Spinal Cord Injury Flashcards
What is NEXUS?
the National Emergency X-Radiography Utilization Study
criteria recommends cervical spine radiography in all patients with traumat unless they meet all of a specific set of criteria
What are the criteria for NEXUS?
no posterior midline cervical spine tenderness
no evidence of intoxication
normal level of alertness
no focal neurologic deficits
no painful distracting injuries
99% sensitive but not very specific
will get lots of imaging studies that aren’t needed, but won’t miss many injuries
NEXUS
level of spinal cord injury if:
loss of spontaneous breathing
C4
level of spinal cord injury if:
loss of shoulder shrug
C5
level of spinal cord injury if:
loss of flexion at elbow/biceps reflex
C6
level of spinal cord injury if:
loss of extension at elbow/triceps reflex
C7
level of spinal cord injury if:
loss of flexion at fingers
C8/T1
level of spinal cord injury if:
loss of intercostal muscle & abdominal muscle use
T1/T2
What is superior to plain film?
CT
When should we used plain films?
for “low risk” patients
70% of detectable abnormalities will be visible on which view?
lateral view
C1
extremely unstable
axial loading (diving)
Jefferson fracture
C2
more than 1/2 of all C2 fractures
extremely unstable
odontoid fracture
C2
falls, MVCs
forced hyperextension of the neck
unstable but opens spinal canal
Hangman’s fracture
