Slideset from SHO teaching session. For further info on anatomy of spinal cord, try this. http://vimeo.com/36370266

1. Spinal
Cord
Injuries

2. Who to
immobilise

3. Immobilisation
“we argue that fully alert, stable and co-operative trauma
patients do not require the application of a semi-rigid
cervical collar, even if they are suspected of underlying
cervical spine fracture, unless their conscious level
deteriorates or they find the short-term support of a cervical
collar helpful

4. When to
image?

5. v

6. NEXUS

7. Canadian

8. What are you
looking at?

12. Vertebral
Body
Pedicle
Lamina
Spinous
Process

13. Ligaments

14. AnteriorLongitudinalLigament
PosteriorLongitudinalLigament
LigamentumFlava

15. AnteriorLongitudinalLigament
PosteriorLongitudinalLigament
LigamentumFlava

16. 3 Columns in
Spinal Injury
AntMidPost

20. What type of
injuries to
expect

21. •Young male
•Fall 10 m on building
site
•Not able to mobilise on
scene
•Back pain, but no other
apparent injuries

22. Examination
•Below T11
•Flaccid Paralysis
•Absent sensation to pain
•Fine touch present at all
levels

23. Posterior
Columns
Cortico
Spinal
SpinoThalamic

24. Touch
Motor
Pain

25. Anterior Cord Syndrome
Touch
Motor
Pain

26. Touch
Motor
Pain

27. Text
Touch
Motor
Pain
Incomplete Cord Injury

28. History
•60 year old male
•Fall from waterski - fairly
low speed
Symptoms
•Complaining of neck and
arm pain
•Arms feel weak
Examination
•Sore - but all in the arms and neck
•Legs moving fine
•Power 3/5 in the upper limbs, esp
proximally

29. Touch
Motor
Pain
Central Cord Syndrome

30. Arms
Trunk
Legs
Arms
Trunk
Legs
The Upper limbs lie
more centrally in the
tracts
Why the upper limb
distribution?

31. Spinal Stenosis

32. •50M chronic LBP
•significant increase in low
back pain
•Some weakness in both legs
but variable between sides and
levels.
•Similar picture regarding
sensation
Is his neurology inconsistent and functional?

33. L3
L5
L1
L2
L4

34. CES Red Flags
•Urinary incontinence/
retention
•Saddle anaesthesia
•Decreased anal tone/faecal
incontinence
•Bilateral neurological
symptoms/deficit
•Major motor/sensory
impairment

35. End