Spinal Cord Injury

The emergency physician are to establish the diagnosis and initiate treatment to prevent further neurologic injury from either pathologic motion of the injured vertebrae or secondary injury from the deleterious effects of cardiovascular instability or respiratory insufficiency. A careful neurologic assessment is required to establish the presence or absence of SCI and to classify the lesion according to a specific cord syndrome. Determine the level of injury and try to differentiate nerve root injury from SCI but recognize that both may be present. The American Spinal Injury Association has established pertinent definitions. Investigations are standard radiographs of the affected region of the spine, CT scanning is reserved for delineating bony abnormalities or fracture and MRI is best for suspected spinal cord lesions, ligamentous injuries, or other nonosseous conditions. The patient should be sent immediately to a hospital with sufficient facilities to treat spinal cord injuries. The care of spinal cord injuries should be centralized to specialist units.


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