Cervical spine trauma

Torretti, Joel; Sengupta, Dilip K.

doi:10.4103/0019-5413.36985

Cited by 57 publications

(18 citation statements)

References 94 publications

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“…angman's fracture is described as a bilateral fracture traversing the pars interarticularis of C2 [1,2]. It accounts for 23% of axis fractures and is commonly seen with motor vehicle accidents [3,4].…”

Section: Background and Importancementioning

confidence: 99%

Hangman’s Fracture with Concomitant Atlantoaxial Dislocation

Faghih-Jouybari

Huec

Kazemi

et al. 2019

Iran. J. Neurosurg.

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Background and Importance: Hangman's fracture concomitant with atlantoaxial subluxation is a rare phenomenon. Herein, we reported the victim of a motor vehicle crash with traumatic spondylolisthesis of the axis and atlantoaxial rotary dislocation. Case Presentation: The patient was a 32-year-old female with the chief complaint of severe neck pain. Her neurologic examination was normal, but did reveal mild torticollis. Imaging revealed anterolisthesis of the C2 over C3 with angulation of C1/ C2 and rupture of the C2/ C3 disc, while the integrity of the transverse ligament was preserved. The patient first underwent a partial close reduction for the dislocation followed by the operation focusing on the Hangman's fracture using a 360-degree approach. An anterior discectomy of C2/ C3 with cage and plate insertion was followed by posterior fixation using C1, C3 and C4 lateral mass screws. The one-year follow-up radiography depicted proper fusion and alignment. Conclusion: Paucity of evidence regarding simultaneous atlantoaxial dislocation and Hangman's fracture made its management challenging. The mechanism of injury is probably hyperextension and rotation. Based on our presented case, anteroposterior fixation resulted in a satisfactory longterm outcome, both clinically and radiologically.

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Section: Background and Importancementioning

confidence: 99%

Hangman’s Fracture with Concomitant Atlantoaxial Dislocation

Faghih-Jouybari

Huec

Kazemi

et al. 2019

Iran. J. Neurosurg.

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“…Hangman's fracture is traumatic anterior spondylolisthesis of the axis due to bilateral fracture of pars interarticularis. [ 1 2 3 ] Hangman's fracture account for 23% of axis fracture. [ 4 ] Hangman's fracture is the second most common injury of axis.…”

Section: Introductionmentioning

confidence: 99%

Functional outcome in unstable Hangman's fracture managed with anterior approach: A prospective study

Jain

Thakur

et al. 2017

J Craniovert Jun Spine

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Aim:To study the functional outcome in unstable Hangman s fracture managed with anterior decompression and stabilization with cervical locking plate and tricortical bone graft.Materials and Methods:Between 2010 and 2016, 44 patients (range: 19-75 years) with unstable Hangman's fracture underwent anterior decompression and stabilization with cervical locking plate and tricortical bone graft in our institution.Result:According to the Levine and Edwards classification, all patients were unstable with Type IA 6 (13.6), Type IIA 35 (79.5%), Type II (0), and Type III (6.8). The mean period of follow-up was 17 months (range: 6-48 months). Neurological recovery was observed in all nine patients. All patients were relieved from axial pain. None of the patients received blood transfusion. All patients showed solid fusion with no complication related to bone graft and plate.Conclusion:The anterior C2/C3 discectomy, fusion, and stabilization with cervical locking plate and tricortical bone graft are feasible and safe method in treating HangmanÊs fracture, with the benefit of high primary stability, anatomical reduction, and direct decompression of the spinal cord.

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“…These approaches are intended to identify presence of any instability or neurological deficits. This information is used to determine the need for and the extent of any intervention ( 3 ). Computed Tomography (CT) scan technology is used extensively, and it has essentially supplanted the role of traditional radiography.…”

Section: Introductionmentioning

confidence: 99%

“…The advantages of this technique are especially apparent in the evaluation of the regions that cannot be visualized acceptably by plain films. These regions include the occipitocervical region, the facets/lamina, and the cervicothoracic junction ( 3 ). However, the use of CT scans for routine screening in cervical spine trauma is still controversial due to its radiation risks and relatively high cost.…”

Section: Introductionmentioning

confidence: 99%

Impact of morphine use in reducing the need for CT scan in patients with cervical spine trauma: a double blinded randomized clinical trial

Sharifi¹,

Doloo²,

Hashemian³

et al. 2016

Electron physician

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BackgroundCervical spine trauma occurs mostly among young males due to falls and car accidents. The CT scan technology is replacing radiography in many medical clinics as it is very capable in detecting subtle cervical spine injuries. However, the use of CT scan for routine screening in patients with cervical spine trauma remains controversial due to its radiation risks and relatively high cost.ObjectiveThe focus of this research was on using morphine in patients with cervical spine trauma. The objective was to determine the ability of morphine to reduce the number of patients in need of CT scans.MethodsThis double-blinded randomized clinical trial study was conducted from April 2014 to March 2015 in Hasheminejad Hospital in Mashhad, Iran. We enrolled 67 patients with cervical spine trauma and normal radiography in the study. They were divided randomly into two groups (groups A and B), where group A received intravenous morphine, and group B received a placebo. We measured the pain scores in both groups before giving the medication and 10 minutes afterwards using a visual analog scale (VAS).ResultsAs a result of receiving morphine, the patients in group A had significantly lower pain than group B (p-value < 0.001). The average pain score in group A was reduced by 43% versus 23% in group B. However, the most pain reduction was in those in group A with a normal CT scan. The pain score of these patients dropped by 52%.ConclusionsThe findings of this study suggest that patients with a normal radiography may be discharged with a cervical collar without a need for a CT scan if morphine reduces their pain. This is because the pain in these patients stem from the muscles and non-bony structures in the cervical spine area. Clinical trial registration: The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the IRCT ID: IRCT2013100214872N1FundingThe authors received no financial support for the research or for the publication of this article.

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Cervical spine trauma

Cited by 57 publications

References 94 publications

Hangman’s Fracture with Concomitant Atlantoaxial Dislocation

Hangman’s Fracture with Concomitant Atlantoaxial Dislocation

Functional outcome in unstable Hangman's fracture managed with anterior approach: A prospective study

Impact of morphine use in reducing the need for CT scan in patients with cervical spine trauma: a double blinded randomized clinical trial

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