4: Vertebral Trauma Flashcards
Example of primary spinal cord injuries:
compression, contusion/concussion, laceration, traction
Examples of secondary spinal cord injuries:
Ischemia, neuroinflammatory, excitotoxicity, edema
Normal forces acting on the axial skeleton:
Bending, torsional, shear, axial loading (tension/compression)
What structure is responsible for resisting bending and axial loading:
vertebral body
What structure is responsible for resisting all forces acting on the axial skeleton:
articular facets
What structure is the most important stabilizer against lateral bending and torsion:
IVD
Where do spinal injuries tend to cluster?
stress riser regions
Locations of common spinal injuries:
Craniocervival junction
Cervicothoracic junction
Thoracolumbar junction
Lumbosacral junction
goal of examining a spinal pt:
Don’t make it worse
Prognosis for T3-L3 and L4-S2 with intact pain perception and conservative management:
~60% will have good prognosis
Prognosis for T3-L3 and L4-S2 with intact pain perception and surgical management:
75-80% will have good prognosis
What is the major consideration for cervical trauma prognosis?
do they survive the acute injury
Prognosis of cervical trauma (if they survive initial injury):
60-70% will have a good prognosis
Prognosis for spinal injury without deep pain perception:
Grave/Hopeless
Rec Euthanasia
Prognosis for IVDD due to trauma:
close to zero
Three compartment model of injury rating:
Dorsal, middle, ventral
Disruption of 2/3 of the compartments = unstable
Treatment for stable spinal injuries:
conservative rx
cage rest (6 weeks) and analgesics
Treatment for unstable spinal injury:
surgical or conservative (depends on severity)
Indications for conservative management of spinal trauma in unstable injuries:
Majority of cervical fractures (sx has high mortality)
Cd Lumbar or LS fractures with minimal neuro deficits
No significant concurrent injuries
Client constraints
Indications for surgical therapy:
Generally indicated with unstable injury and mod-severe neuro signs
Goals of surgical treatment of spinal trauma:
Reduction of malalignment
Achievement of rigid fixation
+/- spinal cord decompression
Clinical signs of sacrocaudal luxations:
Plantigrade stance with paraparesis (transient)
weak/paralyzed flaccid tail
diminished/absent perineal reflex, anal tone, tail pain perception
Urinary/fecal incontinence
Prognosis for sacrocaudal luxations with intact pain sensation:
75-100% will have urinary functions return and 90% will have tail function return
Prognosis for sacrocaudal luxations with absent pain sensation:
50-60% of cats will have urinary function return
15% will have tail function return
