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Br J Neurosurg 2021 May 31:1-8. Epub 2021 May 31.

Department of Spine Services, Indian Spinal Injuries Centre, New Delhi, India.

Study Design: Prospective cohort study.

Introduction: Management of the severe thoracolumbar (TL) spine fracture-dislocation injuries have been further complicated by the COVID-19 pandemic. The need to optimize resources and minimize the personnel in the operating room (OR) led us to develop a novel technique to reduce TL fracture-dislocations (AO type-C) using an orthopedic distractor device (ODD). Read More

Acta Ortop Mex 2020 Nov-Dec;34(6):412-416

Clínica de Columna de la Secretaría de Salud de la Ciudad de México. Hospital General «La Villa». México.

Traumatic spondyloptosis is a serious injury usually caused by high-energy trauma; It consists of the anterior or posterior dislocation of 100% or more of the underlying vertebral body, which can become a total injury of the spinal cord, producing a neurological deficit; this type of injury represents stage 4 and 5 of Allen-Ferguson. A 50-year-old man who suffers a car accident, he receive frontal impact when he was a driver, colliding with the retaining wall, referred from another hospital to emergency room, managed with C7 hemicorpectomy, c7-t1 discectomy, spondylodesis with anterior plate (C6-T1), and posterior approach + Fascetectomies of C7-T1, facet joint screws C6 and transpedicular fixation of T1. Subaxial cervical spondyloptosis is relatively rare clinical entity, a complete clinical examination is important in diagnosis, taking in considerations the injury mechanism. Read More

Cureus 2021 Apr 11;13(4):e14418. Epub 2021 Apr 11.

Trauma and Orthopaedics, Milton Keynes University Hospital, Milton Keynes, GBR.

The unique anatomy and flexibility of the cervical spine predispose it to a risk of injury. Trauma to the cervical spine encompasses a wide range of injuries from minor muscular strains to life-threatening fracture-dislocations associated with spinal cord lesions. Initial assessment and management should follow the Advanced Trauma Life Support (ATLS) protocols with adequate protection of the cervical spine through triple immobilisation to prevent any unnecessary movement, which can make the patient susceptible to further neurological injuries. Read More

J Orthop Sci 2021 Apr 28. Epub 2021 Apr 28.

The Department of Orthopaedic Surgery, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.

Background: Several studies have shown an association between achieving decompression of the spinal cord within a few hours and neurological recovery, even in patients with complete paralysis due to cervical spine dislocation. This study aimed to clarify the impact of helicopter emergency medical services (HEMSs) and craniocervical traction on the rapid reduction of lower cervical spine dislocation in rural Japan.

Methods: The success rate of and factors inhibiting closed reduction, the time from injury to reduction and the functional prognosis of lower cervical spine dislocations treated between July 2012 and February 2020 were retrospectively analysed. Read More

Int J Spine Surg 2021 Feb 18;15(1):55-61. Epub 2021 Feb 18.

Department of Orthopaedics, AIIMS Rishikesh, Uttarakhand, India.

Background: Long-segment posterior fixation has been used as a mainstay treatment of spine fracture-dislocations. Studies using short-segment posterior fixation in cases of thoracolumbar fracture-dislocation are limited. We describe our experience of 26 patients with thoracolumbar fracture-dislocation treated by short-segment or long-segment posterior spinal fixation and fusion. Read More

Zhongguo Gu Shang 2021 Apr;34(4):321-7

Department of Spine Surgery, Zhejiang Ningbo No.6 Hospital, Ningbo 315040, Zhejiang, China.

Objective: To explore the treatment strategy and clinical efficacy for os odontoideum complicated with atlantoaxial dislocation.

Methods: The clinical data of 17 patients with os odontoideum complicated with atlantoaxial dislocation surgically treated from January 2006 to January 2015 were retrospectively analyzed, including 7 males and 10 females, aged 17 to 53 (43.1±11. Read More

Medicine (Baltimore) 2021 Apr;100(16):e25588

Department of Orthopaedic Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Rationale: A case of traumatic atlanto-axial rotatory subluxation (AARS), dens fracture, rupture of transverse atlantal ligament (TAL), and subaxial spinal cord injury without radiographic abnormality (SCIWORA) of Brown-Sequard syndrome has never been reported in a child.

Patient Concerns: A 7-year-old boy presented to hospital with torticollis, neck pain, and limited neck rotation after a seat-belt injury sustained during a car accident. Neurologic examination revealed right-side motor weakness and left-side sensory abnormality, known as Brown-Sequard syndrome. Read More

Cureus 2021 Mar 12;13(3):e13849. Epub 2021 Mar 12.

Anesthesiology and Perioperative Medicine, Loma Linda University Medical Center, Loma Linda, USA.

Osteogenesis imperfecta (OI) is a rare disorder of bone fragility caused by mutations in the COL1A1/2 genes, which encode type I procollagen. It commonly manifests with bone fractures, joint dislocations, and easy bruising. OI patients presenting for surgery may pose multiple challenges to the anesthesiologist such as management of a potentially difficult airway and heightened positional fracture risks. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021 Apr;35(4):453-457

Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China.

Objective: To investigate the relationship between O-EA angle and lower cervical curvature in patients with anterior atlantoaxial dislocation undergoing occipitocervical fusion, and to analyze the effect of O-EA angle on lower cervical curvature.

Methods: The clinical data of 61 patients with anterior atlantoaxial dislocation undergoing occipitocervical fusion who were admitted between April 2010 and July 2018 and met the selection criteria were retrospectively analyzed. There were 32 males and 29 females, with an age of 14-76 years (mean, 50. Read More

BMC Pregnancy Childbirth 2021 Apr 1;21(1):272. Epub 2021 Apr 1.

Department of Anesthesiology, The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.

Background: The preferable choice of anesthesia for the patients with congenital atlantoaxial dislocation (CAAD) and type I Arnold Chiari malformations (ACM-I) has been a very confusing issue in clinical practice. We describe the successful administration of combined spinal-epidural anesthesia for a woman with CAAD and ACM-1 accompanied by syringomyelia.

Case Presentation: Our case report presents the successful management of a challenging obstetric patient with CAAD and ACM-1 accompanied by syringomyelia. Read More

Br J Neurosurg 2021 Apr 1:1-5. Epub 2021 Apr 1.

Department of Neurosurgery, S. Maurizio Hospital, Bolzano, Italy.

Double traumatic non-contiguous lesions of the subaxial cervical region are a rare event mostly caused by multiple, simultaneous or rapidly consecutive high-energy-impact traumas. The modality of treatment chosen for these lesions must be related to local lower cervical spine biomechanics. We present the case of a 59 year-old patient who suffered a subaxial cervical spine double fracture-dislocation following a complex-dynamic trauma. Read More

Medicine (Baltimore) 2021 Apr;100(13):e25334

Department of Pediatric Surgery, University Children's Hospital Basel, University of Basel, Switzerland.

Abstract: Cervical spine (C-spine) fractures in young children are very rare, and little information on treatment modalities and functional, radiographic, and patient-reported outcome exists. In this 2-center, retrospective case series, we assessed subjective and functional mid-term outcomes in children aged ≤5 years whose C-spine fractures were treated nonoperatively.Between 2000 and 2018, 6 children (median age at injury: 23. Read More

Br J Neurosurg 2021 Mar 26:1-3. Epub 2021 Mar 26.

Department of Neurosurgery, Arnavutkoy State Hospital, Istanbul, Turkey.

Background: There are many lateral bending fracture cases presented in the literature that mostly involve facet dislocations or corpus collapse. In this report, we aim to describe a novel asymmetric lateral bending, flexion and distraction fracture, propose a mechanism, and delineate its clinical importance.

Case Description: A 13-year-old girl arrived at our trauma center 12 hours after a head-on truck collision. Read More

Medicine (Baltimore) 2021 Mar;100(12):e25202

Department of Orthopedics, The Second Affiliated Hospital of Bengbu Medical College, Bengbu.

Abstract: To introduce a novel technique of using individualized 3D printing occipitocervical fusion instrument (3D-OCF) for the treatment of upper cervical deformity with atlantoaxial joint dislocation.The surgery for deformity of the craniocervical junction area is a challenge in the field of spine. If the surgical deviation is too large to injure the spinal cord or vertebral artery, it will cause catastrophic damage to the patient. Read More

J Arthroplasty 2021 Jul 16;36(7):2523-2529. Epub 2021 Feb 16.

Melbourne Orthopaedic Group, Windsor, Victoria, Australia.

Background: Despite the placement of acetabular components in the traditional "safe-zone", dislocations and all parts of the instability spectrum, including impingement, continue to be an issue. Recent research has established the importance of a degenerative spine and adverse pelvic mobility on functional acetabular orientation. The purpose of this study is to quantify the clinical consequences of a degenerative spine and adverse pelvic mobility on prosthetic impingement in patients undergoing total hip arthroplasty. Read More

Zhonghua Wai Ke Za Zhi 2021 Mar;59(3):216-221

Department of Neurosurgery,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016, China.

To establish a geometric model of the atlantoaxial dislocation and basilar invagination reduction,and examine its value for clinical application. A retrospective analysis of 35 patients with atlantoaxial dislocation and basilar invagination admitted to the Department of Neurosurgery,First Affiliated Hospital of Chongqing Medical University from May 2018 to May 2020 was conducted.There were 5 males and 30 females,aged (48±15) years(range: 19 to 69 years). Read More

Surg Neurol Int 2021 10;12:47. Epub 2021 Feb 10.

Spinal Unit (UVM), Department of Orthopaedics, Centro Hospitalar Universitário do Porto, Porto.

Background: Sports related cervical spine trauma may range from minor injuries to severe life-threatening fractures with spinal cord injuries as following paragliding accidents.

Case Description: A 52-year-old male sustained C4-C5 and C6-C7 fracture-dislocations (American Spinal Injury Association-D) attributed to a paragliding accident. He underwent a C5 corpectomy with C4-C6 anterior fusion. Read More

World J Clin Cases 2021 Feb;9(6):1461-1468

Department of Orthopedics, Yidu Central Hospital, Weifang Medical University, Qingzhou 262500, Shandong Province, China.

Background: In general, atlantoaxial dislocation is rare due to the stability of the C1-C2 complex. Traumatic atlantoaxial dislocations are usually anterior and accompanied by odontoid fractures. Posterior atlantoaxial dislocations are rare, and complete posterior dislocation without associated fracture is even more rare. Read More

J Orthop Case Rep 2020 Jul;10(4):38-41

Indian Spinal Injury Centre, New Delhi, India.

Introduction: Hip joint fracture-dislocations are rare injuries and usually result from high energy trauma. Femoral head fractures account for only 7-16% of all hip fracture-dislocations. There is always a controversy regarding optimal surgical treatment modality and approach for the treatment of Pipkin type IV fractures. Read More

Postgrad Med 2021 May 4;133(4):409-420. Epub 2021 Apr 4.

Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.

Acute great toe (Hallux) pain is a common complaint encountered by the primary care physician. Pathological conditions can vary from acute trauma to acute exacerbation of underlying chronic conditions. Delay in treatment or misdiagnosis can lead to debilitating loss of function and long-lasting pain. Read More

Spine J 2021 Feb 19. Epub 2021 Feb 19.

Department of Orthopaedics and Sport Medicine, Harborview Medical Center, 325 Ninth Avenue, Seattle, WA 98104, USA. Electronic address:

Background Context: The Allen and Ferguson classification of cervical spine injuries is widely used. They described compressive Extension (CE) injuries as having five progressive stages. Stage 4(CE4) and 5(CE5) have been described as having a posterior vertebral arch fracture involving two motion segments accompanied by displacement (dislocation) of the vertebral body at a single level. Read More

Br J Neurosurg 2021 Feb 15:1-7. Epub 2021 Feb 15.

Department of Orthopaedics, Grant Medical College & Sir J.J. Group of Hospitals, Byculla, Mumbai, India.

Objective: To describe a single-staged procedure for the management of neglected subaxial cervical spine injuries.

Methods: Between January 2012 and December 2014, 12 patients presented to us with healed cervical sub axial dislocations. The deformities could not be reduced using skull traction. Read More

Medicine (Baltimore) 2021 Jan;100(3):e24396

Department of Orthopaedic Surgery, College of Medicine, the Catholic University of Korea, Seoul, Korea.

Rationale: Traumatic atlantoaxial anteroinferior subluxation associated with a dens fracture and a Hangman fracture is a very rare and complex injury. Therefore, appropriate surgical strategy is not established.

Patient Concerns: An 85-year-old female presented with posterior neck pain and atypical neck position caused after rolling down a hill. Read More

BMC Musculoskelet Disord 2021 Jan 29;22(1):121. Epub 2021 Jan 29.

Department of Orthopaedics, Peking University Third Hospital, Beijing, People's Republic of China.

Background: Treatment of atlantoaxial dislocation is aimed at reduction and stabilization of the atlantoaxial joint. 3D printing refers to a process where additive manufacturing is achieved under precise computer control. Literature on its utilization in anterior atlantoaxial fixation and fusion is rare. Read More

Radiographics 2021 Mar-Apr;41(2):543-558. Epub 2021 Jan 22.

From the Division of Musculoskeletal Radiology, Laboratório Delboni Auriemo, Diagnósticos da América SA (DASA), R. Dr. Diogo de Faria 1379, Vila Clementino, São Paulo, SP 04037-005, Brazil (J.E.C.A., S.R.N.C., A.K.T., F.N.C., A.Y.S., A.Y.A.); Division of Musculoskeletal Radiology, Alta Diagnósticos, São Paulo, Brazil (J.E.C.A., S.R.N.C., A.K.T., A.Y.S.); Musculoskeletal Imaging Division, Hospital Israelita Albert Einstein, São Paulo, Brazil (A.K.T.); Department of Diagnostic Imaging, Federal University of São Paulo, São Paulo, Brazil (F.N.C., A.Y.A.); Division of Musculoskeletal Radiology, Hospital do Coração (HCor), São Paulo, Brazil (A.K.T., A.Y.S.); and Teleimagem, São Paulo, Brazil (A.K.T., A.Y.S.).

Spinal pain due to facet joint disease is difficult to diagnose since the clinical history and physical examination findings are usually nonspecific. Facet joint disorders have a wide range of causes and, because of the potential for chronic back pain and disability, an accurate diagnosis is essential. The most frequent cause of pain in facet joints is osteoarthritis, which can be assessed at radiography, CT, or MRI. Read More

Medicine (Baltimore) 2021 Jan;100(2):e24096

Department of Orthopaedic Surgery, Seoul Spine Institute, Sanggyepaik Hospital, College of Medicine, Inje University, Seoul, Korea.

Rationale: We report the first case of the management of spinal cord transection due to thoracolumbar fracture-dislocation in human beings. There are several case reports of cord transection, but only radiological findings have been reported; we report intraoperative findings and management.

Patient Concerns: A 53-year-old man presented to the hospital after falling. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021 Jan;35(1):33-38

Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China;Orthopedic Research Institute of West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China.

Objective: To compare the predictive abilities of O-C2 angle (O-C2a), O-EA angle (O-EAa), and Oc-Ax angle (Oc-Axa) for development of dysphagia in patients after occipitocervical fusion (OCF).

Methods: Between April 2010 and May 2019, 114 patients who underwent OCF and met the selection criteria were selected as the research objects. Among them, 54 were males and 60 were females; they were 14-76 years old, with an average of 50. Read More

Postgrad Med 2021 Apr 18;133(3):320-329. Epub 2021 Jan 18.

Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.

Patients with foot pain commonly present to their primary care physicians for their initial management and treatment. These patients and their respective foot or lesser toe pain can present the physician with a complex problem with a long differential list. Depending on the timing of the pain and underlying pathology, these differentials can be divided into acute and acute exacerbation of chronic conditions. Read More

Pol Merkur Lekarski 2020 Dec;48(288):410-414

Department of Orthopedics, Mazovian Rehabilitation Center STOCER, Konstancin-Jeziorna, Poland.

Spinal injuries can be divided into contusions, sprains of intervertebral joints, their dislocation and also damage to ligaments and muscles attachment, and fractures. Typical injuries of the cervical spine include trauma caused by a rapid hyperextension of the neck with the following hyperflexion, often referred to as "whiplash" injury, mostly as a result of traffic accidents. The annual incidence is estimated to be up to 600 per 100 000 inhabitants of Western Europe and North America. Read More