Injuries Of Upper Cervical Spine Research Articles

The Impact of Engorged Vein within Traumatic Posterior Neck Muscle Identified in Preoperative Computed Tomography Angiography to Estimated Blood Loss during Posterior Upper Cervical Spine Surgery

ObjectiveInjuries of upper cervical spine are potentially fatal. Thus, appropriate diagnosis and treatment is essential. In our institute, preoperative computed tomography angiography (CTA) has been performed for evaluation of injuries of bony and vascular structure. The authors confirmed the engorged venous plexus within injured posterior neck muscle. We have this research to clarify the relationship between the engorged venous plexus and engorged vein.MethodsA retrospective review identified 23 adult patients who underwent 23 posterior cervical spine surgeries for treatment of upper cervical injury between 2013 and 2015. Preoperative CTA was used to identify of venous engorgement within posterior neck muscle. The male to female ratio was 18:5 and the mean age was 53.5 years (range, 25-78 years). Presence of venous engorgement and estimated blood loss (EBL) were analyzed retrospectively.ResultsThe EBL of group with venous engorgement was 454.55 mL. The EBL of group without venous engorgement was 291.67 mL. The EBL of group with venous engorgement was larger than control group in significant.ConclusionThe presence of engorged venous plexus is important factor of intraoperative bleeding. Preoperative CTA for identifying of presence of engorged venous plexus and fine operative techniques is important to decrease of blood loss during posterior cervical spine surgery.

Peculiarities and Patterns of Cervical Spine Injuries in Children and Adolescents: A Retrospective Series of 84 Patients from a Single Institute

Cervical spine injuries occur infrequently in children but are associated with significant disability and mortality. A retrospective analysis was performed of 84 consecutive pediatric spine injuries treated at our institute from January 2002 to December 2011. The mean age was 14.7 years. There were 18 patients (21%) in group A (0-12 years) and 66 patients (79%) in group B (13-18 years). Overall, injury was more common in boys (ratio of 6:1). Trivial fall was the predominant cause in group A and fall from height in group B. There were 30 children (36%) with injuries of the upper cervical spine, 53 (63%) with injuries of the lower cervical spine and 1 patient (1%) with a combined injury of upper cervical spine and thoracic spine. Overall, 22% of the group A children and 67% of the group B patients had more severe injuries (Frankel grades A, B and C); 21% (18/84) were treated by surgical fusion. Where follow-up was available, 17 out of 22 children (77%) had good outcome (Frankel grade >C). In conclusion, mechanisms and patterns of injury in children are age related and the majority of the children had good outcome.

Radiological diagnostics of birth trauma in newborns

Aim of the work . To analyze indices of the different radiological methods and to compare it. Materials and methods . The newborns with spinal trauma (n=33) were analyzed, the children who have been excluded this diagnosis (n=27) formed the control group. All children underwent the radiography of cervical spine, the part of them – MRT and USG. There was carried out the visual assessment and analysis of metrical indices. Results . Patients were separated into groups of heaviness, 16 patients with slight degree, 10 with middle one and 7 with heavy degree of injury. At all methods the width of the Cruveilhier joint fissure in children with an injury of upper cervical spine reliably (р 0,4). When using radiology and MRT in children with traumatic injures the width of prevertebral soft tissues was reliably more and the degree of reliability was higher at radiology (р<0,001), than at MRT (р<0,01). The correlations between the width of soft tissues and the degree of heaviness were detected at all levels at radiography and only at the level C1 at MRT. Conclusions . An analysis demonstrated the different degree of importance of some indices for detecting injuries of the upper cervical spine in newborns. There was also proved that the metrical data of the different methods not reliably differ