Cedera spinal

1. patient with a head injury or

2. severe facial or scalp lacerations.
3. complaints of neck pain or
4. spinal pain
5. flaccid paralysis,
6. hypotonia
7. areflexia (absent bulbocavernosus reflex)
8. include bradycardia despite hypotension

1. Anterior spinal cord syndrome -Complete paralysis - Preservation of vibration and

touch sensations
2. Central spinal cord syndrome- Tetraparesis with arms, and in particular hands,
weaker than legs
3. Brown-sequard syndrome - Ipsilateral paralysis-Ipsilateral vibration and touch
sensory loss and Contralateral pain and temperature loss
4. Posterior spinal cord syndrome- Tetraparesis is due to disruption of the lateral
corticospinal tracts.Sensory loss is profound with the exception of pain and
temperature.
 Pathophysiology

Disruption of the normal blood flow

Vasospasm
Vasoconstriction
Release of histamine, prostaglandins, serotonin, and neurotransmitters such as
norepinephrine
Thrombosis of injured arteries
Ischemia
Initiating a cascade of ion derangement, inflammation, and apoptotic cell
death.
Damage in the rostral and the caudal directions.
Ionic imbalance and nucleolysis
Cytoskeletons of cell bodies and axons destroyed
Demyelination and necrotic cell death.

Pemeriksaan penunjang

Anteroposterior, lateral (cervicothoracic junction), and open mouth views.

anterior and posterior vertebral lines, spinolaminar line, spinous process line
Cross Table Lateral View (CTLV)

SCIWORA

Young patients
because of the elasticity of their ligaments
A central cord-type injury
Should underwent MRI

Axial cervical spine

C1 - (Jefferson), specific patterns of odontoid peg fractures
C2- specific pedicle (Hangman's) fractures

Subaxial cervical spine.

C3 to C7
 Principles of spine injury management

a. to avoid
b. to reduce
c. to maintain
d. to achieve healing

Pharmacologic Treatment

Methylprednisolone- within three hours of the injury for a period of 24 hours

Ganglioside GM1
Naloxone

Immediate spinal immobilization tongs or halo ring traction

Reduction of the deformity, indirect decompression, provisional stability of the spine

six to eight hours during which decompression may reverse neurologic deficits
bed rest and log-rolling the patient
rigid brace (definitive treatment)
Basic cervical orthoses

Surgical objectives include the correction of spine alignment; the restoration and
maintenance of spine stability; and the decompression of compromised neural
elements.
optimum canal clearance is most effective if surgery is ideally performed within four
days