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A 64-slice CT with reconstructions does not entirely rule out ligamentous injury leading to instability, but is a practical means of identifying the majority of C-spine injuries in obtunded patients. MR C-spine has frequent false-positives, limiting its usefulness. [citation needed] In these cases, a consultation with a Spine Surgery specialist ...
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]
Physical therapists can assist immobilized patients with effective cough techniques, secretion clearance, stretching of the thoracic wall, and suggest abdominal support belts when necessary. The amount of time a patient is immobilized may depend on the level of the spinal cord injury.
A medical history and physical examination can be sufficient in clearing the cervical spine.Notable clinical prediction rules to determine which patients need medical imaging are Canadian C-spine rule and the National Emergency X-Radiography Utilization Study (NEXUS).
Some trainers and protocols use an additional (small) 'c' in between the A and B, standing for 'cervical spine' or 'consider C-spine'. [34] This is a reminder to be aware of potential neck injuries to a patient, as opening the airway may cause further damage unless a special technique is used.
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Traction can be applied by free weights on a pulley or a halo type brace. The halo brace is the most rigid cervical brace, used when limiting motion to the minimum that is essential, especially with unstable cervical fractures. It can provide stability and support during the time (typically 8–12 weeks) needed for the cervical bones to heal.
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