Rehabilitation Strategies in Management of Complex Case of Cervical Burst Fracture- A Case Report

A burst fracture is a descriptive term for an injury to the spine in which the vertebral body is severely compressed. They typically occur from severe trauma, such as a motor vehicle accident or a fall from a height. With a great deal of force vertically onto the spine, a vertebra may be crushed .If it is only crushed in the front part of the spine, it becomes wedge shaped and is called a compression fracture. However, if the vertebral body is crushed in all directions it is called a burst fracture. Burst fractures cause severe pain. The diagnosis of a burst fracture is usually made by x-rays and a CT scan. Occasionally, an MRI scan may be ordered as well, in order to assess the amount of soft tissue trauma, bleeding or ligament disruption. The review of the CT scan and x-rays allows the treating physician to make a determination as to the level of the fracture, whether it is a compression fracture, burst fracture or fracture dislocation. A spinal compression fracture also may be caused by trauma to the spine. Events that may cause trauma to the spine can include: A car accident, a hard fall or a fall from a height of more than 15 feet, landing on the feet, and a blow to the head. Any fall from a standing height that results in a spinal compression fracture or any other fracture most likely indicates weak bones due to osteoporosis. The physical exam should be performed to document both spinal deformity, that is, angulation of the spine or tenderness of the spine at the level of fracture, as well as, a neurologic exam. Neurologic exam should include testing of the muscle strength, sensation, and reflexes of the lower extremities, as well as, testing of bowel and bladder sphincter control. A 36 year old man was brought to the hospital as he had a fall from electric pole approximately 20 feet height. He had sustaining injury to the neck. Surgery was done as patient was diagnosed with C6 burst fracture with fracture dislocation of C5-C7. Therapeutic Interventions includes exercises, strengthening exercises, cervical fracture fixation, and traction.

Analysis on the Effect of Different Surgical Methods on the Treatment of Senile Osteoporotic Spinal Compression Fractures and the Influencing Factors of Complications

Osteoporotic fractures are a common type of fractures in the elderly, among which spinal compression fractures are more common. After the occurrence of fractures, due to the compression and burst of the vertebral body, this will lead to local kyphosis deformity and even affect the balance of the sagittal spine. In the past, conservative treatments were used for osteoporotic spinal compression fractures. Although it can relieve pain symptoms, it can easily lead to complications such as aggravation of osteoporosis and deep vein thrombosis of the lower extremities. At present, percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are the main clinical surgical treatments, both of which are minimally invasive surgery, short operation time, effective pain relief, and rapid postoperative recovery. Although both of them are effective, there is still controversy over the efficacy of both in the treatment of osteoporotic spinal compression fractures. The purpose of this study was to investigate the efficacy of PVP and PKP in the treatment of elderly osteoporotic spinal compression fractures and to analyze the related factors that affect the occurrence of postoperative complications. The results show that both PVP and PKP can effectively improve the pain and dysfunction of elderly patients with osteoporotic spinal compression fracture, restoration of vertebral height, and correct kyphosis, but PKP has better effect and higher safety and is worth promoting. Postoperative complications of patients are related to their age, bone mineral density, use of hormones, and antiosteoporosis treatment.

Doxazosin Effect on Neurogenic Bladder with Urine Retention in Female Dogs

This short communication describes the effect of Doxazosin in case of urinary retention in female dogs due to motor neuron lesions produced by spinal trauma or spinal compression consecutively to intervertebral disk degeneration and extrusion. The study aims to determine whether the treatment of urinary retention in case of neurogenic bladder in female dogs, using 1 adrenergic blocker is effective in spontaneous recovery of the examined patients. Ten female dogs presenting with urinary retention were examined in the laboratory of Radiology, Faculty of Veterinary Medicine Cluj Napoca. The patients were examined using CT, radiography and ultrasonography in order to identify the spinal cord injury that is responsible for neurogenic bladder. The dose of Doxazosin used in treatment of voiding problem in neurogenic bladder was 1mg/kg, single dose per day. Depending on the spinal cord compression cause, the urine retention symptom was resolved.

Aggressive vertebral hemangiomas in asymptomatic patients: A review

Background: Hemangioma is the most common benign tumor of the spine. Most patients are asymptomatic, but some lesions can become aggressive, leading to spinal compression. Here, we reviewed the natural history and treatment of aggressive hemangiomas in asymptomatic patients. Methods: An electronic review of the literature was performed regarding the diagnosis/treatment modalities for asymptomatic aggressive hemangiomas of the spine utilizing the Medline (PubMed) and Google Scholar databases. Results: We selected four articles describing the diagnosis/management of four cases of aggressive, asymptomatic hemangiomas in patients averaging 11.25 ± 2.36 years of age. Three of the four patients were females, and all were followed an average of 36.5 ± 25 months. Notably, two of four patients required emergency surgery. Conclusion: There is a paucity of the literature regarding the diagnosis and optimal therapeutic management of aggressive hemangiomas in asymptomatic patients, half of whom may present with acute neurological deterioration warranting emergency surgery.

Acupuncture Combined with Chinese Medicine Iontophoresis Treatment for Chronic Progressive Cervical Intervertebral Disk Disease in a Dog

<b><i>Case Report:</i></b> A 12-year-old castrated male dog with nonambulatory tetraplegia was diagnosed with spinal stenosis at C3–C4 through X-ray examination and with ventral extradural spinal compression at C3–C4 through myelography and computed tomography. The diagnosis of traditional Chinese veterinary medicine was local <i>Qi</i> and blood stagnation, spleen <i>Qi</i>deficiency, blood deficiency, and kidney <i>Yang</i> deficiency. We initiated treatment using a combination of acupuncture and Chinese medicine iontophoresis with laser therapy. After 12 treatment days, there was a significant improvement in the dog’s ambulation function, which was indicated by proper walking and flexible head-turning. <b><i>Conclusion:</i></b> This indicates that combining acupuncture and Chinese medicine iontophoresis could be a potential treatment for chronic progressive cervical intervertebral disk disease in dogs.