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LEFT Light Touch (LTL) Pin Prick (PPL) C2 C2 C3 C2 C4 C3 Elbow flexors C5 C4 C4 UEL Wrist extensors C6 T2 (Upper Extremity Left) T3 Elbow extensors C7 T4 Finger flexors C8 T5 T6 Finger abductors (little finger) T1 T7 T2 C8 T8 MOTOR C7 T9 T3 (SCORING ON REVERSE...

Learning objectives To be familiar with: The accurate assessment of spinal trauma • The basic management of spinal trauma and the major • pitfalls Learning objectives To be familiar with: The accurate assessment of spinal trauma • The basic management of spina...

Magnetic resonance imaging MRI is indicated in all patients with neurological deficit and where assessment of ligamentous structures is important ( Figure 30.18 ). (c) lines Magnetic resonance imaging MRI is indicated in all patients with neurological deficit a...

Neurological examination The American Spinal Injury Association (ASIA) neurological evaluation system ( Figure 30.13 ) is an internationally accepted method of neurological evaluation. Motor function is assessed using the Medical Research Council (MRC) gradin...

OUTCOME The goal of spinal cord injury rehabilitation is based on a multidisciplinary approach. There is a focus on goal-setting, maximising remaining neurological function and reintegration into employment and society . The level of neurological impair - me...

Odontoid fractures There are three types of odontoid peg fracture ( Figure 30.27 ). Neurological injury is rare. The majority of acute injuries are treated non-operatively in a hard collar or halo jacket for 3 /uni00A0 months. Internal fixation with an anteri...

PATHOPHYSIOLOGY OF SPINAL CORD INJURY The primary injury This is the direct insult to the neural elements and occurs at the time of the initial injury .

PATHOPHYSIOLOGY OF SPINAL CORD INJURY The primary injury This is the direct insult to the neural elements and occurs at the time of the initial injury .

PATHOPHYSIOLOGY OF SPINAL CORD INJURY The primary injury This is the direct insult to the neural elements and occurs at the time of the initial injury .

PATIENT ASSESSMENT Basic points The Advanced Trauma Life Support (ATLS) principles apply in all cases (see Chapters 26 and 27 ). The spine should initially be immobilised using full spinal precautions, on the assumption that every trauma patient has a spinal i...

PERTINENT HISTORY The mechanism and velocity of injury should be determined at an early stage. A check for the presence of spinal pain should be made. The onset and duration of neurological symptoms should also be recorded. PERTINENT HISTORY The mechanism a...

PHYSICAL EXAMINATION Initial assessment The primary survey always takes precedence, followed by a careful systems examination paying particular attention to the abdomen and chest. Spinal cord injury may mask signs of intra-abdominal injury . PHYSICAL EXAMINATI...

Prognosis of spinal cord injury Despite continuing improvements in patient care, life expec - tancy remains below normal following spinal cord injury . The median life expectancy is 33 years, but varies considerably ( Table 30.2 ). The prognosis for neurologic...

RIGHT Light Touch (LTR) Pin Prick (PPR) C2 C3 C4 C3 Elbow flexors C5 Wrist extensors UER C6 (Upper Extremity Right) Elbow extensors C7 Finger flexors C8 Finger abductors (little finger) T1 T2 Comments (Non-key Muscle? Reason for NT? Pain? C6 Non-SCI condition...

Regional variations Upper cervical spine anatomy is designed to facilitate motion ( Figure 30.3 ), and stability here is dependent on ligamentous restraints ( Figure 30.4 ). V ertebral anatomy from C3 to C7 is similar. The cervicothoracic ( Figure 30.5 ) and t...

SPECIFIC SPINAL INJURIES Upper cervical spine (skull–C2) Occipital condyle fracture This is a relatively stable injury often associated with head injuries and is best treated in a hard collar for 6–8 weeks. Occipitoatlantal dislocation This injury is usually c...

SPECIFIC SPINAL INJURIES Upper cervical spine (skull–C2) Occipital condyle fracture This is a relatively stable injury often associated with head injuries and is best treated in a hard collar for 6–8 weeks. Occipitoatlantal dislocation This injury is usually c...