Document Detail


Concomitant traumatic spinal cord and brachial plexus injuries in adult patients.
MedLine Citation:
PMID:  22258773     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Combined injuries to the spinal cord and brachial plexus present challenges in the detection of both injuries as well as to subsequent treatment. The purpose of this study is to describe the epidemiology and clinical factors of concomitant spinal cord injuries in patients with a known brachial plexus injury.
METHODS: A retrospective review was performed on all patients who were evaluated for a brachial plexus injury in a tertiary, multidisciplinary brachial plexus clinic from January 2000 to December 2008. Patients with clinical and/or imaging findings for a coexistent spinal cord injury were identified and underwent further analysis.
RESULTS: A total of 255 adult patients were evaluated for a traumatic traction injury to the brachial plexus. We identified thirty-one patients with a combined brachial plexus and spinal cord injury, for a prevalence of 12.2%. A preganglionic brachial plexus injury had been sustained in all cases. The combined injury group had a statistically greater likelihood of having a supraclavicular vascular injury (odds ratio [OR] = 22.5; 95% confidence interval [CI] = 1.9, 271.9) and a cervical spine fracture (OR = 3.44; 95% CI = 1.6, 7.5). These patients were also more likely to exhibit a Horner sign (OR = 3.2; 95% CI = 1.5, 7.2) and phrenic nerve dysfunction (OR = 2.5; 95% CI = 1.0, 5.8) compared with the group with only a brachial plexus injury.
CONCLUSION: Heightened awareness for a combined spinal cord and brachial plexus injury and the presence of various associated clinical and imaging findings may aid in the early recognition of these relatively uncommon injuries.
Authors:
Peter C Rhee; Elena Pirola; Marie-Noëlle Hébert-Blouin; Michelle F Kircher; Robert J Spinner; Allen T Bishop; Alexander Y Shin
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of bone and joint surgery. American volume     Volume:  93     ISSN:  1535-1386     ISO Abbreviation:  J Bone Joint Surg Am     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2012-01-19     Completed Date:  2012-03-12     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  0014030     Medline TA:  J Bone Joint Surg Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2271-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Distribution
Brachial Plexus / injuries*
Brachial Plexus Neuropathies / diagnosis,  epidemiology*
Cervical Vertebrae / injuries
Chi-Square Distribution
Cohort Studies
Comorbidity
Confidence Intervals
Female
Follow-Up Studies
Humans
Injury Severity Score
Lumbar Vertebrae / injuries
Male
Middle Aged
Multiple Trauma / diagnosis,  epidemiology
Odds Ratio
Prevalence
Retrospective Studies
Sex Distribution
Spinal Cord Injuries / diagnosis,  epidemiology*
Thoracic Vertebrae / injuries
United States / epidemiology
Young Adult
Comments/Corrections
Comment In:
J Bone Joint Surg Am. 2011 Dec 21;93(24):e153   [PMID:  22258788 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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