The neck
Ashley W. Blom, David Warwick, Michael R. Whitehouse in Apley and Solomon’s System of Orthopaedics and Trauma, 2017
This is the mainstay of treatment. Analgesics and anti-inflammatory medication can be prescribed to control acute and exacerbating pain. Heat and massage are often soothing and restricting neck movements with a collar is an effective treatment during acute pain. Physiotherpay is a very important part of the treatment strategy, which includes exercises to optimize the range of motion and muscular control. Gentle passive manipulation and intermittent traction can be useful. Prolonged use of a cervical collar or brace may be detrimental.
Early Management of Adult Head Injury
Kajal Jain, Nidhi Bhatia in Acute Trauma Care in Developing Countries, 2023
Every HI patient should be presumed to have a cervical spine injury until proven otherwise. This is specifically for those in comatose state or under alcohol influence/drug intoxication. Therefore, a cervical collar has to be applied until the time a spine injury is ruled out by clinical examination and imaging. While securing the airway, perform manual in-line stabilization and avoid excessive spinal movements (hyperextension/hyperflexion).
Nutrition and surgical recovery
Michael Y. Wang, Andrea L. Strayer, Odette A. Harris, Cathy M. Rosenberg, Praveen V. Mummaneni in Handbook of Neurosurgery, Neurology, and Spinal Medicine for Nurses and Advanced Practice Health Professionals, 2017
Can the patient remove a cervical collar to eat? The answer is “no,” unless cleared with the neurosurgeon. Some minor cervical procedures use a cervical collar for comfort only, but in the case of cervical fractures and some fusions, the surgeon may want the collar on at all times.
Dysphagia following C1 laminectomy and posterior atlantoaxial fixation for retro-odontoid pseudotumor: a case report
Published in British Journal of Neurosurgery, 2020
Satoru Tanioka, Keita Kuraishi, Masaki Mizuno, Fujimaro Ishida, Ikuko Fuse, Ken Umehara, Hidenori Suzuki
A 79-year-old man with a medical history of hypertension and hyperuricemia was admitted to our hospital because of progressive tetraparesis. On admission, the patient exhibited moderate paresthesia and paresis of upper limbs, and mild paresthesia and paresis of lower limbs, inability to walk unaided and bladder and bowel dysfunction. He was able to eat minced food with help without aspiration. Sagittal T2-weighted spine magnetic resonance imaging (MRI) revealed a mass posterior to the odontoid process and a high signal intense legion in the spinal cord at C1 level (Figure 1). Considering that there was no evidence of inflammatory diseases, we made the diagnosis of non-inflammatory retro-odontoid pseudotumor. A Philadelphia cervical collar was used to limit neck motion and to prevent additional cervical cord injury. The patient underwent C1 laminectomy and atlantoaxial fixation consisting of insertion of poly-axial screws (Medtronic, Memphis, TN, USA) into the lateral masses of C1 (4.0 × 36 mm) and the pedicles of C2 (4.0 × 22 mm). Computed tomography on postoperative day (POD) 1 revealed that the differences in the O-C2 angle and the C2-C7 angle were 1° and –12°, respectively, compared with the preoperative status (Figure 2). Although the presenting neurology gradually improved postoperatively, dysphagia and aspiration developed on POD 2. T2-weighted
Cervical Spine Motion During Vehicle Extrication of Healthy Volunteers
Published in Prehospital Emergency Care, 2020
Alberto Gabrieli, Francesca Nardello, Michele Geronazzo, Pierpaolo Marchetti, Alessandro Liberto, Daniele Arcozzi, Enrico Polati, Paola Cesari, Paola Zamparo
Data reported in this study indicate that the positioning of a rigid cervical collar reduces the (flexion-extension) ROM of the cervical spine during exit but the use of an extrication device in addition to the cervical collar implies an increase, rather than a further decrease, in ROM during both the maneuver and the exit. Lower values of speed and acceleration were observed in CC compared to CC + XT and the lowest EMG activity was observed during the positioning of the devices (both cervical collar and XT) and during the exit with the extrication device. The use of the extrication device thus implies the lowest degree of active control (lowest RMS values) in combination with the highest values of peak angular acceleration during exit. Based on these data, the extrication of an awake and cooperative subject from a vehicle with the sole application of a rigid cervical collar seems to be a safer method for limiting cervical spine motion in the sagittal plane. These data are in agreement with recent literature on spinal motion restriction in prehospital care which have challenged the routine use of immobilization devices in trauma patients (25, 26).
Safety and feasibility of an early telephone-supported home exercise program after anterior cervical discectomy and fusion: a case series
Published in Physiotherapy Theory and Practice, 2021
Rogelio A. Coronado, Clinton J. Devin, Jacquelyn S. Pennings, Oran S. Aaronson, Christine M. Haug, Erin E. Van Hoy, Susan W. Vanston, Kristin R. Archer
Over the 6-month period, 29 consecutive patients were screened for inclusion into the case series. Twenty-one (72.4%) patients were excluded due to exclusion criteria (n = 7), declining participation (n = 1), canceling surgery (n = 1), incomplete baseline assessment (n = 1), not responding to study invitation (n = 8), and being unavailable during their preoperative clinic visit (n = 3). Eight (27.6%) patients were eligible, consented, and enrolled. These patients were predominantly female (63%), ranged in age from 35 to 77 years, were all married, and were mostly white (88%) (Table 2). Most patients (88%) had a diagnosis of cervical spondylosis (Table 3). The surgical indication included signs and symptoms of radiculopathy, myeloradiculopathy, or myelopathy. The number of cervical levels fused ranged from 1 to 3. Standard postoperative instructions from the treating surgeons included lifting restrictions (<15 lbs. for 6 weeks), no exercise or stretching involving sudden or extreme neck motion, advice to walk daily, and no driving for 2 weeks after surgery or within 24 hours after taking opioid pain medication. Recommendations for a cervical collar varied (Table 3). Valid physical activity data were obtained from seven (88%) patients at 6 weeks and 6 months.
Related Knowledge Centers
- Clearing The Cervical Spine
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