Cases reported "Spinal Injuries"

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1/331. erectile dysfunction caused by sacral gun-shot injury.

    A 22-year-old man suffering from isolated erectile dysfunction associated with damage to the right spinal nerve S2 caused by sacral gun-shot injury. He has no loss of bladder innervation. Treatment has been implantation of a penile prosthesis. ( info)

2/331. An unusual case of subluxation of C.3-C.4.

    A case is reported of spontaneous subluxation of C.3 on C.4 in a 6-year-old boy due to an upper respiratory infection after surgical treatment for muscular torticollis. ( info)

3/331. Fracture-dislocation of the dorsal spine.

    A patient with fracture-dislocation of D9 on D8 had considerable posterolateral displacement. The neurologic injolvement of his left leg proved to be progressive. Treatment consisted of posterior decompression, exploration, open reduction and stabilization by means of Harrington rods, and fusion. All neurologic findings resolved completely. Final evaluation 18 months later showed a good and serviceable spine with no residual neurologic deficits. In my opinion, the treatment used in this case under given circumstances represented a reasonable modality of therapy. ( info)

4/331. Use of breath-activated Patient Controlled analgesia for acute pain management in a patient with quadriplegia.

    We report the use of breath-activated Patient Controlled analgesia (PCA) for the provision of analgesia in a quadriplegic patient with traumatic neck injury. This provided good pain relief, decreased opioid complications, improved perceptions of self-control, smoothed recovery and enhanced patient, family as well as staff satisfaction. The setup and principles of its use in a patient with high anxiety and unable to use conventionally activated PCA are illustrated. ( info)

5/331. Detection of vertebral artery injury after cervical spine trauma using magnetic resonance angiography.

    BACKGROUND: We prospectively describe the incidence, magnetic resonance-based diagnosis, and treatment of vertebral artery (VA) injury resulting from closed cervical spine trauma. methods: patients with fracture or dislocation on plain radiographic studies underwent computed tomography. Among these patients, the subset with computed tomographic evidence of foramen transversarium (FT) fracture underwent magnetic resonance angiography as early as possible. RESULTS: During a 16-month period, 38 patients with closed cervical trauma were treated. Twelve patients demonstrated fracture extension through at least one FT by computed tomography. Among these patients, four showed unilateral VA injury by magnetic resonance angiography, all ipsilateral to the fractured FT. Three cases of VA occlusion and one of focal narrowing were demonstrated. All four patients were initially treated with aspirin, and two were systemically anticoagulated. None developed irreversible neurologic deficits from the VA compromise. CONCLUSION: Our data suggest that the incidence of VA injury in closed cervical spine trauma is significant and that FT fractures warrant flow-sensitive magnetic resonance imaging. ( info)

6/331. Transoral missile removal from the anterior C1 region following transpharyngeal missile wound.

    We present a successful treatment result in a rare case of low velocity missile transpharyngeal wound to the upper cervical area in a 33-year-old man. There are very few reports concerning related cases, with some disagreement regarding their treatment. The retained missile was successfully removed from the anterior region of the C1 vertebra through a transoral-transpharyngeal approach using the explosive transpharyngeal wound sustained. Neurological status and spine stability were not affected due to the missile's low velocity. The early soft-tissue debridement, missile removal, pharyngeal closure without wound drainage and broad-spectrum antibiotic coverage resulted in an uneventful postoperative course and good long-term outcome. Early surgery is important to prevent complications in such cases. However, the prophylactic tracheostomy, wound drainage and applying of a nasogastric tube could be left to the surgeon's judgment based on the individual patient's respiratory status, intraoperative findings and wound contamination/colonization. ( info)

7/331. Traumatic L5-S1 spondylolisthesis: report of three cases and a review of the literature.

    The literature reports that traumatic spondylolisthesis of L5 is an uncommon lesion. The authors report their experience of three cases of this particular fracture-dislocation of the lumbosacral spine. They stress the importance of certain radiographic signs in the diagnosis: namely, the presence of unilateral multiple fracture of the transverse lumbar apophysis. As far as the treatment is concerned, they state the need for an open reduction and an internal segmental fixation by posterior approach. A preoperative MRI study appears mandatory in order to evaluate the integrity of the L5-S1 disc. In the event of a traumatic disruption of the disc, they state the importance of posterior interbody fusion by means of a strut graft carved from the ilium or, in case of iliac wing fracture (which is not uncommon in these patients), by means of interbody cages. ( info)

8/331. Spinal lesions, paraplegia and the surgeon.

    Thirty-six patients with spinal cord lesions and varying degrees of paraplegia were seen by the surgical team at the Angau Memorial Hospital, Lae, over a thirty month period. Because the continued presence of a spinal lesion may lead to progressive cord destruction and ischaemic myelopathy, prompt treatment is advocated. The depressing results that have followed treatment of fracture dislocations of the cervical spine and secondary neoplasm with paraplegia is recorded and some suggestions are made that may improve the outlook in future cases. Early and major surgery is advocated in the treatment of spinal abscesses, tumours, Pott's paraplegia and unstable fracture dislocations of the lumbar spine. ( info)

9/331. Wandering intraspinal bullet.

    A case of gun shot injury to the spine, with the bullet entering the thecal sac via the right side of the lower chest and wandering freely in the subarachnoid space, is reported. The patient was neurologically intact initially and developed radicular symptoms with foot drop and urinary retention on the third day after injury. The radiological findings and the problems faced at surgery are discussed, and the relevant literature of this uncommon condition is reviewed. ( info)

10/331. Atlantal stenosis: a rare cause of quadriparesis in a child. Case report.

    The authors report the case of a 3-year-old boy who suffered from quadriparesis and respiratory distress after failing to execute a somersault properly. neuroimaging revealed spinal cord contusion with marked spinal canal stenosis at the level of the atlas. No subtle instability, occult fracture, or other congenital abnormalities were confirmed. spinal cord contusion with marked canal stenosis is rare, and only several adult cases have been reported. Severe stenosis at the level of the atlas may predispose individuals to severe spinal cord contusion, as occurred in our patient after sustaining trivial trauma. ( info)
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