Cervical Injury Essay

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TERMINOLOGY
CLINICAL CLARIFICATION
• Group of injuries involving the neck due to a rapid, forceful, backwards motion6
• May involve the following: 6
○ Injury to vertebral and paravertebral structures (fractures, dislocations, ligamentous tears, and disc disruption/subluxation) ○ Spinal cord injury (traumatic central cord syndrome secondary to cord compression or vascular insult)
○ Vascular injury (vertebral artery or carotid artery dissection)
○ Soft tissue injury around cervical spine (cervical strain/sprain)
CLASSIFICATION
• Cervical Injury classification25
○ Major cervical injury
– Radiographic or CT evidence of instability with or without associated or potential localized or central neurologic findings 25
□ Presence of:
□ Displacement of more than 2 mm …show more content…

– Screening tool to diagnose vertebral and carotid artery dissection and/or injury after blunt head and neck trauma
(blunt cerebrovascular injury)
DIFFERENTIAL DIAGNOSIS
• Most common
○ Degenerative cervical spine disease
– Presents with axial neck pain and neurological complications such as radiculopathy and myelopathy
– No history of trauma is a differentiating feature
– Cervical spine radiograph shows degenerative disc or joint
– Cervical MRI shows bone destruction, nerve compression, or intradural/epidural process
○ Non-traumatic neck pain
– Presents with symptoms caused by secondary infection (pain with fever), neoplasia, or inflammation (arthritis)
– No history of trauma is a differentiating feature
– Cervical spine radiograph, CT scan or MRI show bony destruction, neoplastic lesions, vertebral osteomyelitis
– Laboratory findings of blood test include erythrocyte sedimentation rate and C-reactive protein which are elevated in infection, malignancy or arthritis; and CBC shows elevated WBC in infection
Cervical hyperextension injuries
TREATMENT
GOALS
• To relieve symptoms and stabilize spinal column and fracture
• Correct hypotension if present
• To prevent neurological deterioration and permanent disability

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