TITLE

Severity of Cervical Spine Ligamentous Injury Correlates with Mechanism of Injury, Not with Severity of Blunt Head Trauma

AUTHOR(S)
Albrecht, Roxie M.; Malik, Salman; Kingsley, Darra D.; Hart, Blaine
PUB. DATE
March 2003
SOURCE
American Surgeon;Mar2003, Vol. 69 Issue 3, p261
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Clearance of the cervical spine (CS) in obtunded trauma patients in an intensive care unit is problematic. Patients with no osseous injuries have potential unstable extradural supportive soft tissue injury. Evaluation of the supporting structures involves dynamic fluoroscopy or MRI both of which have inherent risks and convenience issues. Defining which of these patients are at highest risk for severe supportive structure injury may improve resource utilization for CS clearance. The purpose of this study was to evaluate clinical factors that may predict the probability of CS supportive soft tissue injury in patients with traumatic brain injury. Patients who sustained traumatic brain injury with intracranial pathology, absence of CS osseous injury, and a limited cervical spine MRI within 72 hours of injury were included. Potential clinical predictors included the severity of the traumatic brain injury defined by the Abbreviated Injury Severity Score for the cerebrum and initial Glasgow Coma Scale, the Injury Severity Score (ISS), mechanism of injury, and high versus low-velocity mechanism. Severity of soft tissue/ligament injury was graded by MRI findings. One hundred twenty-five patients met the study criteria; 81 had negative MRI findings and in 44 the MRI study was positive for potentially unstable injuries. High-velocity mechanisms of injury and ISS--not the severity of the traumatic brain injury or initial Glasgow Coma Scale score--were statistically significant predictors of severe CS supportive soft tissue injuries. Obtunded blunt trauma patients who have been involved in high-velocity-mechanism incidents and have high ISS are at greatest risk for extradural supportive soft tissue CS injuries. These patients should either remain in CS immobilization until clinical evaluation can be completed or undergo further evaluation of their supportive soft tissue structures by MRI or fluoroscopic flexion/extension.
ACCESSION #
10544974

 

Related Articles

  • Detection and characterization of traumatic scalp injuries for forensic evaluation using computed tomography. Malli, Norbert; Ehammer, Thomas; Yen, Kathrin; Scheurer, Eva // International Journal of Legal Medicine;Jan2013, Vol. 127 Issue 1, p195 

    The purpose of this prospective study was to evaluate the rate of detection and correct classification of traumatic soft tissue injuries of the head using clinical multislice computed tomography (MSCT) compared with an external forensic examination. Thirty-one patients with soft tissue injuries...

  • Diclofenac patch For topical treatment of acute impact injuries: a randomised, double blind, placebo controlled, multicentre study. Predel, H. G.; Koll, R.; Pabst, H.; Dieter, R.; Gallacchi, G.; Giannetti, B.; Bulitta, M.; Heidecker, J. L.; Mueller, E. A. // British Journal of Sports Medicine;Jun2004, Vol. 38 Issue 3, p318 

    Objectives: To investigate the clinical efficacy and safety of a newly developed diclofenac patch in the topical treatment of blunt impact injuries. Methods: This was a randomised, placebo controlled, double blind, multicentre study in 120 patients with traumatic blunt soft tissue injury. Within...

  • Isolated closed minor-muscle injury of the lower leg did not cause an obvious systemic immune response. Daniel Schmitz; Joerg Bangen; Christoph Herborn; Baher Husain; Sven Lendemans; Stefanie Flohé; Klaus Metz; F. Schade; Georg Taeger; Jörg Oberbeck; Philipp Kobbe; Christian Waydhas; Sascha Flohé // Inflammation Research;Feb2010, Vol. 59 Issue 2, p141 

    Abstract Objective  A common consequence in patients with blunt trauma is a deterioration of the immune system. The specific impacts of a frequently occurring isolated soft tissue trauma on the immune response are described. However, the dimension of trauma needed to cause systemic effects...

  • Una alternativa de manejo en trauma facial. Reporte de un caso. Velázquez, Joel Omar Reyes; Barbosa, Roberto Pardo // Medicina Oral (16656024);2008, Vol. 10 Issue 3, p76 

    The integral management of the polytraumatized patient requires of immediate and precise care to identify the factors that endanger the patients life. Traumatism that involve the facial region produce diverse damage to the soft and hard tissue depending on the mecanics of trauma, which may be...

  • Prospective Evaluation of Criteria for the Nonoperative Management of Blunt Splenic Trauma. Meguid, Ahmed A.; Bair, Holly A.; Howells, Greg A.; Bendick, Phillip J.; Kerr, Hugh H.; Villalba, Mario R. // American Surgeon;Mar2003, Vol. 69 Issue 3, p238 

    Recent reports have shown an increased mortality associated with the nonoperative management of blunt splenic injury. We have prospectively applied criteria developed from our previous 15-year experience for the nonoperative management (NOM) of blunt splenic injury. These criteria consist of 1)...

  • Management of soft tissue wounds of the face. Bhattacharya, V. // Indian Journal of Plastic Surgery;Sep-Dec2012, Vol. 45 Issue 3, p436 

    Since time, immemorial soft-tissue injuries to the face have been documented in literature and even depicted in sculptures, reflecting the image of society. In a polytrauma the face may be involved or there may be isolated injury to the face. The face consists of several organs and aesthetic...

  • Retrohepatic inferior vena caval injury: Difficult but manageable situation. Darbari, Anshuman; Kumar, Ambrish; Tandon, Shekhar; Kumar, Shailendra // Indian Journal of Surgery;Oct2006, Vol. 68 Issue 5, p267 

    Inferior vena caval injuries remain a challenge for the skill, experience and diligence of a surgeon. Not only vascular surgeons, but all surgeons should be familiar with the principles of their treatment. We are reporting a patient of retrohepatic inferior vena caval injury due to blunt trauma....

  • Blunt Traumatic Pericardial Rupture: a Diagnostic Challenge. Rashid, Moheb A.; Lund, Jens T. // European Journal of Trauma;Dec2003, Vol. 29 Issue 6, p403 

    Traumatic pericardial rupture is a rare lesion associated with a high mortality rate, and its diagnosis poses challenges for the surgeon. Two patients are presented, in whom the diagnosis was not possible pre operatively, and discovered only during surgery for associated lesions. To the best of...

  • Soft Tissue: Infection and Reconstruction. Barker, John; Marzi, Ingo // European Journal of Trauma & Emergency Surgery;Jun2008, Vol. 34 Issue 3, p217 

    The article discusses various reports published within the issue including one about the surgical treatment of necrotizing faciitis in the perineum and abdominal wall and another on the procedures and options for reconstructing soft tissue defects of the lower leg and the foot.

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics