Difference between revisions of "Blunt neck trauma"

(See Also)
(See Also)
Line 29: Line 29:
 
*[[Unstable spine fractures‎]]
 
*[[Unstable spine fractures‎]]
 
*[[C-Spine (Canadian Rule)]]
 
*[[C-Spine (Canadian Rule)]]
*[[Vertebral fractures]]
 
  
 
==Source==
 
==Source==

Revision as of 08:20, 27 January 2015

Background

Three column concept of spinal fracture stability
  • Suspect vascular damage to cord if discrepancy between neuro deficit and level of spinal column injury
  • Cord injury is more likely if anterior (vertebral bodies) AND posterior (spinal canal) columns are disrupted

Differential Diagnosis

Cervical Spine Fracture and Dislocation Types

Vertebral and Carotid Artery Dissection

Workup

X-rays Necessary?

NEXUS Cervical Spine Rule

Radiography is not necessary if the patient satisfies ALL of the following low risk criteria:

  • No midline cervical tenderness
  • No focal neuro deficits
  • Normal alertness
  • No intoxication
  • No painful distracting injury

C-spine imaging should be considered unless the patient meets all of the above low risk criteria[1] [2]

X-rays Positive

  • If find injury consider CT C-spine, x-ray rest of spine

Management

See Also

Source

  • National Spinal Cord Injury Statistical Center (NSCISC). Spinal Cord Injury. Facts and Figures at a Glance. Birmingham, Ala: NSCISC; July 1996
  • Ivy ME, Cohn SM. Addressing the myths of cervical spine injury management. Am J Emerg Med. Oct 1997;15(6):591-5
  • Woodring JH, Lee C, Duncan V. Transverse process fractures of the cervical vertebrae: are they insignificant? J Trauma. June 1993; 34(6):797-802.
  • Tintinalli's
  • 27. Hoffman JR, et al. Low-risk criteria for cervical-spine radiography in blunt trauma: a prospective study. Ann Emerg Med 1992;21:1454-60.
  • Mahadevan, et al. Interrater reliability of cervical spine injury criteria inpatients with blunt trauma. Ann Emerg Med1998;31:197-201