Spine trauma - Neurosurgery(NS)

Question 1

what is central cord syndrome

Answer 1

lesion involving the central fibers of the spinal cord with weakness involving the upper limb more than the lower limb.

Question 2

what is Anterior cord syndrome

Answer 2

cord infarction in the territory supplied by the anterior spinal artery with motor weakness below the level and lost pain and temperature and preserved deep sensation.

Question 3

what is Brown-Sequard syndrome

Answer 3

spinal cord hemisection with ipsilateral motor weakness, lost deep sensation and, contralateral loss of pain and temperature and crude touch

Question 4

what is Posterior cord syndrome

Answer 4

relatively rare, pain and paresthesia in the neck, upper arm and torso.

Question 5

What is spinal shock

Answer 5

1. Hypotension, caused by multiple factors:
   a. Interruption of sympathetic
   b. Loss of muscle tone.
   c. Blood loss
2. Transient loss of all neurologic functions.

Question 6

Mechanisms of spine injury

Answer 6

1. Flexion injury: the commonest type of injury
2. Flexion-rotation injury: the worst type of injury
3. Vertical compression injury
4. Extension injury
5. Flexion-distraction injury
6. Direct injury
7. Indirect injury due to violent muscle contraction

Question 7

Management of Spinal injury

Answer 7

1. Full history taking: detailed history including age – chronic disease – medications – blood thinners – the circumstances in which the accident occurred (this is very important in predicting the mechanism of injury)
   Symptoms:
2. Pain and tenderness with limitation of movement at the site of spinal fracture.
3. the patient may complain of various combination of motor, sensory or autonomic manifestations depending on the level of injury:
4. Deformity: e.g. kyphosis
5. Clinical assessment of the patient: important in determining the level of injury and spinal stability. Various systems for clinical assessment are present, one of the most famous is the ASIA scoring system.