The diagnosis of upper thoracic spinal fractures in multiple-trauma patients remains a challenge. The clinical findings are often difficult to detect, especially in the presence of other (extremity) fractures, head injuries or in patients on respiratory support. The findings of chest radiographs and plain spinal films are described in a series of 23 patients with an upper thoracic spinal fracture. Radiographs were retrospectively reviewed by an orthopaedic surgeon and a skeletal radiologist. Fractures were classified according to Magerl and type A1 and A2 compression fractures were excluded. The neurological outcome was assessed using the Frankel scale.Initially, the fracture was missed in 5 patients (22%), mainly due to concomitant life-threatening injuries. Fractures consisted of type A, B and C in one, 10 and 12 patients, respectively. The main findings were: loss of vertical height of vertebra with or without malalignment (21), widened paraspinal line (21), widened mediastinum (4) and no gross abnormalities (2). Neurological lesions were Frankel A, B, C and E in respectively 14, 1, 1 and 7 patients.Upper thoracic spinal fractures are easily missed in patients with multiple injuries. In patients with neurological symptoms CT and/or MRI is required as soon as the general condition of the patient permits this.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/s0020-1383(99)00235-1 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Pneumocephalus and Pneumorrhachis Following Titanium Rib Implant: A Case Report and Literature Review.
Curr Med Imaging
January 2025
Consultant in Emergency Medicine, WIC Clinic, Primary Health Care Corporation, Doha, Qatar.
Introduction: Pneumocephalus and pneumorrhachis are rare postoperative complications, commonly occurring within a few days to months after spinal surgery. They are very rarely reported after thoracic surgeries. This case highlights a unique presentation in the emergency department involving headache and vomiting caused by late complications following thoracic surgery with a titanium rib implant.
View Article and Find Full Text PDFNavigating the Complexities of Anterior Cord Syndrome in a 71-Year-Old: A Case Study of Vertebral Osteomyelitis and Methicillin-Resistant Staphylococcus aureus Bacteremia.
Cureus
December 2024
Internal Medicine, Merit Health Wesley, Hattiesburg, USA.
Anterior cord syndrome is a rare yet critical neurological condition that poses significant challenges in clinical management. We present the case of a 71-year-old male with a medical history of hypertension, uncontrolled type II diabetes mellitus, hypothyroidism, and end-stage renal disease requiring dialysis who presented to the emergency department with complaints of chills, back pain, abdominal pain, and vomiting episodes. Based on the severity of the patient's illness, it was decided that inpatient admission would be best.
View Article and Find Full Text PDFDistribution of spinal damage in patients with axial spondyloarthritis as assessed by MRI: a prospective and blinded study.
Arthritis Res Ther
January 2025
Division of Rheumatology and Immunology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, Graz, 8036, Austria.
Background: Axial spondyloarthritis (SpA) leads to structural bone lesions in every part of the vertebral column. These lesions are only partially visualized on conventional radiographs, omitting posterior parts of the vertebral column and the thoracic spine, that may nevertheless contribute to impaired spinal mobility and function in patients with axial SpA.
Methods: In this prospective and blinded investigation, we assessed the distribution of structural spinal lesions using magnetic resonance imaging (MRI) of the whole spine in 55 patients with axial SpA classified according to the Assessment in Spondyloarthritis International Society (ASAS) criteria.
Cerebrospinal fluid dynamics and subarachnoid space occlusion following traumatic spinal cord injury in the pig: an investigation using magnetic resonance imaging.
Fluids Barriers CNS
January 2025
Adelaide Spinal Research Group & Centre for Orthopaedics and Trauma Research, Faculty of Health and Medical Sciences, The University of Adelaide, Level 7, Adelaide Health and Medical Sciences Building, North Terrace, Adelaide, SA, 5005, Australia.
Background: Traumatic spinal cord injury (SCI) causes spinal cord swelling and occlusion of the subarachnoid space (SAS). SAS occlusion can change pulsatile cerebrospinal fluid (CSF) dynamics, which could have acute clinical management implications. This study aimed to characterise SAS occlusion and investigate CSF dynamics over 14 days post-SCI in the pig.
View Article and Find Full Text PDFThe aortic-vertebral distance is more associated with axial plane deformities than coronal and sagittal deformities in idiopathic scoliosis patients of Lenke types I and II.
Eur Spine J
January 2025
Center for Musculoskeletal Surgery, Charité- Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Purpose: Although idiopathic scoliosis is a common three-dimensional deformity, there is a lack of studies evaluating the associations between the aortic-vertebral distance (AVD) and spinal deformities in all planes. The study therefore aimed to evaluate how the coronal and sagittal curvature, vertebral rotation and aortic-vertebral angle (AVA) affect the AVD in idiopathic scoliosis.
Methods: The AVD, AVA, vertebral rotation and curve angles were measured on preoperative magnetic resonance imaging and radiographs in 46 patients who underwent posterior spinal fusion with pedicle screw instrumentation for idiopathic scoliosis Lenke types 1 and 2.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!