The majority of the nearly 18,000 new cases of spinal cord injury in the United States each year involve the cervical spine. Although the morbidity, mortality, and healthcare costs associated with these injuries is very high, quality evidence to guide emergency management is limited. Recent changes to guidelines have called into question decades of practice, including prehospital spinal immobilization protocols, timing of surgery, and pharmacotherapy. A systematic approach to the diagnosis and management of the spine-injured patient is outlined in this review, with a focus on recent updates and management of emergent complications.
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Following are the most informative references cited in this paper, as determined by the authors.
2. “National Spinal Cord Injury Statistical Center, Facts and Figures at a Glance.” 2021. Accessed September 10, 2021. (Prospective longitudinal study; 34,734 patients)
7. * Denis F. Spinal instability as defined by the three-column spine concept in acute spinal trauma. Clin Orthop Relat Res. 1984;&NA;(189):65-76. (Cohort study; 412 patients)
22. * Theodore N, Hadley MN, Aarabi B, et al. Prehospital cervical spine immobilization after trauma. Neurosurgery. 2013;72(suppl_3):22-34. (Systematic review and guideline) DOI: 10.1227/NEU.0b013e318276edb1
27. * Hauswald M, Ong G, Tandberg D, et al. Out-of-hospital spinal immobilization: Its effect on neurologic injury. Acad Emerg Med. 1998;5(3):214–219. (Retrospective cohort study; 454 patients) DOI: 10.1111/j.1553-2712.1998.tb02615.x
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61. * Stiell IG, McKnight RD, Schull MJ, et al. The Canadian c-spine rule versus the NEXUS low-risk criteria in patients with trauma. New Engl J Med. 2003:9. (Prospective cohort; 8283 patients) DOI: 10.1056/NEJMoa031375
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Keywords: cervical, spine, spinal cord, injury, MVC, motor vehicle crash, neck pain, head, trauma, compression, fracture, flexion, hyperextension, burst, immobilization, motion restriction, guidelines, paresthesia, airway, intubation, NEXUS, Canadian C-Spine, Denver screening, SCIWORA
Geoffrey Jara-Almonte, MD; Chandni Pawar, MD
Michael Abraham, MD, MS, FAAEM; Jared Ham, MD
October 1, 2021
October 1, 2024   CME Information
4 AMA PRA Category 1 Credits™, 4 ACEP Category I Credits, 4 AAFP Prescribed Credits, 4 AOA Category 2-A or 2-B Credits. Specialty CME Credits: Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME credits
Price: $59
+4 Credits!
Geoffrey Jara-Almonte, MD; Chandni Pawar, MD
Michael Abraham, MD, MS, FAAEM; Jared Ham, MD
October 1, 2021
October 1, 2024
4 AMA PRA Category 1 Credits™, 4 ACEP Category I Credits, 4 AAFP Prescribed Credits, 4 AOA Category 2-A or 2-B Credits. Specialty CME Credits: Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME credits
Pediatric Ocular Trauma: Recognition and Management (Trauma CME and Pharmacology CME)