Spine Flashcards
Cervical spine fractures usually occur following what type of injury?
High energy, often involving significant head trauma
What are the majority of thoracolumbar spine injuries due to?
Falls from height or RTAs
What type of fractures can occur in the spine of older people?
Osteoporotic ‘wedge’ fractures
How are osteoporotic wedge fractures treated?
Symptomatic treatment only since they are relatively stable
Younger patients with high energy injuries tend to have what type of spinal fractures?
Burst fractures
What are chance fractures?
Flexion distraction fractures which involve the posterior ligaments and therefore may be unstable and may require surgery
How are stable fractures of the thoracic spine treated?
Bracing
What are some indications for surgery for spinal fractures?
Neurological defect or highly unstable fractures
What is spinal shock?
A physiological response to injury where there is complete loss of sensory and motor function below the level of the injury
When does spinal shock usually resolve?
24 hours
The presence of spinal shock is identified with what?
Bulbocavernous reflex
What is neurogenic shock?
Temporary shutdown of the sympathetic outflow from T1-L2
With injuries where in the spine does neurogenic shock usually occur?
Cervical or upper thoracic
What does neurogenic shock lead to? When will it resolve?
Hypotension and bradycardia, resolves in 24-48 hours
What may occur in neurogenic shock due to unopposed parasympathetic innervation?
Priapism (prolonged erection)
How is neurogenic shock treated?
IV fluid therapy
Which type of shock is very common in trauma and is more likely to be the cause than neurogenic or spinal shock?
Hypovolaemic shock
What determines a complete spinal cord injury?
No sensory or voluntary motor function below the level of the injury (reflexes should still be intact)
How can you determine the level of injury in a complete spinal cord injury?
The most distal spinal level with partial function
What determines an incomplete spinal cord injury?
Some neurological function (sensory and, or motor) below the level of the injury
What is the prognosis for recovery from complete spinal cord injuries?
Poor
In spinal cord injuries, the sparing of which area implies a good prognosis?
Sacrum
What is the most common pattern of incomplete spinal cord injuries?
Central
What type of injury usually causes a central incomplete spinal cord injury?
Hyperextension injury in a cervical spine with OA
What function is lost in an anterior incomplete spinal cord injury?
Motor function and coarse touch, pain and temperature sensation
What type of injuries tend to cause incomplete Brown-Sequard spinal cord injuries?
Penetrating injuries
What type of neurological loss occurs in Brown-Sequard syndrome?
Motor loss on one side of the body and loss of pain/temperature and light touch on the other side of the body
What x-ray views are required for a C-spine fracture?
AP, lateral, odontoid peg
