Abstract
Spine injuries include injuries to the spinal column and also injuries to the neural structures including the spinal cord and nerve roots. The incidence of spinal cord injury is estimated at 30 to 40 per 1,000,000 persons. Spinal injuries are classified according to location and pattern of disruption of the ligaments and bony elements. Spinal cord injuries are classified according to the level and degree of function using the Frankel or ASIA score. Treatment of spine and spinal cord injuries includes the principles of realignment of the spine and protection of the spinal cord and nerve roots from injury or further injury. A combination of reduction, immobilization and often operative fixation are required to treat the gamut of injuries to the spine. It is important for physicians treating these patients to be familiar with the common and classic patterns of spinal column and spinal cord injuries and the treatment options for each. Pediatric patients represent a group at risk for certain types of injuries, due to unique biomechanical differences between the adult and the pediatric spine.
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References
Harrison CL, Dijkers M. Spinal cord injury surveillance in the United States: an overview. Paraplegia 1991;29:233.
Young JS, Burns PE, Bowen AM, McCutchen R. Spinal cord injury statistics. Phoenix, AZ: Good Samaritan Medical Center, 1982.
Harris, JH. Radiographic evaluation of spinal trauma. Orthop Clin North Am 1986;17:75–86.
Nichols CG, Young DH, Schiller WR. Evaluation of cervicothoracic junction injury. Ann Emerg Med 1987;16:640–2.
Blackmore CC, Emerson SS, Mann FA, Koepsell TD. Cervical spine imaging in patients with trauma: determination of fracture risk to optimize use. Radiology 1999;211:759–65.
Golueke P, Sclafani S, Phillips T et al. Vertebral artery injury: diagnosis and management. J Trauma 1987; 27:856–65.
Bracken MB, Shepard MJ, Collins WF et al. Methylprednisolone or naloxone treatment after acute spinal cord injury: one-year follow-up data. Results of the Second National Acute Spinal Cord Injury Study. J Neurosurg 1992;76:23–31.
Bracken MB, Shepard MJ, Collins WF et al. A randomized, controlled trial of methylprednisolone or naloxone in the treatment of acute spinal cord injury: results of the Second National Acute Spinal Cord Injury Study. N Engl J Med 1990;322:1405–11.
Bracken MB, Shepard MJ, Holford TR et al. Administration of methylprednisolone for 24 or 48 hours or tirilazad mesylate for 48 hours in the treatment of acute spinal cord injury: results of the Third National Acute Spinal Cord Injury Randomized, Controlled Trial. National Acute Spinal Cord Injury Study. JAMA 1997;277:1597–604.
Tator CH, Fehlings MG. Review of the secondary injury theory of acute spinal cord trauma with emphasis on vascular mechanisms. J Neurosurg 1991;75:15–26.
American Spinal Injury Association. Standards for Neurological and Functional Classification of Spinal Cord Injury, Revised. Chicago: American Spinal Injury Association, 1992.
Schneider RC, Cherry G, Pantek H. The syndrome of acute central cervical spinal cord injury. J Neurosurg 1954;11:546–77.
Hamilton MG, Myles ST. Pediatric spinal injury: review of 174 hospital admissions. J Neurosurg 1992;77:700–4.
Bell C. Surgical observations. Middlesex Hospital Journal 1817;4:469.
Anderson PA, Montesano PX. Morphology and treatmentof occipital condyle fractures. Spine 1988;13:731–6.
Wertheim SB, Bohlman HH. Occipitocervical fusion: indications, technique and long-term results in thirteen patients. J Bone Joint Surg [Am] 1987;69:833–6.
Spence K, Decker S, Sell K. Bursting atlantal fracture associated with rupture of the transverse ligament. J Bone Joint Surg [Am] 1970;52:543–9.
Anderson LD, D’Alonzo RT. Fractures of the odontoid process of the axis. J Bone Joint Surg [Am] 1974;56: 1663–74.
Dunn ME, Seljeskog EL. Experience in the management of odontoid process injuries: an analysis of 128 cases. Neurosurgery 1986;18:306–10.
Eichler ME, Vollmer DG. Cervical spine trauma. In: Youmans J, editor. Neurological surgery, Volume 3, 4th Edition. Philadelphia: WB Saunders, 1996; 1962.
Cornish BL. Traumatic spondylolisthesis of the axis. J Bone Joint Surg [Br] 1968;50:31–43.
Taylor AR. The mechanism of injury to the spinal cord in the neck without damage to the vertebral column. J Bone Joint Surg [Br] 1951;33:543–7.
Burke DC. Spinal cord trauma in children. Paraplegia 1971;9:1–14.
Tator CH. Epidemiology and general characteristics of the spinal cord injured patient. In: Benzel EC, Tator CH, editors. Contemporary management of spinal cord injury. Park Ridge, IL: American Association of Neurological Surgeons, 1994.
White AA, Panjabi MM. The basic kinematics of the human spine: a review of past and current knowledge. Spine 1979;3:12.
White AA, Panjabi MM. Clinical biomechanics of the spine. 2nd Edition. Philadelphia: JB Lippincott, 1990.
Holdsworth FW. Fractures, dislocations and fracturedislocations of the spine. J Bone Joint Surg [Br] 1963;45:6.
Denis F. The three-column spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine 1983;8:817.
Maiman DJ, Pintar FA. Anatomy and clinical biomechanics of the thoracic spine. Clin Neurosurg 1990; 38:296.
Chozick BS, Toselli R. Complications of spinal instrumentation. In: Benzel EC, editor. Spinal instrumentation. Park Ridge, IL: American Association of Neurological Surgeons, 1994; 257–74.
Chance CQ. Note on a type of flexion fracture of the spine. Br J Radiol 1948;21:452.
Gertzbein SD. Neurological deterioration in patients with thoracic and lumbar fractures after admission to the hospital. Spine 1994;19:1723.
Jacobs RR, Asher MA, Snider RK. Thoracolumbar spinal injuries: a comparative study of recumbent and operative treatment in 100 patients. Spine 1980;5:463.
Zindrick MR, Wiltse LL, Widell EH et al. A biomechanical study of intrapeduncular screw fixation in the lumbosacral spine. Clin Orthop 1986;203:99–111.
Anderson MJ, Schutt AH. Spinal injury in children: a review of 156 cases seen from 1950 through 1978. Mayo Clin Proc 1980;55:499–504.
Hadley MN, Zabramski JM, Browner CM et al. Pediatric spinal trauma: review of 122 cases of spinal cord and vertebral column injuries. J Neurosurg 1988;68:18–24.
Pang D, Sahrakar K, Sun PP. Pediatric spinal cord and vertebral column injuries. In: Youmans J, editor. Neurological surgery. Volume 3. 4th Edition. Philadelphia: WB Saunders, 1996; 2006.
Sullivan CR, Bruwer AJ, Harris E. Hypermobility of the cervical spine in children: a pitfall in the diagnosis of cervical dislocation. Am J Surg 1958;95:636–40.
Pang D, Wilberger JE. Traumatic atlantooccipital dislocation with survival: case report and review. Neurosurgery 1980;7:503–8.
Alker GJ, Oh YS, Leslie EV. High cervical spine and craniofacial junction injuries in fatal traffic accidents: a radiographic study. Orthop Clin North Am 1978;9: 1003–10.
Centers for Disease Control. “Trends in Traumatic Spinal Cord Injury — New York, 1982-1988.” MMWR 40 (1991): 535.
Feller, BA. “Prevalence of Selected Impairments: United States — 1977.” Vital and Health Statistics. DHSS Publication, Feb: Series 10. No 134. (1981): 81–1562.
Harvey, C., BB Rothschild, AJ Asmann, T Stripling. “New Estimates of Traumatic SCI Prevalence: A Surveybased Approach.” Paraplegia 28 (1990): 537.
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Velez, D.A., Newell, D.W. (2005). Spine Injuries. In: Moore, A.J., Newell, D.W. (eds) Neurosurgery. Springer Specialist Surgery Series. Springer, London. https://doi.org/10.1007/1-84628-051-6_22
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DOI: https://doi.org/10.1007/1-84628-051-6_22
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