Early Management of Cervical Spine Trauma: WFNS Spine Committee Recommendations

Zılelı, Mehmet; Osorio-Fonseca, Enrique; Konovalov, Nikolay; Cardenas-Jalabe, Carlos; Kaprovoy, Stanislav; Mlyavykh, Sergey; Pogosyan, Artur L.

doi:10.14245/ns.2040282.141

Cited by 22 publications

(18 citation statements)

References 46 publications

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“…Some recent studies shorter even further the limit of 24 h from injury for surgical decompression to 12 or 8 h with encouraging results, though data come from small series of patients ( Burke et al., 2019 ; Jug et al., 2015 ). The current guidelines invariably recommend early decompression, whether by closed reduction or/and surgery, within 24 h ( Fehlings et al., 2017a ; Zileli et al., 2020 ; Spinal, 2016 ; Schleicher et al., 2018 ). The recent WFNS Spine Committee recommendations state that surgery within 8 h should be performed in most TSCI cases ( Sánchez et al., 2020 ).…”

Section: Discussionmentioning

confidence: 99%

“…Medical therapies, cardiopulmonary management, surgical decompression and stabilization and rehabilitation are all measures that synergistically can be adopted to mitigate the impact of secondary damage on patients' outcomes and for this reason, most guidelines focus their recommendations on such topics ( Hurlbert et al., 2013 ; Gelb et al., 2013 ; Fehlings et al., 2017a , 2017b ; Zileli et al., 2020 ; Sánchez et al., 2020 ; Takami et al., 2020 ; Ryken et al., 2013 ; Peev et al., 2020 ). However, disparities across the different regions of the world related to distribution of resources, infrastructures, equipment, personnel and knowledge of the guidelines could be responsible for differences in the application of guidelines themselves ( Mukhopadhyay et al., 2019 ; Calderón and Servén, 2014 ; WHO.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Secondary damage management of acute traumatic spinal cord injury in low and middle-income countries: A survey on a global scale (Part III)

Marchesini¹,

Rubiano

Sala³

et al. 2022

Brain and Spine

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Secondary damage management of acute traumatic spinal cord injury in low and middle-income countries: A survey on a global scale (Part III)

Marchesini¹,

Rubiano

Sala³

et al. 2022

Brain and Spine

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“…World Federation of Neurosurgical Societies (WFNS) Spine Committee and other guidelines recommend the use of special gear specifically based on the type and severity of the injury. 17 , 18 The majority of the centers were using a cervical collar (85%) and spine boards (63%) for in-house shifting of trauma patients, so there is a need to create awareness of when and in which type of trauma the cervical collar or spine boards should be used.…”

Section: Discussionmentioning

confidence: 99%

Practice Patterns and Management Protocols in Trauma across Indian Settings: A Nationwide Cross-sectional Survey

Mishra¹,

Jagathkar²,

Soni³

et al. 2022

Indian Journal of Critical Care Medicine

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Background Trauma is the leading cause of death in India resulting in a significant public health burden. Indian Society of Critical Care Medicine (ISCCM) has established a trauma network committee to understand current practices and identify the gaps and challenges in trauma management in Indian settings. Material and methods An online survey-based, cross-sectional, descriptive study was conducted with high-priority research questions based on hospital profile, resource availability, and trauma management protocols. Results Data from 483 centers were analyzed. A significant difference was observed in infrastructure, resource utilization, and management protocols in different types of hospitals and between small and big size hospitals across different tier cities in India ( p < 0.05). The advanced trauma life support (ATLS)-trained emergency room (ER) physician had a significant impact on infrastructure organization and trauma management protocols ( p < 0.05). On multivariate analysis, the highest impact of ATLS-trained ER physicians was on the use of extended focused assessment with sonography in trauma (eFAST) (2.909 times), followed by hospital trauma code (2.778 times), dedicated trauma team (1.952 times), and following trauma scores (1.651 times). Conclusion We found that majority of the centers are well equipped with optimal infrastructure, ATLS-trained physician, and management protocols. Still many aspects of trauma management need to be prioritized. There should be proactive involvement at an organizational level to manage trauma patients with a multidisciplinary approach. This survey gives us a deep insight into the current scenario of trauma care and can guide to strengthen across the country. How to cite this article Sodhi K, Khasne RW, Chanchalani G, Jagathkar G, Kola VR, Mishra M et al . Practice Patterns and Management Protocols in Trauma across Indian Settings: A Nationwide Cross-sectional Survey. Indian J Crit Care Med 2023;27(1):38–51.

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“…Immobilization is necessary to prevent further possible damage in all patients with suspected SCI (characterized, for example, by polytrauma, neck/back spinal pain, dysesthesia, loss of consciousness, or a mechanism of injury with the potential to cause an SCI). [9][10][11] Patients with SCI can present with either complete injury, defined as a lack of motor or sensory function in the anal and perineal region (representing the lowest sacral segments S4-S5), or incomplete injury with varying degrees of motor and sensory function caudal to the level of the injury. 12 The American Spinal Injury Association (ASIA) scoring system is used to stratify injury severity, ranging from complete injury (ASIA-A) to normal neurological exam (ASIA-E), to standardize assessment and treatment of SCI.…”

Section: Clinical Presentationmentioning

confidence: 99%

“…Initial management of patients with suspected acute traumatic SCI follows established trauma guidelines to manage the airway, breathing, and circulation. Immobilization is necessary to prevent further possible damage in all patients with suspected SCI (characterized, for example, by polytrauma, neck/back spinal pain, dysesthesia, loss of consciousness, or a mechanism of injury with the potential to cause an SCI) [ 9 - 11 ].…”

Section: Clinical Presentationmentioning

confidence: 99%

Established and Emerging Therapies in Acute Spinal Cord Injury

et al. 2022

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Acute spinal cord injury (SCI) is devastating for patients and their caretakers and has an annual incidence of 20–50 per million people. Following initial assessment with appropriate physical examination and imaging, patients who are deemed surgical candidates should undergo decompression with stabilization. Earlier intervention can improve neurological recovery in the post-operative period while allowing earlier mobilization. Optimized medical management is paramount to improve outcomes. Emerging strategies for managing SCI in the acute period stem from an evolving understanding of the pathophysiology of the injury. General areas of focus include ischemia prevention, reduction of secondary injury due to inflammation, modulation of the cytotoxic and immune response, and promotion of cellular regeneration. In this article, we review established, emerging, and novel experimental therapies. Continued translational research on these methods will improve the feasibility of bench-to-bedside innovations in treating patients with acute SCI.

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Early Management of Cervical Spine Trauma: WFNS Spine Committee Recommendations

Cited by 22 publications

References 46 publications

Secondary damage management of acute traumatic spinal cord injury in low and middle-income countries: A survey on a global scale (Part III)

Secondary damage management of acute traumatic spinal cord injury in low and middle-income countries: A survey on a global scale (Part III)

Practice Patterns and Management Protocols in Trauma across Indian Settings: A Nationwide Cross-sectional Survey

Established and Emerging Therapies in Acute Spinal Cord Injury

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