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Tendon Although repair follows the normal pattern of wound healing, there are two main mechanisms whereby nutrients, cells and new vessels reach the severed tendon. Intrinsic healing consists of vincular blood fl ow and synovial di ff usion. Extrinsic heal - ...

WOUND MANAGEMENT Assessment Wound management is guided by the timing and mechanism of injury as well as factors a ff ecting healing ( Summary box 3.1 It is also important to assess the patient’s ideas, concerns and expectations. Patient outcomes also rely on go...

A system for evaluation of the lateral cervical spine radiograph 1 Assess prevertebral soft-tissue swelling ( Figure 30.14 2 Assess sagittal alignment using three imaginary lines ( Figure 30.15 ). 3 Assess for instability ( Figure 30.16 ): a 3.5 /uni00A0 mm of...

A system for evaluation of the lateral cervical spine radiograph 1 Assess prevertebral soft-tissue swelling ( Figure 30.14 2 Assess sagittal alignment using three imaginary lines ( Figure 30.15 ). 3 Assess for instability ( Figure 30.16 ): a 3.5 /uni00A0 mm of...

ANATOMY OF THE SPINE AND SPINAL CORD Spinal column anatomy The vertebral column is composed of a series of motion segments ( Figure 30.1 ). A motion segment consists of two adjacent vertebrae, their intervertebral disc and ligamentous restraints ( Figure 30...

ANATOMY OF THE SPINE AND SPINAL CORD Spinal column anatomy The vertebral column is composed of a series of motion segments ( Figure 30.1 ). A motion segment consists of two adjacent vertebrae, their intervertebral disc and ligamentous restraints ( Figure 30...

Atlantoaxial instability This is defined as non-physiological movement between C1 and C2. It can be translational or rotatory and resolves either spontaneously or with traction followed by a cervical collar. Isolated, traumatic transverse ligament rupture leadi...

CLASSIFICATION AND MANAGEMENT OF SPINAL AND SPINAL CORD INJURIES Basic management principles Spinal realignment In cases of cervical spine subluxation or dislocation, skeletal traction is necessary to achieve anatomical realignment. This is done using skull t...

CLASSIFICATION AND MANAGEMENT OF SPINAL AND SPINAL CORD INJURIES Basic management principles Spinal realignment In cases of cervical spine subluxation or dislocation, skeletal traction is necessary to achieve anatomical realignment. This is done using skull t...

Complete versus incomplete spinal cord injury A spinal cord injury is incomplete when there is preservation of perianal sensation. Types of incomplete spinal cord injury There are several types of incomplete spinal cord injuries. These include: /uni25CF cent...

Computed tomography Computed tomography (CT) scanning with two-dimensional reconstruction remains the gold standard in spinal trauma and is indicated for patients with suspected or visible injuries on plain radiographs ( Figure 30.17 ). Patients undergoing a h...

DIAGNOSTIC IMAGING Plain radiographs A full cervical spine series includes anteroposterior and lateral radiographs of the whole cervical spine, and open mouth views. Clear visualisation of the cervicothoracic junction is essential in all cases of suspected s...

Dynamic imaging Lateral flexion–extension radiographs of the cervical spine should not be undertaken acutely , although they can have a role in assessing spinal stability in the longer term. Figure 30.18 Sagittal T2-weighted magnetic resonance imaging scan dem...

EVOLUTION OF THE MANAGEMENT OF SPINAL CORD INJURY The development of specialised spinal cord injury centres has dramatically improved the survival rates, health and functional outcomes of individuals with spinal cord injury . The first spinal cord injury cent...

FURTHER READING American Spinal Injury Association. International standards for neurological classification of SCI (ISNCSCI) worksheet . Available from https://asia-spinalinjury .org/international-standards-neurological - classification-sci-isncsci-worksheet/ (...

Fractures in patients with ankylosing spondylitis Ankylosing spondylitis is a seronegative inflammatory disorder that causes autofusion of the spine. These patients have a higher risk of spinal fractures and spinal cord injury than the normal population. Senior...

INJURY The incidence and causation of spinal cord injury vary globally and reflect the demographics and industrialisation of society . Every year, around the world, between 250 /uni00A0 000 and 500 /uni00A0 000 people su ff er a spinal cord injury according to...

Identification of shock Three categories of shock may occur in spinal trauma /uni25CF Hypovolaemic shock . Hypotension with tachycardia and cold clammy peripheries. This is most often due to haemorrhage. It should be treated with appropriate resus - citation. ...