Skip to main content

Management of Spinal Neurotrauma

  • Chapter
  • First Online:
Neurotrauma

Abstract

In this chapter, the questions and answers are intended to cover the following topics in relation to the neurocritical care and neurosurgical management of spinal cord injuries (SCI) in the following settings: closed and penetrating SCI, cervical spinal fracture, dorsolumbar spinal fractures, sacral spinal fractures, SCIWORA, traumatic spinal hematoma, arterial injuries, dissection, and pseudoaneurysms. In addition, principles on the radiographic evaluation of TBI, indications for head CT, and admission are discussed in depth.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 16.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Suggested Reading

  • Alizadeh A, Dyck SM, Karimi-Abdolrezaee S. Traumatic spinal cord injury: an overview of pathophysiology, models and acute injury mechanisms. Front Neurol. 2019;10:282.

    Article  PubMed  PubMed Central  Google Scholar 

  • Al-Mahfoudh R, Beagrie C, Woolley E, Zakaria R, Radon M, Clark S, Pillay R, Wilby M. Management of typical and atypical Hangman’s fractures. Global Spine J. 2016;6(3):248–56.

    Article  PubMed  Google Scholar 

  • Alterman DM, Heidel RE, Daley BJ, Grandas OH, Stevens SL, Goldman MH, Freeman MB. Contemporary outcomes of vertebral artery injury. J Vasc Surg. 2013;57(3):741–6.

    Article  PubMed  Google Scholar 

  • Anderson LD, D’Alonzo RT. Fractures of the odontoid process of the axis. J Bone Joint Surg. 1974;56A:1663–74.

    Article  Google Scholar 

  • Atkinson PP, Atkinson JLD. Spinal shock. Mayo Clin Proc. 1996;71:384–9.

    Article  CAS  PubMed  Google Scholar 

  • Bhatoe HS, Singh P. Missile injuries of the spine. Neurol India. 2003;51(4):507.

    CAS  PubMed  Google Scholar 

  • Bracken MB. Steroids for acute spinal cord injury. Cochrane Database Syst Rev. 2002;1(1):CD001046.

    Google Scholar 

  • Bydon M, Fredrickson V, De la Garza-Ramos R, Li Y, Lehman RA, Trost GR, Gokaslan ZL. Sacral fractures. Neurosurg Focus. 2014;37(1):E12.

    Article  PubMed  Google Scholar 

  • Chen WH, Jiang LS, Dai LY. Surgical treatment of pyogenic vertebral osteomyelitis with spinal instrumentation. Eur Spine J. 2007;16(9):1307–16.

    Article  PubMed  Google Scholar 

  • Consensus Development Conference. Prophylaxis and treatment of osteoporosis. Am J Med. 1991;90:107–10.

    Article  Google Scholar 

  • Demura S, Murakami H, Shirai T, Kato S, Yoshioka K, Ota T, Ishii T, Igarashi T, Tsuchiya H. Surgical treatment for pyogenic vertebral osteomyelitis using iodine-supported spinal instruments: initial case series of 14 patients. Eur J Clin Microbiol Infect Dis. 2015;34(2):261–6.

    Article  CAS  PubMed  Google Scholar 

  • Denaro V, Longo UG, Maffulli N, Denaro L. Vertebroplasty and kyphoplasty. Clin Cases Miner Bone Metab. 2009;6(2):125.

    PubMed  Google Scholar 

  • Desouza RM, Crocker MJ, Haliasos N, Rennie A, Saxena A. Blunt traumatic vertebral artery injury: a clinical review. Eur Spine J. 2011;20(9):1405–16.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Duz B, Cansever T, Secer HI, Kahraman S, Daneyemez MK, Gonul E. Evaluation of spinal missile injuries with respect to bullet trajectory, surgical indications and timing of surgical intervention: a new guideline. Spine. 2008;33(20):E746–53.

    Article  PubMed  Google Scholar 

  • Erickson RP. Autonomic hyperreflexia: pathophysiology and medical management. Arch Phys Med Rehabil. 1980;61:431–40.

    CAS  PubMed  Google Scholar 

  • Feuchtwanger MM. High velocity missile injuries: a review. J R Soc Med. 1982;75(12):966.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Fielding JW, Hensinger RN, Hawkins RJ. Os Odontoideum. J Bone Joint Surg. 1980;62A:376–83.

    Article  Google Scholar 

  • Fogelman MJ, Stewart RD. Penetrating wounds of the neck. Am J Surg. 1956;91:581–96.

    Article  CAS  PubMed  Google Scholar 

  • Gelb DE, et al. Initial closed reduction of cervical spinal fracture-dislocation injuries. Neurosurgery. 2013;72:73–83.

    Article  PubMed  Google Scholar 

  • Gopinathan NR, Viswanathan VK, Crawford AH. Cervical spine evaluation in pediatric trauma: a review and an update of current concepts. Indian J Orthop. 2018;52:489–500.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hadley MN, Walters BC, Grabb BC, Oyesiku NM, Przybylski GJ, Resnick DK, Ryken TC. Initial closed reduction of cervical spine fracture-dislocation injuries. Neurosurgery. 2002;50(3 Suppl):S44–50.

    CAS  PubMed  Google Scholar 

  • Hall GC, Kinsman MJ, Nazar RG, Hruska RT, Mansfield KJ, Boakye M, Rahme R. Atlanto-occipital dislocation. World J Orthop. 2015;6(2):236.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hitchon PW, Jurf AA, Kernstine K, et al. Management options in thoracolumbar fractures. Contemp Neurosurg. 2000;22:1–12.

    Article  Google Scholar 

  • Hurlbert RJ, Hadley MN, Walters BC, et al. The acute cardiopulmonary management of patients with cervical spinal cord injuries. Neurosurgery. 2013;72(Suppl 2):84–92.

    PubMed  Google Scholar 

  • Jenkins LN, Rezende-Neto JB. Current management of penetrating traumatic cervical vascular injuries. Curr Surg Rep. 2020;8:1–8.

    Article  Google Scholar 

  • Kakarla UK, Chang SW, Theodore N, et al. Atlas fractures. Neurosurgery. 2010;66:60–7.

    Article  PubMed  Google Scholar 

  • Ko HY. Revisit spinal shock: pattern of reflex evolution during spinal shock. Korean J Neurotrauma. 2018;14(2):47.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lee TS, Ducic Y, Gordin E, Stroman D. Management of carotid artery trauma. Craniomaxillofac Trauma Reconstr. 2014;7(3):175–89.

    Article  PubMed  PubMed Central  Google Scholar 

  • Levine AM. The Cervical Spine Research Society Editorial Committee. Traumatic spondylolisthesis of the axis: “Hangman’s fracture”. In: The cervical spine. 3rd ed. Philadelphia: Lippincott-Raven; 1998. p. 429–48.

    Google Scholar 

  • Lo J, Cavazos J, Burnett C. Management of complex regional pain syndrome. In: Baylor University medical center proceedings, vol. 30. Taylor & Francis; 2017. p. 286–8.

    Google Scholar 

  • Maschmann C, Jeppesen E, Rubin MA, Barfod C. New clinical guidelines on the spinal stabilisation of adult trauma patients–consensus and evidence based. Scand J Trauma Resusc Emerg Med. 2019;27(1):1–10.

    Article  Google Scholar 

  • Meyer JP, Barrett JA, Schuler JJ, et al. Mandatory versus selective exploration for penetrating neck trauma. A prospective assessment. Arch Surg. 1987;122:592–7.

    Article  CAS  PubMed  Google Scholar 

  • Mohan B, Singal S, Bawa AS, Mahindra P, Yamin M. Endovascular management of traumatic pseudoaneurysm: short & long term outcomes. J Clin Orthop Trauma. 2017;8(3):276–80.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mueller CA, Peters I, Podlogar M, Kovacs A, Urbach H, Schaller K, Schramm J, Kral T. Vertebral artery injuries following cervical spine trauma: a prospective observational study. Eur Spine J. 2011;20(12):2202–9.

    Article  PubMed  PubMed Central  Google Scholar 

  • Muralidhar BM, Hegde D, Hussain PS. Management of unstable thoracolumbar spinal fractures by pedicle screws and rods fixation. J Clin Diagn Res. 2014;8(2):121.

    Google Scholar 

  • Nowicki JL, Stew B, Ooi E. Penetrating neck injuries: a guide to evaluation and management. Ann R Coll Surg Engl. 2017;100(1):6–11.

    Article  PubMed  PubMed Central  Google Scholar 

  • Phang I, Papadopoulos MC. Intraspinal pressure monitoring in a patient with spinal cord injury reveals different intradural compartments: injured spinal cord pressure evaluation (ISCoPE) study. Neurocrit Care. 2015;23(3):414–8.

    Article  PubMed  Google Scholar 

  • Przybylski GJ. Management of odontoid fractures. Contemp Neurosurg. 1998;20:1–6.

    Article  Google Scholar 

  • Pulivarthi S, Gurram MK. Effectiveness of d-dimer as a screening test for venous thromboembolism: an update. N Am J Med Sci. 2014;6(10):491.

    Article  PubMed  PubMed Central  Google Scholar 

  • Radvany MG, Murphy KJ, Millward SF, Barr JD, Clark TW, Halin NJ, Kinney TB, Kundu S, Sacks D, Wallace MJ, Cardella JF. Research reporting standards for percutaneous vertebral augmentation. J Vasc Interv Radiol. 2009;20(10):1279–86.

    Article  PubMed  Google Scholar 

  • Rajasekaran S, Kanna RM, Shetty AP. Management of thoracolumbar spine trauma: an overview. Indian J Orthop. 2015;49(1):72.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Riascos R, Bonfante E, Cotes C, Guirguis M, Hakimelahi R, West C. Imaging of atlanto-occipital and atlantoaxial traumatic injuries: what the radiologist needs to know. Radiographics. 2015;35(7):2121–34.

    Article  PubMed  Google Scholar 

  • Rozzelle CJ, Aarabi B, Dhall SS, et al. Management of pediatric cervical spine and spinal cord injuries. Neurosurgery. 2013;72(Suppl 2):205–26.

    Article  PubMed  Google Scholar 

  • Sabiston CP, Wing PC. Sacral fractures: classification and neurologic implications. J Trauma. 1986;26:1113–5.

    Article  CAS  PubMed  Google Scholar 

  • Shahlaie K, Chang DJ, Anderson JT. Nonmissile penetrating spinal injury: case report and review of the literature. J Neurosurg Spine. 2006;4(5):400–8.

    Article  PubMed  Google Scholar 

  • Singh RR, Barry MC, Ireland A, et al. Current diagnosis and management of blunt internal carotid artery injury. Eur J Vasc Endovasc Surg. 2004;27(6):577–84.

    Article  CAS  PubMed  Google Scholar 

  • Sözen T, Özışık L, Başaran NÇ. An overview and management of osteoporosis. Eur J Rheumatol. 2017;4(1):46.

    Article  PubMed  Google Scholar 

  • Statements PC. Prevention of venous thromboembolism in individuals with spinal cord injury: clinical practice guidelines for health care providers. Top Spinal Cord Inj Rehabil. 2016;22(3):209–40.

    Article  Google Scholar 

  • Suss RA, Zimmerman RD, Leeds NE. Pseudospread of the atlas: false sign of Jefferson fracture in young children. AJR. 1983;140:1079–82.

    Article  CAS  PubMed  Google Scholar 

  • Tannoury C, Degiacomo A. Fatal vertebral artery injury in penetrating cervical spine trauma. Case Rep Neurol Med. 2015;12:2015.

    Google Scholar 

  • Theodore N, Aarabi B, Dhall SS, et al. The diagnosis and management of traumatic atlanto-occipital dislocation injuries. Neurosurgery. 2013a;72(Suppl 2):114–26.

    Article  PubMed  Google Scholar 

  • Theodore N, et al. Occipital condyle fractures. Neurosurgery. 2013b;72:106–13.

    Article  PubMed  Google Scholar 

  • Vaccaro AR, Lehman RA Jr, Hurlbert RJ, et al. A new classification of thoracolumbar injuries: the importance of injury morphology, the integrity of the posterior ligamentous complex, and neurologic status. Spine. 2005;30:2325–33.

    Article  PubMed  Google Scholar 

  • Wasner G, Schattschneider J, Binder A, Baron R. Complex regional pain syndrome–diagnostic, mechanisms, CNS involvement and therapy. Spinal Cord. 2003;41(2):61–75.

    Article  CAS  PubMed  Google Scholar 

  • Wilson JR, Cadotte DW, Fehlings MG. Clinical predictors of neurological outcome, functional status, and survival after traumatic spinal cord injury: a systematic review. J Neurosurg Spine. 2012;17(1, Suppl):11–26.

    Article  PubMed  Google Scholar 

  • Zaveri G, Das G. Management of sub-axial cervical spine injuries. Indian J Orthop. 2017;51:633–52.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Alkhataybeh, R.A., Madi, H., Muhsen, B.A., Dolachee, A.A., Al-Dhahir, M.A., Al-Sharshahi, Z.F. (2022). Management of Spinal Neurotrauma. In: Neurotrauma. Springer, Cham. https://doi.org/10.1007/978-3-030-80869-3_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-80869-3_5

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-80868-6

  • Online ISBN: 978-3-030-80869-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics