4: Vertebral Trauma

Question 1

Example of primary spinal cord injuries:

Answer 1

compression, contusion/concussion, laceration, traction

Question 2

Examples of secondary spinal cord injuries:

Answer 2

Ischemia, neuroinflammatory, excitotoxicity, edema

Question 3

Normal forces acting on the axial skeleton:

Answer 3

Bending, torsional, shear, axial loading (tension/compression)

Question 4

What structure is responsible for resisting bending and axial loading:

Answer 4

vertebral body

Question 5

What structure is responsible for resisting all forces acting on the axial skeleton:

Answer 5

articular facets

Question 6

What structure is the most important stabilizer against lateral bending and torsion:

Answer 6

IVD

Question 7

Where do spinal injuries tend to cluster?

Answer 7

stress riser regions

Question 8

Locations of common spinal injuries:

Answer 8

Craniocervival junction
Cervicothoracic junction
Thoracolumbar junction
Lumbosacral junction

Question 9

goal of examining a spinal pt:

Answer 9

Don’t make it worse

Question 10

Prognosis for T3-L3 and L4-S2 with intact pain perception and conservative management:

Answer 10

~60% will have good prognosis

Question 11

Prognosis for T3-L3 and L4-S2 with intact pain perception and surgical management:

Answer 11

75-80% will have good prognosis

Question 12

What is the major consideration for cervical trauma prognosis?

Answer 12

do they survive the acute injury

Question 13

Prognosis of cervical trauma (if they survive initial injury):

Answer 13

60-70% will have a good prognosis

Question 14

Prognosis for spinal injury without deep pain perception:

Answer 14

Grave/Hopeless
Rec Euthanasia

Question 15

Prognosis for IVDD due to trauma:

Answer 15

close to zero

Question 16

Three compartment model of injury rating:

Answer 16

Dorsal, middle, ventral
Disruption of 2/3 of the compartments = unstable

Question 17

Treatment for stable spinal injuries:

Answer 17

conservative rx
cage rest (6 weeks) and analgesics

Question 18

Treatment for unstable spinal injury:

Answer 18

surgical or conservative (depends on severity)

Question 19

Indications for conservative management of spinal trauma in unstable injuries:

Answer 19

Majority of cervical fractures (sx has high mortality)
Cd Lumbar or LS fractures with minimal neuro deficits
No significant concurrent injuries
Client constraints

Question 20

Indications for surgical therapy:

Answer 20

Generally indicated with unstable injury and mod-severe neuro signs

Question 21

Goals of surgical treatment of spinal trauma:

Answer 21

Reduction of malalignment
Achievement of rigid fixation
+/- spinal cord decompression

Question 22

Clinical signs of sacrocaudal luxations:

Answer 22

Plantigrade stance with paraparesis (transient)
weak/paralyzed flaccid tail
diminished/absent perineal reflex, anal tone, tail pain perception
Urinary/fecal incontinence

Question 23

Prognosis for sacrocaudal luxations with intact pain sensation:

Answer 23

75-100% will have urinary functions return and 90% will have tail function return

Question 24

Prognosis for sacrocaudal luxations with absent pain sensation:

Answer 24

50-60% of cats will have urinary function return
15% will have tail function return

Question 25

Poor prognostic indicator for sacrocaudal luxations:

Answer 25

absence of perineal or tail sensation for >30 days after injury

Question 26

Location of tail pull injuries:

Answer 26

S1-S3 segments and cauda equina