Cervical Spine Trauma

Cervical Spine Trauma

Epidemiology

50,000 new spinal injuries annually

Half are located in the cervical spine

11,000 will result in spinal cord injury

Average patient is a male in his 30’s

Mechanism of Injury

MVA (40%-56%)

Falls (20%-30%)

Violence (12%-21%)

Sports (6%-13%)

Other

Initial Management

Evaluation

Resuscitation

Immobilization

Extrication

Transport

Cervica Spine Trauma

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Hospital Management

Neurogenic shock

Spinal shock

Autonomic dysreflexia

Pharmacologic therapy

High-dose methylprednisolone

NASCIS 3

Spinal Cord Injury

Central cord syndrome

Anterior cord syndrome

Posterior cord syndrome

Brown-Sequard syndrome

Upper Cervical Spine Injuries

Occipital Condyle Fractures

Atlanto-Occipital Dislocations

Atlas Fractures

C1-C2 Subluxation

Axis Fractures

Occipital Condyle Fractures

Type I Impacted comminuted fracture

Type II Basilar skull fracture

Type III Displaced avulsion fracture

Atlanto-Occipital Dislocations

Type I Longitudinal distraction without dislocation

Type II Anterior dislocation of occiput on C1

Type III Posterior dislocation of occiput on C1

Atlas Fractures

Rarely associated with neuro deficits unless associated with dens Fxs

Associated with cranial nerve / vertebral artery injuries

Look at open-mouth view to determine lateral mass offset

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Lecture by

William Sukovich, MD

Surface Warfare Medicine Institute

2006 Surface Warfare Medical Officer Indoctrination Course
Naval Operational Medicine Institute
340 Huise Road
Pensacola FL 32508-1092

Cervica Spine Trauma

15 MB ppt File

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