Difference between revisions of "Blunt neck trauma"

(See Also)
(Workup)
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==Workup==
 
==Workup==
===X-rays Necessary?===
+
===Fracture===
 
{{C-spine NEXUS}}
 
{{C-spine NEXUS}}
  
===X-rays Positive===
+
^If find injury consider CT C-spine, x-ray rest of spine
*If find injury consider CT C-spine, x-ray rest of spine
+
 
 +
===[[Spinal cord trauma]]===
 +
*Neuro exam
 +
 
 +
===Arterial injury===
 +
*[[Denver Screening Criteria]]
  
 
==Management==
 
==Management==

Revision as of 08:42, 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

Spinal cord trauma

Vertebral and Carotid Artery Dissection

Workup

Fracture

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]

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

Spinal cord trauma

  • Neuro exam

Arterial injury

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