Spinal Fractures and Cord Injuries

Question 1

C- spine injuries investigations

Answer 1

X-ray
- AP, lateral, odontoid peg open mouth view

CT scan

Question 2

C-spine injuries consequences

Answer 2

Can be fatal if above C3

Question 3

C-spine injuries treatment

Answer 3

Stable C-spine injuries
- Firm cervical collar

Unstable. C-spine injuries
- Halovest

Question 4

Insufficiency Wedge fractures epidemiology

Answer 4

Elderly

- With osteoporosis

Question 5

Chance Fractures aetiology

Answer 5

High energy flexion-distraction injury occurring in the thoracic region

Involve failure. of the posterior ligaments in the spine

Question 6

Chance fractures: indications for surgery in thoracolumbar spine

Answer 6

Neurological deficit

Unstable injury

Question 7

Chance Fractures: Surgery Options

Answer 7

Pedicle screws and rods

Spinal fusion

Spinal decompression (if neurological deficit)

Question 8

Secondary damage to spinal cord aetiology

Answer 8

Vascular disruption
Hypotension
Hypoxia
Inflammatory response

Question 9

Spinal shock

Answer 9

Sensation, motor function and reflexes are lost below level of injury

Usually resolves after 24 hours

Bulbocavernous reflex is lost (contraction of anal sphincter)

Question 10

Treatment of neurogenic shock

Answer 10

IV fluid therapy

Question 11

Complete Spinal Cord Injury

Answer 11

No sensory or motor function remains below injury level

Question 12

Incomplete Spinal Cord Injury

Answer 12

Some neurological function remains below the level of trauma

If there is loss of motor function from T1-T12 then ventilatory support may be needed for patient to survive

Question 13

Central Cord Syndrome

Answer 13

Commonest injury pattern of the spine

Question 14

Central Cord Syndrome Aetiology

Answer 14

Hyperextension injury in cervical spine

OA in spine

Question 15

Central Cord Syndrome signs

Answer 15

Paralysed arms

- Corticospinal motor tracts of the upper limbs are more central in the cord

Question 16

Central Cord syndrome results in loss of…

Answer 16

Loss of

• motor function
• Coarse touch
• temperature sensation

Question 17

Central cord syndrome functions preserved

Answer 17

Proprioception
Vibration sense
Light touch

Question 18

Posterior Cord Syndrome

Answer 18

Rare

Question 19

Posterior cord syndrome results in loss of…

Answer 19

Loss of

• dorsal column function
• proprioception
• Vibration sense
• Light touch

Question 20

Brown-Sequard Syndrome

Answer 20

Damage to one half of spinal cord

Question 21

Brown-Sequard Syndrome Aetiology

Answer 21

hemisection of the spinal cord from a penetrating injury

Question 22

Brown-Sequard Syndrome consequences

Answer 22

paralysis of ipsilateral side of spinal cord

Question 23

Brown Sequared Syndrome results in loss of…

Answer 23

Dorsal column function

Contralateral sense of pain, coarse touch and temperature sensation
(nerve fibres of spinothalmic tracts cross to the contralateral side 1-2 levels above their entry to the cord.