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Neurosurgery > Spinal Cord Injuries > Flashcards

Spinal Cord Injuries Flashcards

1
Q

What percentage of spinal injuries result in quad or paraplegia?

A

10%

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2
Q

What demographic group is most commonly affected? From what activity?

A
  • Adolescent and young males

- Traffic accidents

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3
Q

What determines the type of vertebral damage and neurological damage?

A

Mechanism of injury

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4
Q

What are the most common injuries to cervical spine?

A
  • Flexion and flexion-rotation injuries
  • c5/c6
  • unstable
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5
Q

Define unstable fracture?

A

When two parts of vertebra are broken (e.g. facets dislocated and ligamentous damage)

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6
Q

What are the main characteristics of a compression injury?

A
  • loss of height of vertebral body
  • wedge or comminuted with posterior aspect encroaching upon spinal cord
  • c5/c6 most common
  • usually stable because PLL intact
  • when combined with rotation force in flexion – tear drop fx which is unstable.
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7
Q

What are main characteristics of hyperextension injury?

A
  • older age group
  • ALL injury
  • central cervical cord syndrome
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8
Q

Where do thoracolumbar flexion-rotation injuries most frequently occur?

A

T12/L1
Result in anterior dislocation of T12 onto L1.
- PLL disruption

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9
Q

Are thoracolumbar flexion-rotation injuries at t12/l1 stable or unstable?

A

Unstable, usually result in complete neurological deficit of either the spinal cord, conus or cauda equina

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10
Q

Describe thoracolumbar compression injuries?

A
  • Decreased vertebral height
  • stable
  • no neuro deficit
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11
Q

Describe thoracolumbar hyperextension injury?

A
  • very uncommon
  • rupture of ALL
  • Intervertebral disk fracture through vertebrae body anteriorly
  • unstable
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12
Q

What injury needs to be considered in patients in MVA wearing lap band?

A
  • chance fractures
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13
Q

What is a chance fracture?

A
  • hyperflexion distraction injury
  • forward flexion injury
  • two kinds injury
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14
Q

Chance fracture 1 ?

A

spinous process pedical and vertebral fracture

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15
Q

Chance fracture 2?

A

end plate fx and disruption of facet joint and ligamentous structures

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16
Q

What is spinal shock?

A

state of diminished excitability of the isolated spinal cord, duration is variable, 2/2 direct force applied to cord, ischemia, hemorrhage

17
Q

What is a complete lesion?

A
  • most severe consequence, complete transverse myelopathy all neuro fxn is lost below level
18
Q

What characteristics describe UMN lesion?

A
  • hyperreflexia
  • spasticity/increased tone
  • loss of voluntary movements
  • weakness
  • positive babinski
19
Q

What characteristics describe LMN lesion?

A
  • reduced muscular tone
  • muscle wasting
  • loss of reflexes
20
Q

Describe the affect of T5 lesion on autonomics?

A
  • Above T5, you get hypotension 2/2 interruption of sympathetic splanchnic vasomotor control
21
Q

Incomplete lesions include?

A
  • anterior cervical spinal cord sx
  • central spinal cord sx
  • brown sequard (hemisection)
  • spinal cord concussion
22
Q

Describe anterior cervical spinal cord sx?

A
  • motor paralysis below lesion, pain/temp loss
23
Q

Describe central spinal cord sx?

A
  • hyperextension of c-spine with compression of spinal cord

- severe injury to upper limbs vs lower limbs

24
Q

Describe brown sequard?

A
  • ipsilateral paralysis of limbs below lesion with loss of pain, temp, touch on opposite side of body
25
Q

Spinal cord concussion?

A
  • transient loss of fxn

- recovery within 6 to 48 hrs

26
Q

Key features in management of spinal injuries includes?

A
  • prevent further injury
  • reduction and stabilization
  • rehab
  • imaging (plane c-spines, ct, repeat flex/ext)
27
Q

Indications for surgery?

A
  • stabilize spine
  • progressive neuro deficit
  • pt’s that have partial neuro impairment, not improving and imaging shows extrinsic compression
28
Q

Name 3 types of special c-spine injuries?

A
  • jefferson fracture
  • odontoid fracture
  • hangman fracture
29
Q

Describe jefferson fracture?

A
  • bilateral fracture of posterior arch of atlas from direct vertical blow to head
30
Q

Describe odontoid fracture?

A
  • 3 types
    1 = tip of dens
    2 = base of dens
    3 = base of dens and extends into c2 vertebral body
31
Q

Describe hangman fracture?

A

avulsion of laminar arches of c2 with dislocation of the c2 vertebral body from c3.

Neurosurgery (9 decks)

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