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| ==Background==
| | #REDIRECT[[Spinal cord injury]] |
| *Surgical intervention indicated for:
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| **Progressive neurologic deficits
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| **Spinal instability
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| *Penetrating injury
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| **GSW
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| ***Most are stable injuries and only require supportive orthosis, analgesia
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| ***Give Abx if GSW traversed the abdomen before injuring the cord
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| ***Bullet removal does not improve neuro status for stable cervical and thoracic lesions
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| ***Bullet removal may improve neuro status for thoracolumbar region injury (T11-L2)
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| **Stabbing
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| ***Vertebral instability is generally not an issue
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| ***Delayed deficits are rare
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| ****If do occur related to retained fragment of blade within spinal canal
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| ===Peds===
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| *In pts <10yr spinal injury occurs mainly in upper cervical vertebrae
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| *In pts >10yr majority of injuries occur in lower cervical spine, similar to adults
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| *Odontoid fractures are among most common cervical spine injuries in children
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| **Do not confuse w/ normal anatomic variations in odontoid seen in children up to 7yr old
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| *SCIWORA
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| **Spinal cord injury without radiologic abnormality
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| **MRI has shown significant pathology in many of these pts
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| **Symptoms
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| ***Delayed onset (w/in 48hr) of numbness, paresthesias in extremities
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| *Transient quadriparesis ("stinger")
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| **Occurs most often in boys after sports injuries
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| **Paresthesias or weakness of extremities lasting from seconds to minutes
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| ***Complete recovery w/in 48hr
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| ==Diagnosis==
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| See
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| *[[Spinal Cord Syndromes]]
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| *[[C-spine (NEXUS)]]
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| ==Management==
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| *Consider intubation for pt w/ injury at C5 or above
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| *Steroids are no longer recommended
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| *Complete lesion means absence of sensory and motor function below level of injury
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| **May be confused w/ spinal shock
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| ==See Also==
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| *[[Neurogenic Shock]]
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| *[[Cord Compression]]
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| *[[C-spine (NEXUS)]]
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| ==Source==
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| *Tintinalli's
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| [[Category:Neuro]]
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| [[Category:Trauma]]
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