Spinal Cord Injury Flashcards
Which area of the spine is most commonly affected in an acute spinal cord injury?
Cervical vertebrae
What are the causes of a spinal cord injury?
- Trauma (acute)
- Intervertebral disc disease
- Tumours
- Abscess
- Haematoma
- Pathological osteoporotic fractures
What can happen in complete spinal cord transection?
Neurogenic shock (impaired sympathetic pathways), quadriplegia, respiratory insufficiency, loss of bladder/bowel function.
What is the difference between a complete and incomplete spinal cord injury?
- Complete - no preservation of motor and/or sensory function more than 3 segments below level of injury.
- Incomplete - residual motor/sensory function more than 3 segments below level of injury.
What is the classification system used in spinal cord injury?
American Spinal Injury Association (ASIA) classification
How is a spinal cord injury investigated?
- MRI
2. Investigate cancer, infection, bony degeneration, trauma.
What is the acute management of a spinal cord injury?
- ABCDE
- Immobilise with cervical collar and backboard
- Image and refer to neurosurgery for rapid decompression
What is the second stage of management in a spinal cord injury?
- VTE prophylaxis
- High dose methylprednisolone within 8 hours of injury
- Treatment of neurogenic shock with central line and vasopressors
- PPIs for 4 weeks following injury
- Consider NG tube to prevent vomiting
- Catheterise, pressure sore prevention
How should you manage an epidural abscess causing a spinal cord injury?
- Stabilise spine
- Sample abscess (staphylococcus commonly)
- Empirical antibiotics for 12 weeks
- Identify source - dental x-ray, cardiac echo, blood and urine cultures.
How should you manage a malignancy spinal cord compression?
- Corticosteroids provide relief from pain
2. Combined radiotherapy and spinal decompression
What are the most common primary cause of a malignancy spinal cord compression?
BLT-P-K and myeloma
