneous effects of the study variables on the GCS score, only Mg serum level exerted a significant impact on the GCS score at the time of admission (P=0.041) and discharge (P=0.017). Conclusion: The GCS score in patients with DAI at the time of admission and discharge has an association with the Mg serum level but not with Na, K, and Zn levels.
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