2. Spinal Cord Injury
Epidemiology
30-40 million per year
10,000 new cases per year
Etiology
Motor vehicle accident: 44.5%
Falls: 18.1%
Violence: 16.6% (and increasing)
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4. Spinal Cord Injury
Economic Consequences
Between $7.3 billion and $8.3 billion per year
A person with a high cervical injury at age 25 incurs
lifetime costs of more than $3 million
Rehabilitation Treatment
Systematic, intensive, coordinated team approach
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5. Spinal trauma should be suspected in
All unconscious patients
High energy trauma
Evidence of neurological deficit
Multiple injuries
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7. Why do we miss Spinal Injuries !!
A low level of suspicion
Failure to take proper radiographs
Poly trauma
Failure to interpret the x ray
Intoxication
Decrease level of consciousness
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8. History
Mechanism of injury
Position of the patient when found
Transient motor or sensory loss
Paradoxical breathing
Seat belt
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9. Inspection
All clothing should be carefully removed
Any bleeding , abrasion or lacerations
Limb asymmetry
Voluntary limb movement
Chest expansion
Please document the findings..
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10. Palpation
To Remove Cervical collar carefully
1. Tenderness
2. Interspinous widening
3. Malialignement of spinous process
4. Step off
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15. CT SCAN
Injury suspected on plain films
Better visualize fracture (specificity and
sensitivity)
Unable to adequately assess on plain films
Fracture or soft tissue injury in the plane of the CT
can be missed
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16. Invaluable for assessing cord and soft tissues
R/O associated disc herniation ( facet dislocations)
Hemorrhage vs edema in soft tissues ????
Ligamentous tears and facet capsule disruptions visualized with
fat suppression
May allow prognostic assessment of final motor function
Intrasubstance hematoma
MRI SCAN
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27. To Conclude…….
Spinal injuries are serious, dangerous and have
far reaching consequences
Prevention must be the top priority
Legislation, Seat belt , Helmet
Proper Ambulanve and paramedic services
Emergency room assesment
Specialized Treatment
TEAMWORK
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