Cervical Spine CPRs

Question 1

cervical myelopathy (3/5)

Answer 1

• age > 45
• babinski
• inverted supinator sign
• hoffman’s
• gait deviation

Question 2

cervical fracture

Answer 2

1. there are high-risk factors
2. it is safe to assess ROM but < 45 degrees

high-risk factors:

• age > 65 degrees
• dangerous MOI
• paresthesia in the extremities

low risk factors that allow safe assessment of ROM:

• simple rear-end MVA
• normal sitting posture in ED
• ambulatory at any time since injury
• delayed onset of neck pain and absence of midline tenderness

dangerous MOI:

• fall from > 1 m or 5 stairs
• axial load to head (eg diving)
• high speed MVA (>100 km/h), rollover, ejection
• motorized recreational vehicles
• bicycle collision

Question 3

cervical manipulation (3/4)

Answer 3

1. expectation that cervical manipulation will help
2. symptoms < 38 days
3. difference in cervical rotation > 10 degrees between sides
4. pain with P-A’s

Question 4

thoracic manipulation (4/6)

Answer 4

1. symptoms < 30 days
2. no symptoms distal to shoulder
3. no aggravation of symptoms when looking up
4. FABQ-PA < 12
5. decreased thoracic kyphosis
6. cervical extension ROM < 30 degrees

Question 5

traction criteria

Answer 5

1. age > 55
2. positive passive shoulder abduction test
3. positive ULTT-A
4. symptom peripheralization with central P-A motion (C4-C7)
5. positive neck distraction test