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Treatment of unilateral cervical facet fractures without evidence of dislocation or subluxation: a narrative review and proposed treatment algorithm
(2024)
Juan Ignacio Cirillo
;
Guillermo A Ricciardi
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Facundo Lisandro Alvarez Lemos
;
Alfredo Guiroy
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YURAC BARRIENTOS, RATKO JOVAN
<jats:p> <jats:list list-type="bullet"> <jats:list-item> <jats:p>Isolated cervical spine facet fractures are often overlooked.</jats:p> </jats:list-item> <jats:list-item> <jats:p>The primary imaging modality for diagnosing these injuries is a computed tomography scan.</jats:p> </jats:list-item> <jats:list-item> <jats:p>Treatment of unilateral cervical facet fractures without evidence of dislocation or subluxation remains controversial. The available evidence regarding treatment options for these fractures is of low quality.</jats:p> </jats:list-item> <jats:list-item> <jats:p>Risk factors associated with the failure of nonoperative treatment are: comminution of the articular mass or facet joint, acute radiculopathy, high body mass index, listhesis exceeding 2 mm, fragmental diastasis, acute disc injury, and bilateral fractures or fractures that adversely affect 40% of the intact lateral mass height or have an absolute height of 1 cm.</jats:p> </jats:list-item> </jats:list></jats:p>
Scopus© Citations 3 1
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The Effect of Volitional Preemptive Abdominal Contraction on Biomechanical Measures During A Front Versus Back Loaded Barbell Squat
(2023)
Joseph B. McCormick
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Alexander S. Drusch
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Darragh J. Lynch
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Gesine H. Seeber
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Katherine F. Wilford
<jats:sec id="background"> <jats:title>Background</jats:title> <jats:p>Weightlifting is growing in popularity among recreational and competitive athletes. The barbell back squat (BackS) is commonly included in these training programs, while the barbell front squat (FrontS) is commonly performed as a component of other lifts such as the power clean or clean and jerk, it is less commonly practiced in isolation.</jats:p> </jats:sec> <jats:sec id="hypothesispurpose"> <jats:title>Hypothesis/Purpose</jats:title> <jats:p>The purpose of this study was to examine the effects of VPAC performance on trunk muscle and LE biomechanical responses during loaded BackS versus FrontS in healthy subjects.</jats:p> </jats:sec> <jats:sec id="study-design"> <jats:title>Study Design</jats:title> <jats:p>Controlled Laboratory Study</jats:p> </jats:sec> <jats:sec id="methods"> <jats:title>Methods</jats:title> <jats:p>Healthy male subjects with the ability to perform a sub-maximal loaded barbell squat lift were recruited. Subjects completed informed consent, demographic/medical history questionnaires and an instructional video. Subjects practiced VPAC and received feedback. Surface electromyography (sEMG) electrodes and kinematic markers were applied. Muscles included were the internal oblique (IO), external oblique (EO), rectus abdominis, iliocostalis lumborum (ICL), superficial multifidi, rectus femoris, vastus lateralis, biceps femoris, and gluteus maximus. Maximal voluntary isometric contractions established reference sEMG values. A squat one-rep-max (1RM) was predicted by researchers using a three to five repetition maximum (3RM, 5RM) load protocol. Subjects performed BackS trials at 75% 1RM while FrontS trials were performed at 75% BackS weight, both with and without VPAC. Subjects performed three repetitions of each condition with feet positioned on two adjacent force plates. Significant interactions and main effects were tested using a 2(VPAC strategy) x 2(squat variation) and 2(VPAC strategy) x 2(direction) within-subject repeated measures ANOVAs. Tukey’s Post-Hoc tests identified the location of significant differences.</jats:p> </jats:sec> <jats:sec id="results"> <jats:title>Results</jats:title> <jats:p>Trunk muscle activity was significantly higher during FrontS versus BackS regardless of VPAC condition. (IO: p=0.018, EO: p<0.001, ICL: p<0.001) VPAC increased performance time for both squat variations (p=.0011), which may be associated with decreased detrimental force potential on the lumbar spine and knees. VPAC led to improved ability to maintain a neutral lumbar spine during both squat variations. This finding is associated with decreased detrimental force potential on the lumbar spine.</jats:p> </jats:sec> <jats:sec id="conclusions"> <jats:title>Conclusions</jats:title> <jats:p>Findings could help guide practitioners and coaches to choose squat variations and incorporate VPAC strategies during their treatments and/or training programs.</jats:p> </jats:sec> <jats:sec id="level-of-evidence"> <jats:title>Level of Evidence</jats:title> <jats:p>Level 3</jats:p> </jats:sec>
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CT Scan in Subaxial Cervical Facet Injury: Is It Enough for Decision-Making?
(2021)
Juan P. Cabrera
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YURAC BARRIENTOS, RATKO JOVAN
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Andrei F. Joaquim
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Alfredo Guiroy
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Charles A. Carazzo
<jats:sec><jats:title>Study Design:</jats:title><jats:p> Cross-sectional survey. </jats:p></jats:sec><jats:sec><jats:title>Objectives:</jats:title><jats:p> Assessment of subaxial cervical facet injuries using the AO Spine Subaxial Cervical Spine Injury Classification System is based on CT scan findings. However, additional radiological evaluations are not directly considered. The aim of this study is to determine situations in which spine surgeons request additional radiological exams after a facet fracture. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> A survey was sent to AO Spine members from Latin America. The evaluation considered demographic variables, routine use of the Classification, as well as the timepoint at which surgeons requested a cervical MRI, a vascular study, and/ or dynamic radiographs before treatment of facet fractures. </jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p> There was 229 participants, mean age 42.9 ± 10.2 years; 93.4% were men. Orthopedic surgeons 57.6% with 10.7 ± 8.7 years of experience in spine surgery. A total of 86% used the Classification in daily practice. An additional study (MRI/vascular study/and dynamic radiographs) was requested in 53.3%/9.6%/43.7% in F1 facet injuries; 76.0%/20.1%/50.2% in F2; 89.1%/65.1%/28.4% in F3; and 94.8%/66.4%/16.6% in F4. An additional study was frequently required: F1 72.5%, F2 86.9%, F3 94.7%, and F4 96.1%. </jats:p></jats:sec><jats:sec><jats:title>Conclusions:</jats:title><jats:p> Spine surgeons generally requested additional radiological evaluations in facet injuries, and MRI was the most common. Dynamic radiographs had a higher prevalence for F1/F2 fractures; vascular studies were more common for F3/F4 especially among surgeons with fewer years of experience. Private hospitals had a lower spine trauma cases/year and requested more MRI and more dynamic radiographs in F1/F2. Neurosurgeons had more vascular studies and dynamic radiographs than orthopedic surgeons in all facet fractures. </jats:p></jats:sec>
6Scopus© Citations 4
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An independent inter- and intra-observer agreement assessment of the AOSpine upper cervical injury classification system
(2022)
Julio Urrutia
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Byron Delgado
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Gaston Camino-Willhuber
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Alfredo Guiroy
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Nelson Astur
4 1Scopus© Citations 3
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Traumatic cervical spine injury due to pole dance accident: A potentially catastrophic unreported injury with a happy ending. Case report and literature review
(2022)
YURAC BARRIENTOS, RATKO JOVAN
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ZAMORANO PÉREZ, JUAN JOSÉ
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Andrea Marre
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Cristian Diaz
<jats:sec id="st1"> <jats:title>Background: </jats:title> <jats:p>Pole dancing is a sport that has become very popular. However, there is scarce literature on injuries associated with this sport. Here, we present a 23-year-old female who sustained a traumatic C4-C5 vertex cervical spine injury caused by a fall of 1 m while practicing pole dancing in an inverted position, requiring a 360 decompression/fusion.</jats:p> </jats:sec> <jats:sec id="st2"> <jats:title>Case Description: </jats:title> <jats:p>A 23-year-old female sustained a 1 m fall in an inverted position while pole dancing resulting in a direct axial impact to the head. She developed the rapid onset of quadriparesis that was attributed to the emergent CT/MR-documented cervical flexodisruptive luxofracture (AOSpine C4-C5 fracture: C, F4 unilateral, N3, M2). Four hours post injury, she underwent a C4-C5 anterior cervical discectomy and fusion. Four days later, a posterior fusion was performed to add to the stabilization. Six years later, the patient remains neurologically intact.</jats:p> </jats:sec> <jats:sec id="st3"> <jats:title>Conclusion: </jats:title> <jats:p>Pole dance is an emerging sport which carries a risk of cervical spine injury.</jats:p> </jats:sec>
1Scopus© Citations 1
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Reliability Evaluation of the New AO Spine-DGOU Classification for Osteoporotic Thoracolumbar Fractures
(2022)
Guisela Quinteros
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Juan P. Cabrera
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Julio Urrutia
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Charles A. Carazzo
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Alfredo Guiroy
Scopus© Citations 13 1
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Alteraciones de la columna vertebral en el tétanos del niño mayor. Publicado en Revista Chilena de Pediatría 1955
(2021)
Anibal Espinoza
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SCHONHAUT, LUISA
12 1Scopus© Citations 1

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