Evaluation of the thoracic and lumbar spine after blunt trauma

Durham, Rodney M.; Luchtefeld, William B.; Wibbenmeyer, Lucy; Maxwell, Alexander P.; Shapiro, Marc J.; Mazuski, John E.

doi:10.1016/s0002-9610(99)80041-5

Cited by 49 publications

(30 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…5,8,29,30 In our study, the presence of laminar fractures in patients with burst fractures of the thoracolumbar spine was associated with higher ISS and NISS values, consistent with other studies on similar fractures caused by blunt trauma secondary to diverse aetiologies. 8,31,32 Both the ISS and NISS are not appropriate markers for the presence of lamina fractures, because the ranges of both scores were wide in patients without laminar fractures. Narrowing of the spinal canal is more sensitive and specific than the ISS and NISS for correlating laminar fractures.…”

Section: Discussionmentioning

confidence: 99%

Laminar Fractures as a Severity Marker in Burst Fractures of the Thoracolumbar Spine

Tisot¹,

Avanzi

2009

J Orthop Surg (Hong Kong)

View full text Add to dashboard Cite

Purpose. To assess the correlation between the presence of lamina fractures, narrowing of the spinal canal, and the severity of injury. Methods. Records of 146 men and 44 women aged 13 to 84 (mean, 39) years diagnosed with burst fractures of the thoracolumbar spine were retrospectively reviewed. The laminar fractures and narrowing of the spinal canal were measured using computed tomography. The severity of injury was determined using the Injury Severity Score (ISS) and the New Injury Severity Score (NISS). The ISS and NISS of patients with and without laminar fractures were compared. The sensitivity and specificity of ISS, NISS, and narrowing of the spinal canal in association with laminar fractures were also compared. Results. 92 (48%) of the patients had laminar fractures. The mean narrowing of the spinal canal was more severe in patients with laminar fractures than those without (47% vs 28%, p<0.001). Patients with laminar fractures had a significantly higher mean ISS (17 vs 12, p<0.001) and NISS (19 vs 13, p<0.001). Narrowing Surgery 2009;17(3):261-4 of the spinal canal is more sensitive and specific than the ISS and NISS when correlating laminar fractures. Conclusion. In patients with burst fractures of the thoracolumbar spine, the presence of laminar fractures indicates a more severe injury. Journal of Orthopaedic

show abstract

Section: Discussionmentioning

confidence: 99%

Laminar Fractures as a Severity Marker in Burst Fractures of the Thoracolumbar Spine

Tisot¹,

Avanzi

2009

J Orthop Surg (Hong Kong)

View full text Add to dashboard Cite

show abstract

“…1,3,4,34,35,37,43Y45,51,52 The majority of the literature supports the notion that TLS fractures may be asymptomatic, yet several studies suggest that clinical examinations can be highly sensitive for patients with reliable physical examinations. 3,4,27,35,37,43,45,52 Terregino et al 35 found that in conscious patients with a normal mental status and no distracting injuries, the absence of back pain or tenderness had a 95% negative predictive value for TLS fractures. Yet, Sava et al 53 prospectively compared physical examination findings with plain films in 537 patients with reliable mental status examinations and found clinical examination to be only 80% sensitive in the identification of TLS fractures.…”

Section: Indications For the Screening For Tls Fractures In Blunt Tramentioning

confidence: 99%

Screening for thoracolumbar spinal injuries in blunt trauma

Sixta

Moore

Ditillo

et al. 2012

Journal of Trauma and Acute Care Surgery

View full text Add to dashboard Cite

“…Three studies [16][17][18] investigated diagnosis of fracture in a mix of primary and secondary care settings, and nine studies [19][20][21][22][23][24][25][26][27] investigated detection of fracture after blunt trauma in emergency departments. The diagnostic accuracy of features conventionally thought to be associated with fracture, such as age .55 years, use of corticosteroids, and trauma, was low and/or inconsistent across the studies.…”

Section: Spinal Fracturementioning

confidence: 99%

Low back pain investigations and prognosis: a review

Refshauge

Maher

2006

Br J Sports Med

View full text Add to dashboard Cite

Low back pain is reviewed in terms of when investigations are useful and its clinical course. Despite the extensive evaluation of the accuracy of investigations such as radiography, magnetic resonance imaging, and myelography, there is a surprising dearth of research to inform their use in primary care. There is no clear evidence on which to base judgments for selection of appropriate tests to confirm or exclude low back pain pathology. It appears that investigations are rarely necessary for low back pain. Specific investigations should be ordered to identify a particular pathology but should not be ordered routinely for general screening. In the absence of pathology, low back pain and its associated disability improve rapidly in the first weeks after onset, but, in contradiction to all guidelines, both commonly persist and the best evidence suggests that recurrences are common.

show abstract

Evaluation of the thoracic and lumbar spine after blunt trauma

Cited by 49 publications

References 11 publications

Laminar Fractures as a Severity Marker in Burst Fractures of the Thoracolumbar Spine

Laminar Fractures as a Severity Marker in Burst Fractures of the Thoracolumbar Spine

Screening for thoracolumbar spinal injuries in blunt trauma

Low back pain investigations and prognosis: a review

Contact Info

Product

Resources

About