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Clearing the Cervical Spine
Published in Kajal Jain, Nidhi Bhatia, Acute Trauma Care in Developing Countries, 2023
Apinderpreet Singh, Rajesh Chhabra, Pravin Salunke
Cervical spine injury is a serious entity which might cause permanent neurological deficits, severe morbidity and even death. Prompt diagnosis and management henceforth become important. Children, in particular, pose a significant diagnostic challenge for the reasons discussed. In a tertiary care and high-volume centre, focused history and examination and triaging the patients into high-risk and low-risk groups will help clinicians to avoid unnecessary investigations and will decrease the chances of missing a cervical spine injury particularly in equivocal conditions.
Injuries in Children
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
Sports injuries, RTCs and falls from heights are the most common causes of cervical spine injury. In the case of RTCs, spine injury is commonly seen in pedestrians who are hit by a car and in passengers in high-speed impacts. Rarer causes include diving accidents, non-accidental injuries and birth-related injuries in neonates. It is important to note that there may be some under-representation in hospital audits of cervical spine injuries in children because many high-speed cervical spine injuries will cause death at the scene of the accident.
Emergency Surgery
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
Alastair Brookes, Yiu-Che Chan, Rebecca Fish, Fung Joon Foo, Aisling Hogan, Thomas Konig, Aoife Lowery, Chelliah R Selvasekar, Choon Sheong Seow, Vishal G Shelat, Paul Sutton, Colin Walsh, John Wang, Ting Hway Wong
How does this change your management?In a patient like this with multiple distracting injuries (Colles fracture and pelvic fracture), clinical clearance of C-spine cannot be achieved, and hence even without this imaging, the intubation should be performed under C-spine control (second person assists to main C-spine stability during intubation).Definitive management of the cervical spine injury will wait till after haemorrhage control is achieved, and C-spine must be protected until then.
Effects of a contusion load on spinal cord with different curvatures
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2021
Qian-qian Yu, Si-qing Liu, Jian-jie Wang, Meng-lei Xu, Wen-xuan Zhang, Li-ming Cheng, Rui Zhu
The cervical spine injury is a very complicated procedure in the combination of the different injury loads and postures. The cervical biomechanical performance may vary in different cervical sagittal curvatures. With the changes in living and working habits, more and more people have problems with cervical curvature. Investigations on this point can provide some data. Some components such as the pia matter are missing in lots of investigations. The pia matter wraps the white matter and gray matter in terms of anatomical knowledge and affects the spinal cord deformation (Nishida et al. 2011; Persson et al. 2011). By covering the parenchyma and making the spinal cord as a whole, pia matter increases the stiffness of the spinal cord and enhances its recovery of shape after removal of the compression. Simulating this effect may improve our understanding of biomechanical behaviour of spinal cord. But no data was provided to quantitatively state its function.
Halo vest immobilization – an institutional review of safety in acute cervical spine injury from 2013 to 2017
Published in British Journal of Neurosurgery, 2021
Samuel L. Malnik, Kyle W. Scott, M. Zino Kuhn, Dunbar Alcindor, Kourosh Tavanaiepour, Daryoush Tavanaiepour, Marie Crandall, Gazanfar Rahmathulla
The mortality from HVI has raised concerns about the proper management of acute cervical spine injuries.10 While the nature of our institution as a trauma center on a major interstate makes continuity of care difficult for many patients, particularly those involved in motor vehicle accidents, we exclusively analyzed original hospital stay mortality for this cohort. Of the four individuals who were discharged as deceased or to hospice, three presented with GCS scores of 3 suggesting that their mortality resulted from the initial injury. The fourth individual was the oldest member of our cohort at 78 years old presenting with an ISS of 26 post-MVA. As Sime et al.17 noted in their study, there may also be an underappreciated role for demographic prognostic factors when weighing different management options for the treatment of acute cervical spine injury. In the absence of an RCT on the safety and effectiveness of halo vest immobilization vs. surgery, it remains important to recognize HVI as a critical adjunct tool in the treatment of cervical spine injury while simultaneously being cognizant of potential complications.
New Immobilization Guidelines Change EMS Critical Thinking in Older Adults With Spine Trauma
Published in Prehospital Emergency Care, 2018
Linda Underbrink, Alice “Twink” Dalton, Jan Leonard, Pamela W. Bourg, Abigail Blackmore, Holly Valverde, Thomas Candlin, Lisa M. Caputo, Christopher Duran, Sherrie Peckham, Jeff Beckman, Brandon Daruna, Krista Furie, Debra Hopgood
We compared cohorts of older adult patients with cervical spine injury admitted 2.5 years prior (1/1/12–6/30/14) and 1.5 years after (7/1/14–12/31/15) implementation of the Spinal Precautions Protocol. Patients were included in the study if they were ≥60 years, were transported by one of the 24 participating EMS agencies, were admitted to one of the 9 participating trauma centers, and had a diagnosis of cervical cord injury and/or cervical spine fracture. The following International Classification of Diseases 9th revision (ICD-9) diagnosis codes were used to identify patients with a cervical fracture and/or cervical cord injury: ICD-9 805.00 through 805.18: Cervical fracture without cord injuryICD-9 806.00 through 806.19: Cervical fracture with cord injuryICD-9 952.00 through 952.09: Cord injury without cervical fracture