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Spinal Trauma2
Spinal Trauma2
Spinal Trauma2
The thoracic spine is relatively protected due to limited mobility from support of the •
rib cage (T1–T10); however, the spinal canal through which
,the spinal cord traverses is relatively narrow in this region. Therefore •
.when injuries to this region do occur, they usually have devastating results •
The lumbosacral region (L2 and below) contains the region of the spinal •
canal below which the spinal cord proper ends and the cauda equina begins •
:Mechanisms suspicious for spinal injury •
.Diving ■ •
.Fall from > 10 feet ■ •
Injury above level of shoulders ■ •
.)cervical spine( •
.Electrocution ■ •
High-speed motor vehicle crash ■ •
.)MVC( •
Rugby or football injury ■ •
Spinal injuries can generally be classified •
:based on
Fracture/dislocation type (mechanism, ■ •
.stable vs. unstable)
Level of neurological (sensory and motor) ■ •
.and bony involvement
Severity (complete vs. incomplete spinal ■ •
.cord disability)
:Complete vs. incomplete •
Complete spinal cord injuries demonstrate no •
preservation of neurologic function distal to the level of
injury. Therefore, any sensorimotor function
.below the level of injury constitutes an incomplete injury
Posterior columns
: •
.Located in the posterior aspect o the spinal cord ■ •
Responsible or ipsilateral position and vibratory sense and some ■ •
.light touch sensation •
Tested using a tuning fork and position sense of the fingers and toes ■ •
Spinal Cord Syndromes
:Anterior cord syndrome-1 •
Pattern seen with injury to the anterior portion of the ■ •
spinal cord or with compression of the anterior spinal
.arteries (artery o Adamkiewicz)
Has a better prognosis than the other partial cord syndromes with a
characteristic pattern of recovery (lower extremity recovery progressing upward •
to upper extremity recovery, then the hands recover strength
:Manegment of spinal cord injuries
Always start with the ABCs of trauma resuscitation-1 •
. •
.Maintain spinal immobilization throughout the resuscitation-2 •
:Treatment •
Surgical lysis of fibrous band or removal of C7 •
transverse process by either transaxillary or
.supraclavicular approach to thoracic outlet