Intraoperative Positioning in Maxillofacial Trauma Patients With Cervical Spine Injury - Is It Safe? Radiological Simulation in a Healthy Volunteer.

IF 0.8 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Craniomaxillofacial Trauma & Reconstruction Pub Date : 2022-12-01 Epub Date: 2022-01-03 DOI:10.1177/19433875211053091
Thomas Pepper, Harry Spiers, Alex Weller, Clare Schilling
{"title":"Intraoperative Positioning in Maxillofacial Trauma Patients With Cervical Spine Injury - Is It Safe? Radiological Simulation in a Healthy Volunteer.","authors":"Thomas Pepper, Harry Spiers, Alex Weller, Clare Schilling","doi":"10.1177/19433875211053091","DOIUrl":null,"url":null,"abstract":"<p><strong>Study design: </strong>Observational.</p><p><strong>Objective: </strong>To investigate the effects on the cervical spine of positioning patients for maxillofacial procedures by simulating intraoperative positions for common maxillofacial procedures.</p><p><strong>Methods: </strong>Magnetic resonance imaging was used to assess the effects of head position in common intraoperative configurations - neutral (anterior mandible position), extended (tracheostomy position) and laterally rotated (mandibular condyle position) on the C-spine of a healthy volunteer.</p><p><strong>Results: </strong>In the tracheostomy position, maximal movement occurred in the sagittal plane between the cervico-occipital junction and C4-C5, as well as at the cervico-thoracic junction. Minimal movement occurred at C2 (on C3), C5 (on C6) and C6 (on C7). In the mandibular condyle position, C-spine movements occurred in both rotational and sagittal planes. Maximal movement occurred above the level of C4, concentrated at atlanto-occipital and atlanto-axial (C1-2) joints.</p><p><strong>Conclusions: </strong>Neck extension is likely to be relatively safe in injuries that are stable in flexion and extension, such as odontoid peg fracture and fractures between C5 and C7. Head rotation is likely to be relatively safe in fractures below C4, as well as vertebral body fractures, and laminar fractures without disc disruption. Early dialogue with the neurosurgical team remains a central tenet of safe management of patients with combined maxillofacial and C-spine injuries.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":"15 4","pages":"312-317"},"PeriodicalIF":0.8000,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9647385/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Craniomaxillofacial Trauma & Reconstruction","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/19433875211053091","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/1/3 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 0

Abstract

Study design: Observational.

Objective: To investigate the effects on the cervical spine of positioning patients for maxillofacial procedures by simulating intraoperative positions for common maxillofacial procedures.

Methods: Magnetic resonance imaging was used to assess the effects of head position in common intraoperative configurations - neutral (anterior mandible position), extended (tracheostomy position) and laterally rotated (mandibular condyle position) on the C-spine of a healthy volunteer.

Results: In the tracheostomy position, maximal movement occurred in the sagittal plane between the cervico-occipital junction and C4-C5, as well as at the cervico-thoracic junction. Minimal movement occurred at C2 (on C3), C5 (on C6) and C6 (on C7). In the mandibular condyle position, C-spine movements occurred in both rotational and sagittal planes. Maximal movement occurred above the level of C4, concentrated at atlanto-occipital and atlanto-axial (C1-2) joints.

Conclusions: Neck extension is likely to be relatively safe in injuries that are stable in flexion and extension, such as odontoid peg fracture and fractures between C5 and C7. Head rotation is likely to be relatively safe in fractures below C4, as well as vertebral body fractures, and laminar fractures without disc disruption. Early dialogue with the neurosurgical team remains a central tenet of safe management of patients with combined maxillofacial and C-spine injuries.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
颌面外伤合并颈椎损伤患者术中定位安全吗?健康志愿者的放射模拟
研究设计:观察性研究。目的:通过模拟普通颌面手术术中体位,探讨颌面手术体位对患者颈椎的影响。方法:采用磁共振成像技术评估了一名健康志愿者在常见的术中体位——中立(前下颌骨体位)、伸展(气管造口体位)和侧向旋转(下颌髁体位)对c -脊柱的影响。结果:在气管造口位置,最大运动发生在颈枕交界处和C4-C5之间的矢状面以及颈胸交界处。最小的运动发生在C2(在C3上),C5(在C6上)和C6(在C7上)。在下颌髁位,颈椎在旋转面和矢状面均发生运动。最大活动发生在C4水平以上,集中在寰枕关节和寰枢关节(C1-2)。结论:对于屈伸稳定的损伤,如齿状突钉骨折和C5 - C7骨折,颈部伸展可能是相对安全的。对于C4以下的骨折,以及椎体骨折和无椎间盘破坏的椎板骨折,头部旋转可能相对安全。与神经外科团队的早期对话仍然是颌面部和颈椎合并损伤患者安全管理的核心原则。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Craniomaxillofacial Trauma & Reconstruction
Craniomaxillofacial Trauma & Reconstruction DENTISTRY, ORAL SURGERY & MEDICINE-
自引率
0.00%
发文量
39
期刊最新文献
Guidelines for Orbital Defect Assessment and Patient-Specific Implant Design: Introducing OA2 (Orbital Assessment Algorithm). Moving Forward: The Last Subscription Issue and the Dawn of Open Access. Opportunity Cost of Surgical Management of Craniomaxillofacial Trauma: A Longitudinal Study. Does More Invasive Surgery Result in Higher Patient Satisfaction? A Long-Term Follow-Up of 136 Zygomaticomaxillary Complex Fractures. Microvascular Reconstructions in Elderly Patients With Oral Squamous Cell Carcinoma - Too Old for Surgical Treatment?
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1