1/50. Recreational bicycling and injury to the external iliac artery.Because the bony girdle of the pelvis protects the external iliac artery except where it enters the femoral canal, reports of blunt injury to this artery are rare. Emphasizing the importance of a thorough physical examination and judicious use of angiography, this case study discusses the diagnosis and treatment of an isolated external iliac artery injury rendered by a bicycle handlebar, a previously unreported cause of this type of injury.- - - - - - - - - - ranking = 1keywords = canal (Clic here for more details about this article) |
2/50. Spinous process fractures in a jockey: a case report.Spinous process fractures typically represent avulsion injuries involving the lower cervical spine. This case report describes the clinical and radiographic findings in a patient with spinous process fractures at the T-2, T-3, and T-4 vertebral levels. The fractures, which were obscured on conventional radiographs by overlying osseous and soft-tissue structures, were optimally shown on axial and computer-reconstructed sagittal computed tomographic (CT) images. Although isolated spinous process fractures do not compromise spinal stability, chronic sequelae associated with fracture nonunion may occur if a fracture is not recognized and treated. Because conventional radiographic assessment of the thoracic posterior elements is often limited, cases of clinically suspected spinous process fracture often require CT evaluation to confirm the diagnosis.- - - - - - - - - - ranking = 17.5875097929keywords = spinal (Clic here for more details about this article) |
3/50. Sledging related spinal injuries and fracture patterns: a report on five cases.The cases are reported of five patients who presented to The Queens Medical Centre, Nottingham after a sledging accident. All five patients presented consecutively during the first weekend in 1997 having sustained the accident in the same public park. The mechanism and subsequent fracture type is described for each. These injuries are preventable, and increasing public awareness of the risk of sledging in public places may reduce the incidence.- - - - - - - - - - ranking = 70.350039171601keywords = spinal (Clic here for more details about this article) |
4/50. Spontaneous remission of a solitary intraspinal synovial cyst of the lumbar spine.We report on a 15-year-old boy in whom a spontaneous remission of a symptomatic synovial cyst, possibly emanating from the L4-5 facet joint, was noted. The medical history suggested that sport-related overactivity and/or minor trauma was the underlying cause. Conservative treatment for several months may be one treatment option if the cyst wall is not calcified and the symptoms and signs related to radiculopathy show a gradual decrease.- - - - - - - - - - ranking = 70.350039171601keywords = spinal (Clic here for more details about this article) |
5/50. spinal cord injury without radiographic abnormalities in children and adolescents: case report of a severe cervical spine lesion and review of literature.The biomechanics of the child's and juvenile's spine is responsible for the commonly encountered closed spinal trauma with significant neurological injury but without bony or ligament injury (particularly of the cervical spine). The ligamentous laxity and hypermobility of the young bony cervical and thoracic spine predispose to spinal cord injury without radiographic abnormalities. We report a 16-year-old girl with typical features of this type of injury after a "flic-flac" sports injury. We conclude that children and adolescents who have neurological deficits without positive radiographic findings require appropriate diagnostic screening, monitoring, and often a prolonged therapy. The sometimes changing neurological deficits should never be ignored or dismissed as psychogenic affection.- - - - - - - - - - ranking = 35.1750195858keywords = spinal (Clic here for more details about this article) |
6/50. Cervical spine injuries in the athlete.Special considerations must be brought into play when the physician is consulted about when to allow an athlete to return to play following injury. This is especially true for brain and spinal cord injury. Although it is generally best to be on the conservative side, being too reticent about allowing any athlete to return may be very detrimental to the athlete and/or the entire team. Therefore, it behooves the sports physician to be circumspect with regard to not only the type of injury the athlete has suffered but also the nature, duration, and the repetitive aspects of the trauma along with the inherent strengths of any player. This article will provide the sports physician with criteria for making sound decisions regarding return to competition after cervical spine injury and "functional" cervical spinal stenosis.- - - - - - - - - - ranking = 35.1750195858keywords = spinal (Clic here for more details about this article) |
7/50. Neurologic complications of sit-ups associated with the valsalva maneuver: 2 case reports.We present 2 cases of potentially catastrophic neurologic consequences occurring in healthy individuals engaged in sit-up exercises. Two young healthy men were engaged in sit-ups when one developed a stroke and the other developed a spinal epidural hematoma. The valsalva maneuver involved in the sit-up exercise can produce supraphysiologic increases in blood pressure, which can lead to vascular injury and serious neurologic consequences. Proper breathing should be encouraged and patients with known predisposing factors should avoid such exercises. Prompt recognition of neurologic signs and symptoms during exercise can be life saving. This is the first report of the neurologic complications of sit-ups.- - - - - - - - - - ranking = 17.5875097929keywords = spinal (Clic here for more details about this article) |
8/50. Late recovery following spinal cord injury. Case report and review of the literature.The authors of this prospective, single-case study evaluated the potential for functional recovery from chronic spinal cord injury (SCI). The patient was motor complete with minimal and transient sensory perception in the left hemibody. His condition was classified as C-2 American Spinal Injury association (asia) Grade A and he had experienced no substantial recovery in the first 5 years after traumatic SCI. Clinical experience and evidence from the scientific literature suggest that further recovery would not take place. When the study began in 1999, the patient was tetraplegic and unable to breathe without assisted ventilation; his condition classification persisted as C-2 asia Grade A. magnetic resonance imaging revealed severe injury at the C-2 level that had left a central fluid-filled cyst surrounded by a narrow donutlike rim of white matter. Five years after the injury a program known as "activity-based recovery" was instituted. The hypothesis was that patterned neural activity might stimulate the central nervous system to become more functional, as it does during development. Over a 3-year period (5-8 years after injury), the patient's condition improved from asia Grade A to asia Grade C, an improvement of two asia grades. Motor scores improved from 0/100 to 20/100, and sensory scores rose from 5-7/112 to 58-77/112. Using electromyography, the authors documented voluntary control over important muscle groups, including the right hemidiaphragm (C3-5), extensor carpi radialis (C-6), and vastus medialis (L2-4). Reversal of osteoporosis and an increase in muscle mass was associated with this recovery. Moreover, spasticity decreased, the incidence of medical complications fell dramatically, and the incidence of infections and use of antibiotic medications was reduced by over 90%. These improvements occurred despite the fact that less than 25 mm2 of tissue (approximately 25%) of the outer cord (presumably white matter) had survived at the injury level. The primary novelty of this report is the demonstration that substantial recovery of function (two asia grades) is possible in a patient with severe C-2 asia Grade A injury, long after the initial SCI. Less severely injured (lower injury level, clinically incomplete lesions) individuals might achieve even more meaningful recovery. The role of patterned neural activity in regeneration and recovery of function after SCI therefore appears a fruitful area for future investigation.- - - - - - - - - - ranking = 87.937548964501keywords = spinal (Clic here for more details about this article) |
9/50. Fracture of a vertebral body end plate and disk protrusion causing subarachnoid block in an adolescent.An apparently unique case of retroprotrusion of a portion of the vertebral end plate plus L4 disk in a 16-year-old boy demonstrated a complete myelographic block. The block was produced by a large fragment of bone which had broken off the inferior end plate of the body of L4 and was protruding into the spinal canal. Removal of the bony block and protruding disk resulted in complete resolution of symptoms.- - - - - - - - - - ranking = 18.5875097929keywords = spinal, canal (Clic here for more details about this article) |
10/50. Congenital predisposition to spontaneous intracranial hypotension: a case report.Dural rupture, cerebrospinal fluid leakage, and spontaneous intracranial hypotension may complicate significant or minimal spinal trauma and cause chronic headache with a positional component. While such cases typically reflect no pre-existing predilection, we encountered a patient whose cervicothoracic anatomy appeared to predispose him to this complication.- - - - - - - - - - ranking = 35.1750195858keywords = spinal (Clic here for more details about this article) |
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