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spinal fractures resulting from traumatic injuries

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Chinese Journal of Traumatology 2010年第1期13卷 3-9页

作者： Heidari Pedram Zarei Mohammad Reza Rasouli Mohammad Reza Alexander R Vaccaro Rahimi-Movaghar Vafa Orthopedic Surgery Department Imam UniversityHospital Tehran University of Medical Sciences TehranIran Sina Trauma and Surgery Research Center Sina Hospital Tehran University of Medical Sciences Tehran Iran Emergency Medicine Department Imam Khomeini Hospital Tehran University of Medical Sciences Tehran Iran Department of Orhtopaedics and Neurosurgery Thomas Jefferson University and the Rothman Institute Philadelphia USA

Objective： To illustrate mechanisms of spine fractures and the pattern of spinal injuries characterized by the major mechanisms in urban population of Iran. Methods： Data regarding spinal injuries including demographics, mechanism and level of spinal injury, abbreviated injury score, associated injuries and final fate of the patients were extracted from the Iranian national trauma registry database from 1999 to 2004. Results： A total of 619 patients with traumatic spine fractures were identified, of whom 68.5% were males. The peak frequency of these injuries occurred in the 21-40 year age-group. Accidental falls and road traffic crashes （RTCs） were the most common mechanisms of spinal fractures （47.2% and 44.1%, respectively）. RTCs tended to occur in younger patients compared with accidental falls. The most common spinal region for spinal fracture was the lumbar spine （53.63%）. Cervical spine fractures were significantly more common in RTCs, while lumbar spine fractures were more common in accidental falls （P〈0.001）. A total of 171 （27.6%）patients had associated non-spinal injuries, of whom 127 had associated extremity injuries, and 55 had head injuries. Thirty-six （5.6%） patients had spinal cord injury （SCI）.The injury severity score of the RTC group was significantly higher than that of accidental falls （P=-0.002）. Fifteen （4%） patients died of traumatic injuries. The rate of death was significantly higher in RTCs compared with accidental falls （5.1% vs 2.1%, P=0.039）. Conclusions： The patterns of spinal fractures are similar to those reported from developed countries. RTCs tend to affect the younger age population and are associated with a higher degree of associated injuries and mortality than accidental falls. Therefore preventive strategies should be based on reduction of the number and severity of RTCs.

关键词： Accidents, traffic Accidental faUs spinal fractures Wounds and injuries Cross-sectional studies Retrospective studies

Pressure ulcers and acute risk factors in individuals with traumatic spinal fractures with or without spinal cord injuries:A prospective analysis of the National spinal Column/Cord Injury Registry of Iran(NSCIR-IR)data

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Chinese Journal of Traumatology 2023年第4期26卷 193-198页

作者： Farzin Farahbakhsh Hossein Rezaei Aliabadi Vali Baigi Zahra Ghodsi Mohammad Dashtkoohi Ahmad Pour-Rashid James SHarrop Vafa Rahimi-Movaghar Sina and Trauma Surgery Research Center Tehran University of Medical SciencesTehranIran Brain and spinalCord Injury Research Center NeuroscienceInstute Tehran Universityof Medical SciencesTehranIran Department of Neurosurgery Shariati HospitalTehran University of Medical SciencesTehranIran Sports Medicine Research Center Tehran University of Medical SciencesTehranIran School of Medicine Bam University of Medical SciencesBamIran Students'Scientific Research Center(SSRC) Tehran University of Medical SciencesTehranIran Department of Neurosurgery Sina HospitalTehran University of Medical SciencesTehranIran Department of Neurosurgery Thomas Jefferson UniversityPhiladelphiaUSA Universal Scientific Education and Research Network(USERN) TehranIran Institute of Biochemistry and Biophysics University of TehranTehranIran Spine Program University of TorontoTorontoCanada

Purpose:To identify risk factors for developing pressure ulcers(PUs)in the acute care period of traumatic spinal fracture patients with or without spinal cord injuries(SCIs).Methods:Data were collected prospectively in participating the National spinal column/Cord Injury Registry of Iran(NSCIR-IR)from individuals with traumatic spinal fractures with or without SCIs,in-clusive of the hospital stay from admission to *** nursing staff examined the patients for the presence of PUs every 8 h during their hospital *** presence and grade of PUs were assessed according to the European Pressure Ulcer Advisory Panel *** addition to PU,following data were also extracted from the NSCIR-IR datasets during the period of 2015-2021:age,sex,Glasgow coma scale score at admission,having SCIs,marital status,surgery for a spinal fracture,American spinal Injury Association impairment scale(AIS),urinary incontinence,level of education,admitted center,length of stay in the intensive care unit(ICU),hypertension,respiratory diseases,consumption of ciga-rettes,diabetes mellitus and length of stay in the *** regression models were used to es-timate the unadjusted and adjusted odds ratio(OR)with 95%confidence intervals(CI).Results:Altogether 2785 participants with traumatic spinal fractures were *** them,87(3.1%)developed PU during their hospital stay and 392(14.1%)had *** the SCI population,63(16.1%)developed PU during hospital *** logistic regression for the whole sample showed that marital status,having SCIs,urinary incontinence,level of education,treating center,number of days in the ICU,age,and Glasgow coma scale score were significant predictors for ***,further analysis by multiple logistic regression only revealed the significant risk factors to be the treating center,marital status,having SCIs,and the number of days in the *** the subgroup of individuals with SCIs,marital status,AIS,urinary incontinenc

关键词： spinal fractures spinal cord injuries Pressureulcer NSCIR-IR

RADIOGRAPHIC　MEASUREMENTS　OF　THEHEIGHTS　OF　VERTEBRAL　BODIES　INTHORACICANDLUMBARSPINE

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Chinese Medical Sciences Journal 1996年第2期11卷 117-119页

作者：戴力扬 Department of Orthopaedics Changzheng Hospital Shanghai.

Radiographic measurements was performed on 124 normal adults for anterior, posterior and middle heights of the vertebral bodies in thoracic and lumbar spine. The normal ratios of vertebral height in one vertebral body and one with the adjacent bodies were presented. The method for measurement and its diagnostic value to osteoporotic vertebral fractures were discussed.

关键词： osteoporosis spinal fractures

Pressure changes in spinal canal and evaluation of spinal cord injuries in spinal section subjected to impact

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Chinese Journal of Traumatology 2001年第3期4卷 175-179页

作者：谢宝钢吴梅英杨吉祥 DepartmentofOrthopedics 254thHospitalofPLATianjin300142China

Objective: To observe pressure changes in the spinal canal of the vertebrarium subjected to impact. From the point of view of impact, pressure changes and spinal cord injuries, the relationship between the type of spinal fracture and the severity of spinal cord injuries were analyzed and some experimental data were provided for early evaluation of severity of spinal cord injuries. Methods: An experimental model of spinal burst fracture was made with Type BIM I bio impact machine and techniques of high velocity vertical loading in static pattern and stress shielding were adopted. Vertebral sections T10 L4 taken from fresh cadavers were impacted and pressure changes in the spinal canal were observed. The types and severity of spinal fracture were studied with gross and radiography examination. Results: Great positive pressure wave (wave A) in the spinal canal of the 4 vertebral specimens with burst fracture was recorded. The peak value of pressure was correlated with the severity of posterior column injuries. Generally, the peak value of pressure was low in the samples with posterior column injuries, but high in the samples without injuries. The predominant features of fractures were burst fractures of vertebral body and severe destruction of the skeletal and fiber structure of the spinal canal. Positive and negative pressure waves (wave B) were recorded in 2 vertebral samples in which no significant abnormal changes were found by radiography examination, however, a little liquid effusion in the vertebral body was found by gross examination. Conclusions: The type of pressure wave in the spinal canal is related to the deformation or the destruction of the spinal canal structure. The peak value of the pressure is non linearly related to the obstruction in the spinal canal, but related to posterior column injuries.

关键词： Pressure spinal fractures spinal cord injuries

Value of multidetector spiral CT in diagnosis of acute thoracolumbar spinal fracture and fracture-dislocation

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Chinese Journal of Traumatology 2004年第5期7卷 289-293页

作者：龚静山徐坚民 Department of Radiology Shenzhen People's Hospital (Second Affiliated Hospital School of Medicine Jinan University) Shenzhen 518020 Guangdong Province China

Objective: To investigate the diagnostic value of multidetector spiral CT (MSCT) in acute thoracolumbar spinal fracture and fracture-dislocation. Methods: CT imaging files of 152 consecutive traumatic patients with thoracolumbar fractures were retrospectively reviewed. MSCT scannings were performed with a collimation of 3-5 mm and a pitch of (5.5). The postprocessing included sagittal and coronal multiplannar reconstruction, and 3-D ***: There were 88 cases of compression fracture, 54 cases of burst fracture and 10 cases of fracture-dislocation. Transverse images of MSCT could visualize all fractures directly and determine whether spinal canal was intact. Postprocessing image was helpful in depicting the displacement of fragment and orientation of ***: MSCT plays an important role in diagnosis and management of acute thoracolumbar spinal fracture and fracture-dislocation.

关键词： Image Processing, Computer-Assisted Tomography, Spiral Computed Adult Aged Cohort Studies Comparative Study Female Follow-Up Studies Fracture Fixation Fracture Healing Humans Injury Severity Score Lumbar Vertebrae Male Middle Aged Retrospective Studies Risk Assessment Sensitivity and Specificity spinal fractures Thoracic Vertebrae Treatment Outcome

CLINICAL APPLICATION OF THE TONIFICATION METHOD IN ORTHOPEDICS AND TRAUMATOLOGY

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Journal of Traditional Chinese Medicine 1998年第2期18卷 115-117页

作者：倪凌朱燕中 Orthopedics and Traumatology Department Beijing College of Acupuncture and Orthopedics Beijing 100015 Beijing University of Traditional Chinese Medicine Beijing 100029

Traumatological and orthopedical diseases with obstruction and blockage are in most cases treated by the reducing method like promoting qi flow and activating blood circulation, dispersing and removing obstruction. Ho... 详细信息

关键词： Shoulder Joint Adult Ankle Injuries Drugs, Chinese Herbal Female Humans Lumbar Vertebrae Male Middle Aged Periarthritis spinal fractures Urinary Retention

Mechanism of thoracolumbar burst fractures：a biomechanical study

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Chinese Medical Journal 2002年第3期115卷 336-338页

作者：戴力扬上海第二医科大学附属新华医院骨科上海200092

OBJECTIVE: To investigate the mechanism associated with thoracolumbar burst fractures. METHODS: Stress distribution of the spine in the upright, flexion and extension positions was analyzed using a three-dimensional finite element model of the spinal motion segment. RESULTS: Stress concentration was noted at the pedicle and posterosuperior part of the vertebral body near the pedicle. CONCLUSION: Stress concentration of the spine may be implicated in the biomechanical mechanism underlying thoracolumbar burst fractures.

关键词： Biomechanics Imaging, Three-Dimensional Lumbar Vertebrae Models, Biological Research Support, Non-U.S. Gov't spinal fractures Thoracic Vertebrae

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Preliminary study on a single balloon cross-midline expansion via unipedicular approach in kyphoplasty

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Chinese Medical Journal 2008年第18期121卷 1811-1814页

作者： SUN Gang JIN Peng LI Fan-dong LIU Xun-wei HAO Run-song YI Yu-hai XIE Zhi-yong Department of Medical Imaging Jinan Military General Hospital of People's Liberation Army Jinan Shandong 250031 China

Background Recently, bilateral transpedicular kyphoplasty with a single balloon was performed for osteoporotic vertebral body compression fractures （OVCFs） to reduce the fees of the operation, but the time of operation and radiation exposure are longer. The aim of this study was to determine the safety and effectiveness of a single balloon cross-midline expansion via unipedicular approach in kyphoplasty for OVCFs. Methods Thirty-six patients with painful OVCFs （61 vertebrae） were enrolled in this research. Unilateral transpedicular puncture was performed under the fluoroscopy monitoring of an oblique angle down the pedicle. A single balloon was introduced through unipedicular approach, The final balloon position was in the midline of the vertebral body with the balloon cross-midline expansion and bone cement filled. Clinical outcomes were determined by comparison of the preoperative and postoperative visual analogue scale （VAS） and Oswestry disability index （ODI）. Radiographic assessment included restoration of vertebral height and correction of kyphosis. Follow-up was conducted for 6-12 months （mean 9.2 months）. Results Thirty-six consecutive patients with 61 vertebrae were successfully operated on with a mean operation time of 37.4 minutes per vertebra. All patients had dramatic pain relief and functional recovery within 96 hours after the procedure with no surgery or device-related complications. VAS score improved from 7.27±1.02 preoperatively to 2.71±0.75 postoperatively （P 〈0.01）. ODI score was decreased from （71.14±10.94）% preoperatively to （26.56±6.35）% postoperatively. The average loss of anterior body height was （14.33±2.76） mm before procedure and （10.03±1.83） mm after procedure （P 〈0.01）, while the average loss of middle body height was （10.15±2.70） mm before procedure and （5.89±1.83） mm after procedure （P 〈0.01）. The kyphotic deformity was corrected from （23.43±5.00） degree to （16.16±2.77） degree （P 〈0.01）. The pain relief and functional recovery were s

关键词： radiology, interventional kyphoplasty osteoporosis spinal fractures

Complete L5 burst fracture treated by 270-degree decompression and reconstruction using titanium mesh cage via a single posterior vertebrectomy

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Chinese Journal of Traumatology 2014年第5期17卷 307-310页

作者： Zeng Hanbing Wang Haibao Xu Huazi Chi Yonglong Mao Fangmin Wang Xiangyang Department of Orthopaedic Surgery Taizhou Municipal Hospital Taizhou 318000 Zhejiang Province China Department of Orthopaedic Surgery The Second Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325027 Zhejiang Province China

Complete burst fractures of the L5 is relatively *** to accomplish a rigid internal fixation as well as preserve motor function is an enormous *** report such a case treated via a single posterior vertebrectomy with 270-degree decompression and reconstruction using titanium mesh *** disc between L5/S1 was preserved by placing the titanium mesh cage on the inferior endplate of the *** hope this method can offer a possible solution for other surgeons when they meet a similar fracture pattern.

关键词： Decompression spinal fractures Lumbar vertebrae