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Maxillofacial Trauma
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
The initial management of a facial injury follows the principles described earlier in this manual. Particular care should be taken to stabilize the cervical spine. The primary survey is intended to detect and remedy immediately life-threatening injuries and the exact diagnosis of the type of facial injury is unnecessary at this stage. Those aspects of the primary and secondary survey particularly relevant to maxillofacial injuries are detailed in the following.
Converting a total disc replacement to an ACDF
Published in Gregory D. Schroeder, Ali A. Baaj, Alexander R. Vaccaro, Revision Spine Surgery, 2019
Joseph D. Smucker, Rick C. Sasso
Anterior cervical spine surgery is a common method for treatment of degenerative cervical spine pathology and plays a substantial role in a spine surgeon's choice of approach. Anterior decompressions in the cervical spine have traditionally been complemented by a reconstruction following the removal of pathological material such as cervical disc, osteophytes, and degenerative ligament pathology. Anterior cervical fusion plays a role in many of these reconstructions, but there are known concerns related to the index procedure and the adjacent levels following healing of the index procedure. Anterior cervical discectomy and disc replacement is a more recent method for the treatment of degenerative conditions focused at the disc level, and seven such devices have been approved by the U.S. Food and Drug Administration (FDA) for use. In addition to the utilization in the FDA trials, which began about a decade ago, clinical use has slowly increased.
A to Z Entries
Published in Clare E. Milner, Functional Anatomy for Sport and Exercise, 2019
The bones of the head and neck comprise the bones of the skull and the seven vertebrae of the cervical spine. The bones of the skull, which are fused in the adult, are the cranium – the large dome that houses and protects the brain – and the bones of the face (Figure 11). The skull is made up of 8 cranial and 14 facial bones. All of these, except the mandible (jawbone), are attached rigidly to each other by interlaced articulations called sutures. The bones of the skull are not fully fused at the sutures until old age and do not begin to close until about age 22 years, with the process being mostly complete by age 30. This should be taken into consideration when younger athletes suffer a traumatic injury to the head, since the skull serves to protect the delicate tissues of the brain. Damage to the bones of the skull tends to be due to acute trauma from contact with another athlete, equipment, or the ground.
Neuroimaging in professional combat sports: consensus statement from the association of ringside physicians
Published in The Physician and Sportsmedicine, 2023
An urgent CT scan of the head without contrast is recommended if the combat sports athlete demonstrates any of the ‘red flag’ during the bout or in the immediate aftermath of the bout (Table 2).A combat sports athlete who demonstrates any of the ‘red flag’ signs and symptoms should be transported immediately via on-site ambulance to a designated trauma center for evaluation. Transport to a Level I trauma center with 24 h in-house coverage by neurosurgery and neurology is recommended.Clinical decision regarding the need for cervical spine imaging should be made on a case-by-case basis determined by the mechanism of injury, presence or absence of numbness and tingling in the extremities, neck pain, midline tenderness, and neurological deficit.
Short-term effects of spinal thrust joint manipulation on postural sway in patients with chronic mechanical neck pain: a randomized controlled trial
Published in Disability and Rehabilitation, 2022
Raúl Romero del Rey, Manuel Saavedra Hernández, Cleofás Rodríguez Blanco, Luis Palomeque del Cerro, Raquel Alarcón Rodríguez
In this respect, the cervical spine is of great importance [12]. Firstly, this is because the cervical musculature is a major source of proprioceptive information, especially the suboccipital muscles, which contain a large number of mechanoreceptors [13]. In addition, these muscles also have relationships with the central nervous system, vestibular system and visual system [10], which explains why a proprioceptive information disorder in the cervical spine may affect sensory integration [13]. On the other hand, pain may be the cause of an increase in presynaptic inhibition of muscular input and may affect the central sensory modulation of proprioceptive information that comes from neuromuscular spindles [14]. As a result, this may cause a decrease in motor control, and subsequently, a decrease in postural stability.
Reliability and discriminative validity of a screening tool for the assessment of neuromuscular control and movement control in patients with neck pain and healthy individuals
Published in Disability and Rehabilitation, 2022
Robby De Pauw, Eveline Van Looveren, Dorine Lenoir, Lieven Danneels, Barbara Cagnie
The procedure to assess neuromuscular control and movement pattern for the adapted CCFT consists of three subparts. During the craniocervical test protocol, the participant is positioned supine with both arms in a resting position on the abdomen and knees in flexion with both feet flat on the table. The cervical spine is positioned in a neutral position (as depicted in Figure 2(B)). Patients then are asked to perform an active craniocervical flexion movement by head-nodding. The aim of the first subpart is to reach five progressive stages (20–30 mmHg), measured by a suboccipital pressure biofeedback unit, without substitution of superficial muscles (SCM and Scaleni) or (increased) sensation of pain as described by Jull and colleagues [22]. In-between progressive phases, a rest interval of 15 s, are implemented to minimize the effect of fatigue. The second part of the tool evaluates the breathing pattern, fluency of movement and substitution of the superficial muscles during five repetitions of craniocervical flexion from 20 mmHg to a normative score of 26 mmHg [34–37]. The third and final part concerning endurance is only assessed if the first and second part is completed without any noticeable substitution. Patients were asked to maintain a gradually build craniocervical flexion at a normative score of 26 mmHg for ten seconds, aiming at a maximum of ten repetitions.