Curiosity or Underdiagnosed? Injuries to Thoracolumbar Spine with Concomitant Trauma to Pancreas

Hax, Jakob; Halvachizadeh, Sascha; Jensen, Kai Oliver; Berk, Till; Teuber, Henrik; Primio, Teresa Di; Lefering, Rolf; Pape, Hans-Christian; Sprengel, Kai; Dgu, TraumaRegister

doi:10.3390/jcm10040700

Cited by 3 publications

(2 citation statements)

References 38 publications

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“…This leads to a horizontal split of the spine with the fracture line passing transversely through the vertebral body and pedicles, or solely through the intervertebral disk and facet joint, with any combination of the above being also possible. Associated intra-abdominal injuries are often found, prompting a careful examination of the abdomen with contrast CT scanning [ 19 ].…”

Section: Reviewmentioning

confidence: 99%

Posterior Ligamentous Complex Injuries of the Thoracolumbar Spine: Importance and Surgical Implications

Bizdikian¹,

Rachkidi²

2021

Cureus

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The soft tissues surrounding the spine play a primordial role in its stability, the most important of which are located posteriorly and are deemed the posterior ligamentous complex (PLC). Injuries to the PLC in the setting of thoracolumbar trauma are often dreaded and little attention has been given to them in the management protocols of thoracolumbar trauma. This review aims to summarize and contextualize current concepts in PLC injuries of the thoracolumbar spine with the aim to provide a clear guide for clinical management.Injuries to the PLC may be suspected on the clinical exam but are often missed, leading to serious complications, including instability and neurological compromise. The diagnosis is often made indirectly by spinal radiographs and CT-scanning or by direct visualization of soft tissues via magnetic resonance imaging. The latter remains the standard imaging modality and is mandatory for patients with a high suspicion of PLC injury. PLC injuries are associated with vertebral fractures and follow a progressive pattern of severity, depending on the mechanism of injury and extent of trauma. Surgical management is warranted, as PLC damage renders the spine unstable. Although fusion was once the standard of care and remains applicable for certain patients, recent endeavors of temporary spinal fixation without fusion are increasingly gaining traction in patients with PLC injuries.In conclusion, PLC injuries are challenging as they are often missed, poorly understood, and are not easily managed. Proper diagnosis and management are crucial to avoid long-standing complications such as spinal instability. Considering the paucity of available data on such an important topic in thoracolumbar trauma, this review article aims to contextualize current concepts in PLC injuries in order to demystify this sparsely covered subject.

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Section: Reviewmentioning

confidence: 99%

Posterior Ligamentous Complex Injuries of the Thoracolumbar Spine: Importance and Surgical Implications

Bizdikian¹,

Rachkidi²

2021

Cureus

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“…The pancreas extends across the spine near the upper lumbar vertebrae. This close location of the lumbar spine can lead to a rare type of horizontal laceration [ 1 ]. The early diagnosis is challenging and the clinical examination result is initially inferior [ 2 ].…”

mentioning

confidence: 99%

Traumatic horizontal transection of the pancreas

Panyko,

Dubovský,

Hájska

2024

Surgery Open Science

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The role of big data management, data registries, and machine learning algorithms for optimizing safe definitive surgery in trauma: a review

Pape,

Starr,

Gueorguiev

et al. 2024

Patient Saf Surg

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Digital data processing has revolutionized medical documentation and enabled the aggregation of patient data across hospitals. Initiatives such as those from the AO Foundation about fracture treatment (AO Sammelstudie, 1986), the Major Trauma Outcome Study (MTOS) about survival, and the Trauma Audit and Research Network (TARN) pioneered multi-hospital data collection. Large trauma registries, like the German Trauma Registry (TR-DGU) helped improve evidence levels but were still constrained by predefined data sets and limited physiological parameters. The improvement in the understanding of pathophysiological reactions substantiated that decision making about fracture care led to development of patient’s tailored dynamic approaches like the Safe Definitive Surgery algorithm. In the future, artificial intelligence (AI) may provide further steps by potentially transforming fracture recognition and/or outcome prediction. The evolution towards flexible decision making and AI-driven innovations may be of further help. The current manuscript summarizes the development of big data from local databases and subsequent trauma registries to AI-based algorithms, such as Parkland Trauma Mortality Index and the IBM Watson Pathway Explorer.

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Curiosity or Underdiagnosed? Injuries to Thoracolumbar Spine with Concomitant Trauma to Pancreas

Cited by 3 publications

References 38 publications

Posterior Ligamentous Complex Injuries of the Thoracolumbar Spine: Importance and Surgical Implications

Posterior Ligamentous Complex Injuries of the Thoracolumbar Spine: Importance and Surgical Implications

Traumatic horizontal transection of the pancreas

The role of big data management, data registries, and machine learning algorithms for optimizing safe definitive surgery in trauma: a review

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