Clearing the cervical spine of paediatric trauma patients

Acute cervical facet fractures are increasingly being detected due to the use of cervical spine CT imaging in the initial assessment of trauma patients. For displaced cervical facet fractures with dislocations and subluxations, early surgery can decompress the spinal cord and stabilize the spine. For patients with non-displaced cervical facet fractures, the challenge in managing these patients is the determination of spinal stability. Although many of the patients with non-displaced cervical facet fractures can be managed with a cervical collar, the imaging needs to be analyzed carefully since certain fracture patterns may be better managed with early surgical stabilization.

Download Full-text

Faculty Opinions recommendation of Plain radiography does not add any clinically significant advantage to multidetector row computed tomography in diagnosing cervical spine injuries in blunt trauma patients.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1157915.617976 ◽

2009 ◽

Author(s):

Elfyn Thomas

Keyword(s):

Computed Tomography ◽

Cervical Spine ◽

Blunt Trauma ◽

Plain Radiography ◽

Multidetector Row Computed Tomography ◽

Trauma Patients ◽

Cervical Spine Injuries ◽

Multidetector Row ◽

Spine Injuries ◽

Clinically Significant

Download Full-text

Outcome of Cervical Spine Trauma Patients Admitted to the Intensive Care Unit at a Tertiary Government Referral Trauma Center in Nepal

Global Spine Journal ◽

10.1177/2192568220980703 ◽

2021 ◽

pp. 219256822098070

Author(s):

Gyanendra Shah ◽

Gaurav Raj Dhakal ◽

Anil Gupta ◽

Pawan Kumar Hamal ◽

Siddhartha Dhungana ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Cervical Spine ◽

Cervical Spinal Cord ◽

Limited Resource ◽

Trauma Patients ◽

Cervical Spine Injuries ◽

Resource Setting ◽

Cord Injury ◽

Huge Impact

Study Design: Retrospective study. Objectives: Cervical spinal cord injury (SCI) is a devastating event for patient and family. It has a huge impact on society because of intensive resources required to manage the patient in both acute and rehabilitation phases. With the limited resource setting in underdeveloped countries like Nepal, questions are often raised regarding whether the outcome justifies the expenses of their care. The objective was to assess the outcomes of cervical SCI patients admitted to intensive care unit (ICU). Methods: All cervical SCI admitted in ICU during May 2017 to August 2018 were included in this study. Demographic details, mode, morphology, and neurological level of injury, intervention performed and outcomes of ICU stay were analyzed. Results: Out of 48 patients, 36 (75%) were male and 12 female with mean age 43.9 ± 15.9 years. Fall injury was the commonest mode of injury (83.3%). Most patients presented within 1 to 3 days of injury and C5-C6 (33.3%) was the most common involved level and 75% presented with ASIA A neurology. Mechanical ventilation was required in 95.8% of the patients and 22 patients were operated upon. The average stay in ICU was 15 days and 13 patients died in the ICU. Conclusions: Majority of cervical SCI with complete motor paraplegia required ICU care. Inspite of the intensive care, a subset of these patients succumbed to the complications of the injury. Therefore, it is essential to establish trauma ICU care with specific protocols on managing cervical spine injuries.

Download Full-text