Clearing the Spine in the Unconscious Trauma Patient: An Update

Scott, Timothy; Coates, P.; Davies, Siân

doi:10.1177/175114371201300312

Cited by 3 publications

(3 citation statements)

References 32 publications

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“…In the very few patients in whom the recurrent injury led to severe, permanent neurological deficit, the possibility of an alternative diagnosis, such as acute transverse myelitis, was often considered but never excluded. 3,6,7 An alternative explanation for the phenomenon of recurrent or delayed presentation, SCIWORA is the well understood progressive nature of spinal cord injuries. Several inflammatory mediators such as arachidonic acid and glutamate cause progressive lipid peroxidation and cell membrane destruction in the injured spinal cord, gradually causing expansion of the zone of injury.…”

Section: Occult Instability and The Need For Immobilisationmentioning

confidence: 99%

“…Rigid collars also interfere with nursing, feeding, oral care, central venous catheterisation and patient positioning in the severely injured child. 6 The purpose of this study is to determine whether there was any evidence of injury to the paraspinal soft tissues on MRI in patients diagnosed with SCIWORA at our institution. We aim to provide objective evidence to support clinical practice, be it rigid immobilisation or not.…”

Section: Introductionmentioning

confidence: 99%

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Ligamentous integrity in Spinal Cord Injury without Radiographic Abnormality (SCIWORA): a case series

et al. 2017

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Purpose of study: Prolonged bracing following injury in patients with Spinal Cord Injury without Radiographic Abnormality (SCIWORA) remains controversial. Some authors claim that there is occult instability and a risk of recurrent injury whereas others propose that the spinal column will deform elastically, but will return to its baseline stability by elastic recoil. We aim to assess the presence of ligamentous injury on MRI and the incidence of recurrent instability following SCIWORA in order to determine the need for prolonged bracing.Methods: A retrospective chart review was performed for a series of 12 patients with documented SCIWORA that presented to Red Cross Children's Hospital over the past 8 years. Details regarding mode of injury, age at presentation, neurological deficit at presentation, MRI findings and long-term prognosis were documented.Results: There were nine males and three females. The median age was 4.35 years. All patients were victims of high energy motor vehicle accidents. In two patients there was disruption of the ligamentum flavum at the level of the injury. There were no episodes of recurrent instability or neurological compromise in those patients that had recovered. None of our patients had rigid bracing following the diagnosis of SCIWORA. Conclusion:Infrequently observed disruption of isolated stabilising structures in SCIWORA did not lead to early or delayed instability in our patients. We did not find evidence to support the practice of prolonged rigid bracing to prevent recurrence following SCIWORA. Level of evidence: Prognostic case study, level IVKey words: SCIWORA, paediatric spinal cord injury, MRI findings in SCIWORA, bracing in SCIWORA, paediatric trauma http://dx

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Section: Occult Instability and The Need For Immobilisationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ligamentous integrity in Spinal Cord Injury without Radiographic Abnormality (SCIWORA): a case series

et al. 2017

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“…Indeed, detailed guidance exists for the choice of appropriate imaging when screening the obtunded blunt trauma patient for cervical spine injury. 58,59…”

Section: Cervical Spine Protectionmentioning

confidence: 99%

Injury after non-judicial hanging

Chikhani

Winter

2014

Trauma

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Hanging is an important and increasingly common method of suicide in developed countries. Little is known about the true human pathophysiological changes and injury patterns associated with hanging and near hanging. Cervical spine injury is commonly reported; however, there is a paucity of large data sets concerning this injury. This review article focuses on the incidence of cervical spine and associated neck injuries and their role in morbidity and mortality following non-judicial hanging. A total of 26 heterogeneous studies were identified examining injury after hanging or near hanging. In total, there were 2795 patients; 1530 (54.7%) with true hanging and 1265 (45.3%) with near hanging. Cervical spine injury was reported in a total of 58 (2.08%) patients. Injuries to the airway and vessels of the neck seem rare. This is somewhat lower than the current accepted incidence for cervical spine injury after hanging or blunt force trauma. The overall incidence of cervical spine injury after hanging is low. Spinal immobilisation should probably be instituted depending on the mechanism of the hanging. However, a patient presenting with signs of life to an emergency department is unlikely to have a severe cervical spine injury.

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Prehospital Damage Control Resuscitation

Scott

Stuke²

2018

Damage Control in Trauma Care

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Clearing the Spine in the Unconscious Trauma Patient: An Update

Cited by 3 publications

References 32 publications

Ligamentous integrity in Spinal Cord Injury without Radiographic Abnormality (SCIWORA): a case series

Ligamentous integrity in Spinal Cord Injury without Radiographic Abnormality (SCIWORA): a case series

Injury after non-judicial hanging

Prehospital Damage Control Resuscitation

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