We concluded that any neurologic deficit in a patient with a stab-wound injury in the spine must mandate surgical exploration and in patients without neurological deficit, direct removal of the stabbing object is a safe and effective method without adding the risks of a surgical exploration.
Objective:The purpose of this study is to report epidemiological and clinical data of the patients that were admitted with spinal gunshot injuries. Methods: This was retrospective study and observational study. Patients who had a spinal injury secondary to a gunshot wound that was admitted to our hospital (level III trauma center) from July 2018 through July 2020 were included in the study. Demographic and clinical data including age, gender, civil status, occupation, level of injury (cervical, thoracic, or lumbar), degree of neurological impairment at admission, associated injuries, treatment established, length of hospital stay, and mortality rate were recorded. Results: A total of 55 patients were included in the study, of which 50 patients (90.9%) were men and five female patients (9.09%). The average age was 30.2 years. Three patients died during hospitalization representing a mortality rate of 5.45%. Conclusions: Spinal gunshot injuries are associated with significant sequelae, requiring long and costly treatments. This study obtained one of the highest incidences of gunshot injuries to the spine reported in the literature.
The Torg-Pavlov ratio is a method used to detect cervical stenosis. A Torg-Pavlov ratio ≤0.80 suggests significant stenosis. This ratio is obtained by dividing the anteroposterior diameter of the cervical canal by the anteroposterior diameter of the vertebral body. The aim of this study was to evaluate these parameters and determine if there are significant differences with respect to sex and age. This is an anatomical and comparative study in which 1020 cervical vertebrae from C2-C7 from an osteological collection were evaluated. We determined the anteroposterior diameter from the vertebral body, the anteroposterior diameter from the vertebral canal and the Torg-Pavlov ratio. The pieces studied were divided into groups according to sex and age, resulting in six groups of study. A statistical analysis was made to determine the significance of the differences between sex and age groups. The size of the vertebral body diminished form C2-C3 and increased from C4-C7. The canal diminished form C2-C4 and increased from C5-C7. The Torg-Pavlov ratio decreased from C2-C7. The body and the canal were higher in men, while the Torg-Pavlov ratio was higher in women. With age, in men, the size of the body increased, the canal maintained its size, and the Torg-Pavlov ratio diminished significantly. In the group of women ≥60 years, the size of the body decreased, and the canal and the Torg-Pavlov ratio increased. In men, the Torg-Pavlov ratio is determined by the vertebral body and canal, because these did not show differences in most of the age groups. While in women, it is determined mostly by the spinal canal because it presented more variability between the age groups.
MORALES-AVALOS, R.; VILLARREAL-GARCIA, F. I.; REQUENA-ARAUJO, P. M.; VÍLCHEZ-CAVAZOS, F.; REYES-FERNÁNDEZ, P. M.; MARTÍNEZ-GUTIERREZ, O. A.; PEÑA-MARTÍNEZ, V. M.; GUZMÁN-LÓPEZ, S. & ELIZONDO-OMAÑA, R. E. Análisis morfométrico del axis para la fijación atlantoaxial. Int. J. Morphol., 36(4):1331Morphol., 36(4): -1336Morphol., 36(4): , 2018 RESUMEN: El objetivo de este estudio fue evaluar de manera integral los parámetros morfométricos de la vértebra axis (C2) en la población mexicana involucrados en la realización de procedimientos quirúrgicos con el fin de proveer datos cuantitativos indispensables en su abordaje quirúrgico. Para este estudio se utilizaron un total de 576 vértebras axis (C2) de población mexicana contemporánea. Las mediciones de las vértebras se efectuaron bilateralmente utilizando un vernier digital milimétrico con una precisión de 0.01 mm (Mitutoyo Digimatic w/Absolute Encoders-Series 500). Un total de 576 vértebras axis (C2), fueron medidas de manera bilateral, todas nuestras mediciones se reportaron en mm. El promedio del ancho del pedículo fue de 8,96 mm con una DE ± 2,11 mm. El promedio de la altura del pedículo fue de 10,82 mm con una DE de ± 1,89 mm. El promedio de la altura del proceso odontoideo fue de 16,90 mm con una DE de ± 2,99 mm. El promedio del ancho del proceso odontoideo fue de 9,99 mm con una de DE de ± 0,80 mm. El promedio del diámetro de la faceta articular fue de 8,44 mm con una DE de ± 1,04 mm. El promedio del diámetro AP del cuerpo vertebral fue de 15,11 mm con una DE de ± 1,88 mm. El promedio del diámetro trasverso del cuerpo vertebral fue de 17,93 mm con una DE de ± 2,22 mm. El promedio de la altura del cuerpo vertebral fue de 18,54 mm con una DE de 2,38 mm. El promedio de la altura de las láminas fue de 11,53 mm con una DE de ± 1,39 mm. El promedio del ancho de las láminas fue de 6,10 mm con una DE de ± 1,44 mm. Los resultados obtenidos en nuestras mediciones demuestran una variación con los resultados de otros autores en diferentes estudios de piezas osteológicas y de estudios de imagen del axis (C2), lo que sugiere, con el fin de reducir los riesgo de daño a estructuras neurovasculares, utilizar técnicas y medidas especiales para la estabilización atlantoaxial de la población mexicana.
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