Cervical Spine Injury
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Introduction
The Case of...
a simple case introducing clincial presentation and calling for a differential diagnosis to get students thinking.
Causes and Risk Factors
Pathophysiology
Types of Fractures
Jefferson: burst C1
Hangman's: C2
dens #: falls (three types)
compression #: usually stable
flexion teardrop #:
burst #: axial load, usually C4-C6
facet dislocation:
clay shoveller's: C7 spinous process
Signs and Symptoms
- history
- physical exam
History
Physical Exam
Investigations
Radiography
Canadian C-spine rule
not applicable if:
- non-trauma
- GCS<15
- unstable vitals
- age <16 years
- acute paralysis
- known vertebral disease
- previous C-spine injury
High-risk?
- age >65 years
- dangerous mechanism
- paresthesias in extremities
Low-risk factor which allows safe assessment of range of motion?
- simple rear-end MVC
- sitting position in emergency department
- ambulatory at any time
- delayed onset of neck pain
- absence of C-spine midline tenderness
Able to actively rotate neck, 45o right and left?
- lab investigations
- diagnostic imaging
Lab Investigations
Diagnostic Imaging
Differential Diagnosis
Treatments
Consequences and Course
Resources and References
Topic Development
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