Approach and considerations regarding the patient with spinal injury
| Autor: | P. Licina, Adrian M. Nowitzke |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
medicine.medical_specialty
Emergency Medical Services Resuscitation Physical examination Physical medicine and rehabilitation Musculoskeletal disorder Deformity medicine Humans Physical Examination Rachis General Environmental Science medicine.diagnostic_test business.industry Spinal cord medicine.disease Spinal column Magnetic Resonance Imaging medicine.anatomical_structure Spinal Injuries Radiological weapon Physical therapy General Earth and Planetary Sciences medicine.symptom business Tomography X-Ray Computed Vertebral column |
| Zdroj: | Injury. 36 |
| ISSN: | 0020-1383 |
| Popis: | Spinal trauma often results in a complex interaction of injuries to the musculoskeletal and nervous systems. This combination of biomechanical and neurological considerations provides a unique challenge to those dealing with the spinally injured patient. Proper assessment of the injuries sustained by the patient remains the initial, yet key, step in determining appropriate management. The aim of the physical examination is not only to characterize the nature of the injury to the vertebral column, but also to determine the extent of actual and potential damage to the neural elements. It is also concerned with detecting associated injuries of the brain, viscera, and limbs that can impact on management and outcome, particularly of any neurological deficit. Further information about the spinal column and spinal cord is derived from appropriate radiological assessment, which is evolving with the increasing sophistication of imaging modalities. In spinal injury, classification systems are particularly important as they simplify a diverse range of injury patterns into a useable and reproducible form that may be used to aid communication among clinicians, guide management for individual patients, and provide the basis for research consistency. The medical management involves consideration of the impact of spinal injury, in particular cord injury, on aspects including resuscitation and anticoagulation, as well as the role of steroids. The definitive management of the spinal column injury may be operative or nonoperative. Factors influencing this decision are biomechanical (stabilization of the unstable spine and reduction of deformity) and neurological (improvement in deficit and decompression of neural elements). This article considers these issues and aims to present a balanced and useful algorithm for clinicians to use when faced with spinal injury. |
| Databáze: | OpenAIRE |
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