#l1 burst fracture

[normajwalters16]

Check out this listing I just added to my Poshmark closet: BLACK AND WHITE HOODIE SWEATER MED @d.

[im-bi-this-is-my-life]

One year ago this month I got out of a back brace and now I’m getting muscle definition back!!!

[kk095]

Malpractice

When it comes to treating patients, it’s all about risk versus reward. Is the risk of the procedure/medication worth trying for the reward? In most cases, the answer to that question is an easy yes. But sometimes the answer isn’t so clear, and every procedure has its potential complications, ranging from infection, side effects, and error from the medical professional. This particular case focuses on a surgical error that wasn’t discovered until 3 years after the procedure in question during the patient’s autopsy after she had experienced delayed onset symptoms for several days until she was ultimately brought to our emergency department.

The patient was 24 year old Christy Stadtler. She was a pleasantly plump brunette with beautiful blue eyes, large natural breasts, and spoke with a cute southern accent. 3 years ago, Christy was hurt in an ATV accident after the vehicle tipped over and landed on her back, leading to stable burst fractures in the L1 and L2 vertebrae with herniated discs in the L2 and L3 area. It was a miracle that Christy was able to walk again and regain full range of motion after the accident, given that 65-70% of patients with similar injuries end up being paraplegic or have severely diminished range of motion in their back and lower extremities. Christy considered herself very lucky and was able to get her life back on track after approximately 6 months worth of recovery efforts and physical therapy. She assumed this accident was in the past, but little did she know, it would come back to haunt her.

A few days prior to her death, Christy was experiencing lower back pain. However, she didn’t think anything of it since this was something that she experienced on occasion because of the spinal endplates, pedicle screws, and other bits of hardware that were placed into her lower back in order to surgically reduce the fractures and alleviate the herniated discs.

But over the coming days, her symptoms didn’t improve. She began to experience dizziness, weakness in her lower extremities, and nausea+loss of appetite. Unfortunately, things came to a head when she experienced an episode of syncope with hemoptysis, and was subsequently transported to our emergency department.

Upon arrival to the ER, Christy was hypotensive with a blood pressure of 72/47 mm/HG with a heart rate of 143bpm, showing clear signs of shock. The emergency department ordered STAT labs such as a CBC, BMP, toxicology screening, and D-dimer. With the patient’s vital signs being unstable, the ER team hung a bag of ringer’s lactate to commence fluid resuscitation.

Since Christy experienced hemoptysis, a chest x ray was ordered, which showed completely normal anatomy in the thoracic region. Transesophogeal echocardiogram and auscultation of the patient’s heart and lungs further confirmed this. There were also no signs of oral/dental trauma upon examination of the patient’s mouth and throat, so the blood had to originate from elsewhere.

Christy also complained of nausea and loss of appetite, so the emergency department team decided to conduct an abdominal ultrasound. The ultrasound found evidence of a massive retroperitoneal hemorrhage in the upper abdominal quadrants, but the bleeding appeared to be nonspecific and a location of the bleeding’s source was unable to be identified. Because of that, the emergency department called for a surgical consultation.

The surgical consultation confirmed the emergency department’s findings, and felt that an exploratory laparotomy would be the best option in order to properly investigate Christy’s abdominal cavity. It was also decided that the patient be started on blood transfusions, so the ringer’s lactate was swapped out and Christy was given 2 units of o-negative blood, 1 unit of platelets, and 1 unit of FFP.

Christy was then immediately taken up to the operating room and prepped for surgery. Christy seemed very nervous, since all of this seemed to be coming out of nowhere and not even the doctors seemed to fully know what was going on. The surgical team tried to reassure Christy, telling her she would be ok and that she was in good hands, despite the fact that the busty brunette would be donning a toe tag in our hospital’s morgue later that day.

After Christy was prepped, anesthetized, and intubated, the procedure began. The brunette’s abdominal cavity was accessed via a large midline incision. The cut began slightly below the xiphoid process, continued inferiorly, curved around the umbilicus, and continued further downwards towards the pubic symphysis. The underlying subcutaneous tissue and fascia were cut through, exposing the patient’s abdominal muscles. The muscles were split rather than cut- this is common practice in order to promote better postoperative wound healing and less scar tissue buildup. The abdominal muscles are divided along Langer’s lines. My best way of explaining Langer’s lines to non-medical personnel is this: when you’re cutting a piece of meat while eating, you cut the meat along “the grain” as they say, since the fibers separate more easily that way. So with that said, Langer’s lines are essentially “the grain” in human anatomy.

Even though there was sufficient evidence of a large retroperitoneal hemorrhage, there was surprisingly minimal blood loss when the surgical team entered Christy’s abdomen, and the early portions of the procedure appeared to be going well.

The surgical team began to sense something wasn’t quite right further along into the procedure. After retracting some of the more anterior organs, the right kidney and renal fascia were exposed. Normally, the renal fascia is a bright yellowish color that surrounds each kidney, protecting it and holding it in place. But Christy’s right renal fascia was bright red, absolutely engorged in blood. The renal fascia acted like a sponge in this case and absorbed some of the retroperitoneal bleeding.

Further along during the team’s investigation, a large accumulation of coagulated blood was noticed. The area was suctioned out, only to be replaced with fresh blood in an instant. The area was suctioned out, and then packed with surgical sponges, only to be quickly soaked in fresh arterial blood. The patient’s vitals were still unstable throughout the duration of the procedure, and quickly went through the first set of blood products administered preoperatively. The surgical nurses hung a 2 more units of o-negative blood, and 2nd bags of platelets and plasma, but the patient’s systolic pressure kept dropping incrementally. Initially in the 70s, then the 60s, and then the 50s.

The source of bleeding couldn’t be adequately identified as investigation continued. The patient’s abdominal cavity was now a bloody mess and her vital signs were slowly but surely dropping. Vasopressors were administered intravenously in an attempt to increase the patient’s blood pressure via vasoconstriction, but this was simply treating symptoms rather than the problem itself.

All abdominal organs and the IVC appeared to be intact and in good shape, so the surgical team was able to deduce that the hemorrhage was originating from the abdominal aorta. But the patient had no history of aneurysms, connective tissue disorders, or anything cardiovascular in nature, so the usual suspects for an abdominal aortic dissection were ruled out. But regardless, there was a bleed in the aorta or one of its corresponding arteries that the team was having difficulty treating.

Eventually, Christy deteriorated further and converted to pulseless electrical activity. ACLS protocols were promptly started by the surgical team. Deep, strong chest compressions were started. Christy’s flabby torso caved in rhythmically, causing her large, natural breasts to jiggle around from the residual force of the compressions. Epinephrine and atropine were injected into the young lady’s IV line, and the surgical vent was detached and swapped for an ambu bag.

The surgical site was packed and covered with a blue surgical drape since the procedure was essentially put on pause while resuscitation efforts were being simultaneously performed a short distance away. Christy’s chest was being pummeled repeatedly from the deep, violent chest compressions she was receiving. Her torso caved inwards, her head lolled to the side, and her feet were bobbing around on the other side of the table, with the thick, soft, prominent wrinkles in the soles of her feet being visible for all to see.

It took approximately 6 minutes worth of efforts and a second dose of epinephrine and atropine to convert the 24 year old to a shockable rhythm. The defibrillator paddles were procured from the crash cart and charged to 250 joules. After rubbing the conductive gel around the paddles for a moment, they were pressed up against Christy’s bare chest, and the first shock was delivered. A “ka-thunk” was heard in the operating room after the shock was delivered. Her thick torso flopped violently on the table in response to the quick jolt of electricity sent into her, but the heart monitors still showed v-fib. The defibrillator paddles were recharged to 300 joules that time while a cycle of chest compressions and ambu bagging were performed. Once the paddles were readied, the ambu bag was detached and everyone backed away from the table in anticipation of shock #2. The second shock caused the young patient’s large, D cup breasts to flop around in response to the electric shock. But unfortunately, v-fib was still present on the heart monitors after this shock. A third shock at 360 joules was delivered a few moments later. The stronger intensity of the shock caused Christy’s feet to leap up on the other end of the table, slamming back down hard half a second later, showcasing the silky wrinkles throughout her size 10 soles. Unfortunately, this 3rd shock converted the busty brunette back to pulseless electrical activity, so CPR was promptly resumed.

Resuscitation efforts continued for a bit to no avail. One of Christy’s arms dangled off the side of the table, wiggling around in sync with each of the compressions she received. Her complexion was pasty white with a sickly grey tinge to it, and her skin was beginning to become cold to the touch. More doses of epinephrine and atropine were injected intravenously, and the fist dose of bicarb was added. The purpose of bicarb is to neutralize the blood’s pH. This is important in a prolonged code because when a person begins to die, their blood tends to become acidic because the chemicals of the blood clotting cascade tend to be acidic in nature.

It took an additional dose of medications and another 4 and a half minutes worth of efforts to obtain a shockable rhythm. The monitors showed fine v-fib, so the surgical team recharged the paddles to 360 joules, pressed the paddles up against Christy’s bare chest, and delivered the next shock. Her chest shot up and her back arched slightly, before returning to her previous position. Fine v-fib still ran across the heart monitor, so another shock was promptly delivered moments later. The jolt of electricity caused Christy’s eyes to open up slightly while her lifeless body twitched sharply on the table.

Christy was shocked unsuccessfully 3 more times and coded for an additional 15 minutes. At the 32 minute mark of the code, the surgical team noted fixed and dilated pupils, and persistent asystole displayed on the monitors. The surgical team terminated their resuscitation efforts at that point, calling time of death on Christy at 14:46. The ambu bag was detached and the flatlined monitors were switched off. The young lady’s eyes remained half open while the OR team performed basic postmortem care, giving it the appearance that the 24 year old was watching them. The EKG electrodes were disconnected and the surgical equipment was removed from the large surgical site in her abdomen. Christy’s eyes were gently shut for the final time and a cover was placed over her battered body, leaving her feet exposed. A toe tag was filled out and placed, and she was sent up to our hospital morgue.

The autopsy revealed some noteworthy findings. The pedicle screw at the L1 level was placed way too deep, causing a ruptured pseudoaneurysm with a 6cm tear in the posterior portion of the abdominal aorta. What happened was the pedicle screw that was drilled to deep penetrated the outer layer of the aorta slightly, separating the various layers of the vessel. Over time, blood accumulated in the separated layers, causing the pseudoaneurysm, which subsequently burst, causing lethal hemorrhaging. The pseudoaneurysm wouldn’t have been present at the time of her initial postoperative period, but a post-op CT scan should’ve been performed to make sure hardware has been placed correctly and no complications would take place. But upon our investigation, no such post-op CT scan was performed by the surgical team 3 years ago. Between the pedicle screw being inserted too far and the lack of a post-op CT scan, our surgical team and pathology team recommended that her next of kin take legal recourse against the hospital that performed the surgery 3 years ago, to which they agreed.

No amount of lawsuits would bring Christy back of course, but the physician and hospital needed to be held accountable for such egregious negligence. Christy’s family went through with the lawsuit per our advice, and decided to settle the case out of court for a substantial amount.

Unfortunately, medical malpractice is something that happens on occasion in our profession, and sadly, a beautiful young lady lost her life as a result this time.

[bsiofsa7]

Nonsurgical Treatment for Spine and Pressure break

Many individuals with spine pressure breaks needn't bother with an operation. Spine specialists at BSI San Antonio, TX, propose medication, particularly fit back upholds, and a blend of action and development change to lessen torture and help you remain dynamic.

Our experts in solid wellbeing, sensory system science, and neurosurgery moreover work personally with BSI San Antonio endocrinologists—who address impressive experts in treating people with osteoporosis—to give broad treatment. Our experts offer nonsurgical thought to help you create bone mettle, stay aware of safety in the spine, and walk around torture.

What is a Tension Break?

A strain break of the back or spine happens when your vertebrae or bones of the spine break. Pressure breaks can happen in the spine, notwithstanding, most consistently in the T9 through L1.

Compression fracture Treatment San Antonio TX shows up in a wide scope of shapes, sizes, and names. They are often called impacted breaks, crush breaks, or wedge breaks. These different breaks construe different things and may have assorted long stretch effects. Acknowledging which kind of break you have is critical considering the somewhat long ramifications of the various breakages. For example, a burst break might have more outrageous long-haul impacts, including neurological compromises.

Wedge Break: The vertebrae were broken at the front of the bone toward the front of the spine.

Squash Break: The entire bone breaks rather than just the front of the vertebrae.

Burst Break: This happens when there is a height mishap in both the vertebra's front and back.

Spinal Setting: A Treatment Decision for Spinal Breaks

Dependent upon the sort of spinal break you have, your PCP may propose that you wear support as the break recovers. Assuming the suspension is a consistent break—not causing any neurologic injury or responsible for causing neurology mischief—you may have to wear support (On the off chance that the hole is shaky—suggesting that the vertebra is so broken, it can't offer assistance to the spine and that there's conceivable neurological damage—supporting may not be a respectable treatment decision for you You'll possibly require an operation.)

Regardless, the vertebra can pass on its conventional weight without the risk of extra injury. That infers that, by and large, the vertebra can, regardless, tackle its work of supporting you to move. Regardless, a broken vertebra doesn't "work" similarly to an ordinary vertebra, so your spine could use some help with passing on the load. The help will offer that extra assistance during the retouching period.

Do I have the Signs of a Vertebral Tension Break?

Signs of a vertebral tension break vary remarkably, making it hard to recognize. Explicit people experience extraordinary back torture that additional time becomes tireless, while others have unexpected limit back torture.

• Intense back torture that turns relentless additional time.

• Recognizable hunchback deformity called kyphosis. Examine more on kyphosis. This is, by and large ordinary if you have a wedge break on your vertebrae.

• Loss of height

• Swarming of inside organs

• Loss of muscle and high-sway shaping in light of a shortfall of development and exercise

• Torment that wrecks when you walk or stand

• Trouble bowing or reshaping

• Torment is seen routinely when performing step by step tasks that insignificantly strain back muscles. For example, putting sheets on the bed or unloading food.

Alleviation from inconvenience Medication

Spine fracture Treatment near me San Antonio TX, Spine pressure breaks may cause monstrous torture, basically assuming the break occurred as the delayed consequence of a disaster like a fall. Our exacerbation board specialists can outfit you with the medication to lessen enduring while your bones retouch. Torture drug doesn't help the recovering framework, yet lessened torture may allow you to remain convenient as you recuperate.

Depending on your level of misery, experts may recommend over-the-counter quitting medication, similar to ibuprofen, or help with inconvenience drugs, like acetaminophen. Our specialists may support a more grounded pain reliever if irritation drives forward

What are Treatment Decisions for Spine Strain Break?

Treatment for spine pressure break can often be conservative, and treatment normally incorporates a mix of diminishing your activity, medication, and backing wearing. The lessening in development will help retouch your messed-up vertebrae while the medication manages torture.

At BSI San Antonio, TX, we offer a wide scope of recommended supports for osteoporosis or tension breaks of the vertebra. Coming up next are two or three of the assorted help decisions open.

This TLSO support is an extraordinary decision for overseeing pressure breaks. This helps have a three-point pressure system that reduces issues identified with pressure breaks. The endorsement applies strain to the sternum, mid-back (where most spinal tension breaks happen), and the front of the hips. The help was made in light of customer comfort.

This help made for osteoporosis holds the mid-spine in a suitably extended position, thwarting bothersome spine flexion due to conditions like osteoporosis. This help is useful for uncommon osteoporosis as its essential assumption is to make proper spinal courses of action

If you experience a more delicate kind of osteoporosis or a strain break, any back assists arranged in the thoracic and lumbar region will help drive you toward recovery. This back gets ready for mid to bring down back torture is a mind-blowing decision for less serious cases.

If your tension break is arranged in your L1 or lower, endeavor this expansive spine change support. This help helps with limiting unsafe development in the region to get many lower mid-back conditions.

[drkarunaspine]

Spine anatomy

Spine comprises 24 individual bones or vertebrae which together support the human structure as well as nervous system. In addition to this we have sacrum and coccyx at the lower end. Such structure is classified in 5 regions namely cervical, thoracic, lumbar, sacrum and coccyx. Cervical spine consists of 7 vertebrae starting from the neck and referred to as C1 to C7. Thoracic section consists of 12 vertebrae from mid back and is known as T1 to T12. Lumbar spine encompasses 5 vertebrae from L1 to L5. Besides providing support, the spine has adequate shock absorbing qualities. What are functions of the spine? The spine protects spinal cord, nerve roots and other internal organs, provides flexibility in movements, structural support which also enables upright position. The cervical spine connects the skull and the upper back at shoulder level. The curve towards the front and then backwards manages the weight and pressure from the skull. The thoracic spine connects the cervical spine with the lumbar spine and runs from the base of the neck to the abdomen. Besides protecting the spinal cord, it anchors the ribs and protects the heart and lungs. While the cervical spine and lumbar spine offer mobility, the thoracic spine offers stability. Lumbar spine bears the weight of the body and is susceptible to pain caused by heavy lifting, prolonged sitting and wearing improper shoes. Sacrum connects hips to the spine bones while coccyx provides for ligaments and muscles in the pelvic floor. The space between vertebrae contain intervertebral discs which act as shock absorbers and the gelatinous cushions protect vertebral bones when a person moves. How is spine anatomy diagnosed for health problems? Apart from imaging tests, neurological examinations which check attributes including reflexes, muscle strength, comfort in walking, ability to feel light touches, prickles and vibration are also conducted. What are spinal fractures? Dislocation of vertebrae anywhere in the spine is known as spinal fracture. It is caused by injury or trauma that follows high velocity impact from car accidents, falls and sports. The results of spine fractures may be mild muscle and ligament damages to serious spinal cord damages. Spine fractures may be classified as compression fracture, axial burst fracture and chance fracture. While compression fracture and axial burst fracture are caused by osteoporosis and loss of height due to vertical fall impact respectively, chance fracture happens when vertebrae is pulled apart due to violent forward flexed injury like car accident. Spinal fractures are treated through physical rehabilitation therapies and medications for entities like bowel and bladder dysfunctions, pain, muscle spasticity and blood pressure. Read the full article

[ijcmcrjournal]

Case Report: T4 Vertebral Fracture in an Obese Patient by Gabriel MN

Abstract

Introduction: A vertebral fracture is an injury that can involve only the vertebral body or the entire functional vertebral unit. They are very frequent, it ranks second in the frequency of fractures, it is more frequent among men and between T11 and L1. They are usually accompanied by neurological deficit due to their proximity to the spinal cord. The diagnosis and management decision is made supported by a combination of plain radiographs, Computed Axial Tomography (CAT) and Magnetic Resonance Imaging (MRI). The therapeutic options include conservative and surgical treatment, in order to readjust the compressed vertebra and maintain its position until the consolidation.

Case Report: 51-year-old male patient, smoker 30 years ago, social alcoholism. Diabetic and hypertensive diagnosed 5 years ago with poor adherence to treatment, obese with a BMI of 41.5 who reported a fall of approximately 2.5 meters in height with a fall in the cephalic position, without loss of consciousness, reported severe pain in the spine in the thoracic region, in the shoulder left and head. A T3 vertebra fracture is diagnosed, which is operated on with arthrodesis in T2-T4 and T5, without complications and with a favorable recovery and evolution.

Conclusions: This was a complicated case due to its comorbidities, Diabetes Mellitus, Hypertension and Obesity with a BMI of 39.4. The amount of fatty tissue in the affected region made access difficult due to the lack of sharp images on the fluoroscope. Despite the imaging difficulties, the surgical intervention was carried out successfully and the patient had a successful recovery.

Keywords: Vertebral Fracture; Osteosynthesis; Spine; Spine Surgery; Cervical Trauma

Introduction

Vertebral fracture is an injury that can affect only the vertebral body or the entire functional vertebral unit. Fractures of the spine are very frequent, occupying the second place in frequency of fractures, more frequent among men with a ratio of 2: 3. The vertebrae most affected are those between T11 and L1 in 52% of cases, L2-L5 in 32% and T1 to T10 in 10% with a higher incidence between 25 and 40 years. The thoracic vertebrae are very close to the spinal cord, so the reserve space of the spinal canal is less than 10%. Thus, burst fractures of the thoracic spine are usually accompanied by neurological deficits.

Clinical Diagnosis

Investigate mechanism of injury, comorbidities, search for associated spinal cord injuries, and exact assessment of the patient's neurological status.

Physical Examination

The ASIA scale is used (modified Frankel).

Radiological Diagnosis

The identification of vertebral fractures is important because they are predictors of future fractures.

The combination of plain radiographs, Computerized Axial Tomography (CT) and Magnetic Resonance Imaging (MRI) allows the identification of bone and ligamentous lesions of the thoracolumbar vertebrae. Allowing to identify unstable lesions and classify them to select the appropriate treatment.

Treatment

The goal of treating spinal fractures is to readjust the compressed vertebra and maintain its position.Therapeutic options include conservative and surgical treatment. The main advantage of conservative treatment is the absence of morbidity associated with the access route, the short duration of hospital admission and the rapid referral to rehabilitation and lower costs, however, in thoracic vertebral fractures, it is indicated on few occasions. It can be considered for conservative treatment, when they are stable fractures and without neurological deficit.

The ultimate goal of surgical treatment for thoracolumbar fractures is to maximize function, prevent deformity, avoid instability and pain, and shorten days of hospitalization.

Presentation of the Case

Non-pathological personal history: 51-year-old male patient, resident of Guadalajara, positive social tobacco, more than 30 years of having been an active smoker for two years, positive alcohol consumption for social reason without reaching delivery, drug consumption, tattoos, piercings denied in a type or positive drug intake metoprolol and losartan hydrochlorothiazide and application of insulin NPH. Pathological personal history: he refers to being a diabetic diagnosed 5 years ago on current treatment with nph insulin 34 units in the morning and 20 units at night, as well as hypertension diagnosed 5 years ago on treatment with irbesartan-hydrochlorothiazide and metoprolol with poor adherence to treatment. Rest questioned and denied.

Current condition: He refers to a fall of approximately 2.5 meters in height with a fall in the cephalic position, without loss of consciousness, he refers to intense pain in the spine in the thoracic region, in the left shoulder and head.

Physical examination: Conscious, oriented and cooperative patient, Glasgow 15/15, showing pain fascies. Normal-looking skull with multiple lacerations and bruises. Normoreflexic pupils, reflexes preserved, without neurological alterations. Inability to ambulate and move left arm. Spinal pain at the thoracic level with intensity 10/10. Obese patient, with the presence of a very thick hump at the vertebral fracture level. Height 1.67 meters, weight 110 KG. BMI: 39.4 Surgical intervention: Under balanced general anesthesia, the procedure is started incising by planes until spinous processes are identified, pedicles are located and transparent screws are placed with fluoroscopic support in T2 T4 and T5, crossling and bone matrix are placed, hemostasis is performed, gania drainage is placed and closes by plans without incident. Ten days after the surgery, without complications, wandering, without referring severe pain and with good wound healing, he was discharged for follow-up in the neurosurgery outpatient clinic.

Discussion

In the literature, it is mentioned that vertebral column fractures are very frequent, being the second place in frequency of fractures, with a distribution of 2: 3 men and women. The least affected vertebrae are between T1 to T10 which represent only 10% and we find it in people between 25 and 40 years old. In recent years, evidence has been gathered that overweight and fat mass can have a negative influence on the risk of fracture, especially when adjusted according to the patient's bone mass. Obesity is an important risk factor for presenting multiple complications, pseudoarthrosis, increased bleeding during surgery, difficult surgical technique, failure in the evolution after degenerative spine surgery.

Conclusion

Vertebral fractures are common, however, this patient's fracture height only corresponds to 10% of vertebral fractures. In addition, it is out of the most common age range for this condition. It was a complicated case due to its comorbidities, Diabetes Mellitus, Hypertension and Obesity with a BMI of 39.4. The amount of fatty tissue in the affected region made access difficult due to the lack of clear images in the fluoroscope. Despite the imaging difficulties, the surgical procedure was successful and the patient made a successful recovery.

For more information about Journal : https://ijclinmedcasereports.com/

https://ijclinmedcasereports.com/ijcmcr-cr-id-00073/ https://ijclinmedcasereports.com/pdf/IJCMCR-CR-00073.pdf

[normajwalters16]

Check out this listing I just added to my Poshmark closet: BLACK AND WHITE HOODIE SWEATER MED @d.

[im-bi-this-is-my-life]

Pre order shirts are $17 $20 in a couple of weeks so order now

Fight with Bree

My name is Bree Baslington. I have been struggling with Lyme Disease for the past nine years of my life, all the while striving towards a better future for myself and others like me. I was born and raised in Spokane Valley, WA, only moving away to progress my treatments. Until I started to get sick, I was a very active member of the community; participating in all kinds of sports, volunteering, and working with children at the city’s day camp.

Moving away from Spokane was a difficult decision for me considering how little support I would have in the Seattle area, but it was one that I do not regret. I chose to move to Woodinville, WA in May of 2016 after avoiding the move for several months prior. There I became a full-time patient at Sophia Health Institute, seeing multiple doctors at a time, receiving daily IVs, and numerous injections. Without the time I spent there, I would not be here today.

During one of my trips to Spokane during the holiday season, my father and I were in a car accident that destroyed most of my possessions including the majority of my medical supplies and tools, as well as broke my back. I suffered an L1 burst fracture that left me in severe chronic pain. I spent three months in a back brace, requiring a special hospital bed and equipment to remain semi-functional without help. Replacing all of my medical equipment as well as purchasing more drained the remainder of my medical funds and left me struggling to make ends meet.

As time progressed in Woodinville, the treatments began to get more and more of a financial burden. With the cost of living rapidly increasing in the area, and the medical bills piling up, I chose to move back to the Spokane area in order to regroup and start to save in order to go back. The cost of care at Sophia Health Institute is purely dependent on how well I am doing at any given time, but typically it cost anywhere from $7,000- $10,000, or more a month.

My goal is to one day go to medical school and become a doctor that helps others the way so many of my doctors have helped me. Being twenty-five, this seems like a hefty goal, but I am used to defying the odds and pushing myself past the limits that others have placed on me. More than anything, what I want to do is inspire others like me that they can be more than their diagnosis.

For me, being healthy is not as simple as staying focused on treatments for a fixed amount of time, my condition is chronic meaning that I will be always need some form of treatment to manage my condition. That being said, my hope is to start to work more and more as I progress in my journey to a healthier life, but that is easier said than done. As of right now, I am able to work a few hours a week- something I never thought I’d be able to do at this point in my treatment. Soon, I hope to go back to college and begin working on my bachelor’s degree and eventual doctorate.

Now that I have recovered as much as I can from the car accident, I am in a place to continue to push forward towards my goal of managing my Lyme to a place that allows me to work more consistently and go back to college. In order to do this, I need to make another big step in my health journey; receiving treatment in Europe.

When I was sixteen, I had my wisdom teeth removed in an attempt to stop my headache. Long story short, because of my compromised immune system I ended up with an infection in my jaw (cavitation) that prevents my head from draining properly thus pushing the majority of my infection in my brain. German medicine has the technology to circumnavigate the nerves near where my wisdom teeth used to be, so they are the only ones who can fully clean out the infection. On top of this, I also need cryotherapy on my tonsils. My tonsils were removed when I was a sophomore in high school after suffering severe tonsillitis, but over time with my weakened immune system, one has begun to grow back- full of infections. This new tonsil has a very high likelihood of becoming cancerous if I do not take action soon. The nature of these procedures may seem fairly harmless, but because of the severity of my condition and my current heart problems will require me to seek addition support. My hope is to not only have doctor support in Europe, but also a full-time caregiver to help get me from appointment to appointment. On top of scrambling to pay for my basic every day needs, I am trying my best to save enough to travel for these surgeries.

[uniquestream]

The Push 2018 Grant Korgan is a world-class adventurer, nano-mechanics professional, and husband. On March 5, 2010, the Lake Tahoe native burst-fractured his L1 vertebrae, and suddenly added the world of spinal cord injury recovery to his list of pursuits.

[mikaelahamilton]

1 year

Climbing — like running, owning a business, facing a fear, or being a human— at times asks us to suffer.

I’ll save the story of my accident for another day, as right now my mind is flooded with memories of my recovery.

I fell 15 ft while lead climbing on this day last year, suffering a three-column compound burst fracture of my L1 vertebrae, retropulsed bone fragments 8mm into my spinal canal, and a triangular fracture of my T12 vertebrae.  In non-medical terms, this is code for “hurts like hell.”  I should have experienced nerve and neurological damage, if not death.

Instead, I was told I could recover.  After an invasive spinal fusion surgery and six brutal days in the hospital, the medical staff sent me home with one simple command: walk.

So, every day I pushed myself up out of my geriatric recliner and gave thanks that I hadn’t lost feeling in my legs, that I could still feebly get myself out the door, to stand in the sun and remember that I was alive.  I was given another day.

I cruised the sidewalks around my neighborhood, slow at first and then swiftly.  Paired with my methodical, step-and-breathe routine came a newfound awareness of my body and surroundings.  I began to intimately pay attention to the neighborhood I had called home for over a year, yet barely known.

Every day, I walked by the “weave on Marie street” — a sad, abandoned clump of hair that once resided on someone’s head.  I passed the shirtless, overweight man at the top of the hill who routinely yelled in a monotone voice, “beautiful day”.  I frequently passed a sharply-dressed elderly man who was always chasing a family of kittens around his yard.  I anticipated waving to the two women who sat in rocking chairs on their porch every afternoon.  I winced at the effects of gentrification weighing on my fellow neighbors.

I noticed a familiar determination in the young boy who practiced basketball in his front yard, without a hoop.  Neither of us had the immediate gratification of a scored goal, yet we labored on.

On one particularly rough morning, I turned a corner to stare at the face of Jesus on a pillow in the middle of the sidewalk.  I took the encounter as a divinely comedic reminder that healing also requires rest.

I routinely smiled at the shy, awkward neighbor who religiously tended his garden.  He was the proud owner of an albino turkey that squawked every 30 minutes.  I learned to walk-sprint by the man who always, without fail, let his damn dog chase me a block before he called it home.

Over the span of a year, I counted 15 abandoned diapers, watched the construction of an entire row of new houses, and developed a deep admiration for the guy who built out three Volkswagon camper vans two blocks from my house.  And as I grew more aware of the world around me, what was broken within me healed, a little stiffer & a little stronger.

I watched spring shift to summer, day-by-day.  This is not a sudden process.  It happens gradually, patiently, faithfully — and most of us feel sideswiped by the change because we are too busy being busy.

I walked and I walked and I walked.  My neck brace was removed, and my wobbly, tentative stride took a more purposeful pace.  My lungs regained their strength, and I learned about balance.  I relearned how to trust.  Eventually, I could bend and touch my toes.  Then I ran, over and over again, arguably faster than I’d even been before my accident.  

I can’t help but think: what if I paid this much attention for longer than a span of a few months?  What would I see? What have I already missed?

To my friends & family: you were my backbone when I was broken.  Thank you for the meals, the walking buddies, the hugs, the listening, the truth-telling.

A year later, I stand a little straighter, stretch longer, breathe deeper.  A year later, I continue to say: Thank you God, for this day.  Thank you God, for this body.  Help me to steward it well.

Climbing also compels us to reach.  It demands that we stretch beyond our limits and muster the strength to pull ourselves up, crack-by-crack, finger-by-finger, breath-by-breath.  

May we all look back, bless how far we’ve come, and never stop reaching.

[neurocirurgiabr]

Case 1: L1 AO classification A3 burst fracture. 25 yr old female, restrained driver, high speed rapid deceleration avoiding freeway wildlife. Rolled into bank. Self extricated and walked 500m for mobile reception. Severe thoracolumbar back pain and mild perineal numbness with normal catheter tug. #Repost @spinesurgeon with @repostapp ・・・ I will be documenting a series of cases where step by step pics over days will describe the surgical intervention. Join me for some very interesting and challenging cases in the life of a Neurosurgeon. #nervepain #disc #sciatica #backpain #neurosurgeon #neurosurgeryblog #surgery #trauma #spinesurgery #spinalfusion #mva #fracture #backpain #medical #medicine #medicalstudent #medicalassistant #scrublife #screws #fusion #spinesurgeon #neurocirurgiabr

[juniperpublishers-oajnn-blog]

360° Fusion for Mid Lumbar Traumatic Instable Burst Fractures in Osteoporotic Patients

Authored by  Tony Van Havenbergh

Introduction

Mid lumbar traumatic burst fractures are not so uncommon. They mostly occur in high energy axial loading traumas. In patients with a predisposing osteoporotic situation though, severe burst fractures at the mid lumbar level can develop after relatively minor trauma [1-3]. The fragments of the vertebra can cause a narrowing of the spinal canal and in some cases devastating neurological deficit. Thoraco lumbar burst fractures can be classified using the Denis classification [4], the AO- classification of Magerl [5] and a load sharing classification according to Mc Cormack [6]. These fractures can lead to severe functional impact. Long term complications in terms of kyphosing and persistent pain are common if not treated properly [7,8]. Especially in the osteoporotic patient a first line stable reconstruction of the spine is mandatory to prevent long term complications. We present 2 cases of L3 burst fractures in patients with an osteoporotic predisposition.

Case 1

A 56 year old lady presented after falling of a staircase. She immediately experienced a stabbing pain in the lumbar region with irradiation in both legs. Upon admission there was no neurological deficit. X-ray of the lumbar spine showed a burst fracture of L3. On CT there was an almost 90% stenosis at the L3 level, caused by a fragment of the L3 burst fracture. Patient was transferred to the neurosurgery department. She was initially stabilized through a posterior approach with a pedicle screw and rod fixation from L1 to L5. The bone quality was poor because of known osteoporosis. Through distraction, a partial reposition of the L3 fragment in the spinal canal was achieved and an adjuvant laminectomy and facetectomy was performed to fully decompress the spinal canal. A dural tear was encountered with rootlets bulging out. The dural tear was repaired. Patient was neurologically intact after the surgery. In view of the osteoporosis we decided to add an anterior stabilization to prevent pseudarthrosis and kyphotic complication on the medium long term. In a second stage, an anterolateral approach was done to L3 with corporectomy and interposition of an expandable cage. Patient recovered well after this procedure and could be mobilized within 2 days. She was discharged for further rehab at the 4th postoperative day.

Case 2

A 63 year old female patient was admitted through emergency ward after she stumbled and fell on her buttocks. She suffered immediate excruciating low back pain, she was neurologically intact. X-ray and CT of the lumbar spine demonstrated a burst fracture of L3 with a fragment in the spinal canal causing a 50% canal stenosis and a suspicion of severe osteoporosis. The patient received a 2 step surgery consisting of posterior pedicle screw stabilisation from L2 to L5with cement augmentation of the screws and an additional antero lateral approach with partial corporectomy of L3 and expandable cage interposition (Figure 1). Her recovery was uneventful with immediate pain relief and discharge on day 3 after her anterior surgery.

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Discussion

Burst fractures of the mid lumbar spine are not uncommon. These fractures can cause severe complications such as neurological deficit or untreatable pain due to sagittal balance disruption. In about 60% there is an important impact on quality of life [1-3]. The severityof these fractures can be defined with different classifications. The most commonly used classifications are: The Denis classification [4] where the posterior, middle and anterio column is taken into account. The AO Magerl [5] score defining compression [A], distraction [B] or axial torque [C]. The Load Sharing Score by McCormack [6-8] based on comminution, apposition and kyphosis. Based on these scoresthere is a consensus on which fractures should be treated surgically and which can be treated conservatively [9]. In general the high grade instable fractures are indications for surgical stabilization [10]. The reason is the high risk for progressive hyperkyphosis leading to severe disability. There is an ongoing discussion on how to treat these instable midlumbar burst fractures. Some advocate posterior stabilization [11] without bony augmentation, others advocate adjuvant bone grafting, Some prefer unique anterior stabilization [12]. The role of vertebroplasty or kyphoplasty is still under debate, but the application of cement in a severely fractured vertebral body, especially with a disruption of the posterior wall, is questionable. In osteoporotic unstable communitive fractures with a load sharing score of >7, a combined posterior and anterior stabilization seems the best option for long term good outcome [13-15]. Using minimally invasive techniques as well for posterior as anterior approaches, one can minimize surgical trauma to the patient and provide very early mobilization.

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Conclusion

Unstable osteoporotic lumbar burst fractures can cause severe disability by neurological deficit but also by chronic pain through sagittal balance disruption. 360° lumbar stabilization can be performed with minimally invasive techniques leading to direct mobilization of the patients.

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[normajwalters16]

Check out this listing I just added to my Poshmark closet: BLACK AND WHITE HOODIE SWEATER MED @d.

[im-bi-this-is-my-life]

December 26th my Dad was driving me back to Seattle when we hit a patch of ice and slid off of the freeway into a large pile rocks. We went up them, flew about 200 feet, and rolled, eventually landing upside down. All of my clothing and medical equipment was strewn across the side of the freeway, and most of it was either lost or unsalvageable. My dad walked away with a few bruises, but I ended up with a burst fracture of my L1 (spinal fracture). I am in no need of surgery right away and have been released from the hospital on 12/29. My expected recovery time is about three months in which I will need massive PT and my back brace. For how bad the accident was we are extremely lucky to be alive, but of course this throws a wrench (and large expenses) in my healing plan.

I know with it being right after the holidays and before the end of the year, money has a tendency to be tight right now, but if everyone gave only $5 there wouldn’t be as much concern in how I will be able to afford the medical expenses and to replace the medications and medical tools that have been destroyed. All in all, please drive safe this season. Www.gofundme.com/fightwithbree

Also, I would love to thank the bystanders who pulled over to help my dad and I right after the accident. I thank you more than words can express. Thank you.

[chriscmcnamara]

An award-winning documentary is coming to The Black Bear Lodge TONIGHT!!. NOTE, due to weather, it has moved inside the warm cozy lodge (it’s no longer outdoors). Link to tickets in profile. The Push is an inspirational documentary about the power of never giving up. Grant Korgan is a world-class adventurer, nano-mechanics professional, and husband. On March 5, 2010, while filming a snowmobiling segment in the Sierra Nevada backcountry, the Lake Tahoe native burst-fractured his L1 vertebrae, and suddenly added the world of spinal cord injury recovery to his list of pursuits. On January 17, 2012, along with two seasoned explorers, Grant attempted the insurmountable, and became the first spinal cord-injured athlete to literally PUSH himself ~nearly 100 miles (the final degree of latitude) to the most inhospitable place on the planet – the bottom of the globe, the geographic South Pole. View the Trailer All proceeds go to the Mitch Underhill Mountain Fund and High Fives Foundation. EVENT SCHEDULE - 6:00 pm - Doors open. Wine, beer and special bagel dogs from Dragonfly Bagels - 6:30 pm - Film cast introduces the film - 8:00 pm - Raffle and Q and A with Grant and Shawna LOCATION Black Bear Lodge 1202 Ski Run Blvd, South Lake Tahoe, CA 96150 Feel free to join us for a drink beforehand from 5:00-6:00 pm. See you there! - Chris McNamara and Corey Rich Ski Run Presents: (at Black Bear Lodge) https://www.instagram.com/p/BowksvZjk7O/?utm_source=ig_tumblr_share&igshid=7svefx3j5zfu

[nbntv-blog]

Injured British F3 driver to make comeback in Supercars

Injured British F3 driver to make comeback in Supercars

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Harry Hayek is set to make a return to motorsport in the third-tier Kumho V8 Touring Car Series this weekend, more than a year after a British Formula 3 crash left him sidelined with a fractured vertebra.

The Australian crashed during practice for the BRDC British F3 round at Snetterton last May, a burst fracture in the L1 vertebra leading to his T12 to L2 being fused together with metal…