Q) Out of the following which will require Spinal immobilization most?
a. 22 yr Female had a high-speed motor vehicle collision who complains of back pain and no numbness
b.16 yr male jumped from 6ft landed on both foot denies back pain and weakness
C. Gunshot injury
D. Abdominal injury
Answer is free
a)
Spinal cord injuries are a common cause of morbidity and expenditure. Mortality is associated with cervical injuries but not lower spinal cord injuries.
Motor vehicle accidents are the most common cause and gunshot injuries the least common for spinal cord injuries.
Mechanism of injury
- Blunt trauma - Direct impingement, Ischemia, compression or bleeding
- Penetrating - Laceration of spinal cord
Chance fracture - is a type of spinal cord fracture in which there is transverse fracture of all vertebral elements
Management
1 Complete immobilisation
2. Management of associated neurogenic shock ( due to loss of sympathetic tone) with vasopressors and fluids
Sabiston page 420
Schwartz's Principles of Surgery ABSITE and Board Review, 10/e
