spinal injury Flashcards
where are most of the injuries
at the junctions of the spinal cord: LS, CC< CT, TL
you have stabilized a neuro patient. what do you want to do now
assess deep pain perception.
motor=deep pain positive
which location has the best prognosis without surgery
cervical
if you have a MFS grade 5 what is the prognosis
zero. grave prognosis
once localized, what pain medication class do we reach for
full mu agonists– fentanyl, oxy, morphine, hydro
after rads you identify a stable fracture. what is the plan moving forward
cage rest for 6 weeks and analgesics.
you have an unstable fracture identified on radiographs, what indicators would make you think that you can treat this conservatively
controllable pain, unstable fracture but not a surgical candidate, good motor function, cervical fracture, financial limitations, intact deep pain perception
what is the plan for unstable fractures external coaptation
rigidly immobilize high motion areas above and below the lesion. do NOT reduce the fracure. recheck weekly. repeat rads in 4 weeks
where is a tail pull injury
traction to S1-S3
treatment plan for tail pull
cage rest, analgesics, +- bladder management (catheter) +- tail amp
what is the prognosis of a tail pull with perianal sensation present
75% will recover bladder tone
90% regain tail function
tail pull prognosis with no perianal sensation
50-60% regain bladder tone and 15% regain tail function- tail amp
flaccid tail, plantigrade stance, deminished perianal tone, urinary incontinence
tail pull injury
what is our biggest prognostic indicator in spinal trauma
deep pain perception
what is the goals of surgical management of spinal injuries
rigid fixation realign and decompress spinal cord
