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Excluding a cervical spinal injury requires clinical judgement and training. Under the NEXUS guidelines, when an acute blunt force injury is present, a cervical spine is deemed to not need radiological imaging if all the following criteria are met: There is no posterior midline cervical tenderness; There is no evidence of intoxication
Finally, the use of magnetic resonance imaging (MRI) allowed for even better depiction of the spine and soft tissue abnormalities in particular. Again, a novel acronym was proposed to classify patients without traumatic signs using radiographs, CT and MRI. The term spinal cord injury without neuroimaging abnormality (SCIWONA) was used.
There are two main algorithms, the Canadian C-spine rule and NEXUS, which are used to decide who requires cervical spine imaging via CT scan [6] after blunt trauma, and who can be cleared without imaging. [4] The Canadian C-spine rule appears to have greater sensitivity and specificity (i.e. fewer false positives and false negatives). [17]
Spinal cord injury; MRI of a fractured and dislocated cervical vertebra (C4) in the neck that is compressing the spinal cord: Specialty: Neurosurgery: Types: Complete, incomplete [1] Diagnostic method: Based on symptoms, medical imaging [1] Treatment: Spinal motion restriction, intravenous fluids, vasopressors [1] Frequency: c. 12,000 annually ...
Central cord syndrome (CCS) is the most common form of cervical spinal cord injury (SCI). It is characterized by loss of power and sensation in arms and hands. It usually results from trauma which causes damage to the neck, leading to major injury to the central corticospinal tract of the spinal cord. [1]
There are many grading systems for degeneration of intervertebral discs and facet joints in the cervical and lumbar vertebrae, of which the following radiographic systems can be recommended in terms of interobserver reliability: [1] Kellgren grading of cervical disc degeneration; Kellgren grading of cervical facet joint degeneration
A more detailed and rapid neurological evaluation is performed at the end of the primary survey. This establishes the patient's level of consciousness, pupil size and reaction, lateralizing signs, and spinal cord injury level. The Glasgow Coma Scale is a quick method to determine the level of consciousness, and is predictive of patient outcome ...
It represents <1% of all cervical spine injuries. [1] Several subtypes of atlanto-occipital dislocation are known. One suggested categorization scheme includes anterior, vertical and posterior of the head relative to the spine. Other variants with lateral or rotatory displacement have been described, as well as mixed types.