Abstract
The acute care physician or surgeon will address issues such as appropriate resuscitation and stabilization, type of spinal injury, neurological deficit secondary to spinal cord injury, lesion stability, and surgical or nonsurgical treatment. Early or acute hospital treatment includes diagnostic assessment and decision-making for surgery of spinal injuries and associated injuries, as well as management of complications resulted from spinal cord injuries such as cardiac, respiratory, genitourinary, gastrointestinal, nutritional problems, venous thrombosis, and pressure injuries. Gastric hyperacidity, paralytic ileus, and pancreatic sphincter dysfunction can cause stress ulcers, vomiting, aspiration, fecal impaction, and pancreatitis. Bladder dysfunction leads to urinary stasis, which can lead to cystitis, pyelonephritis, hydronephrosis, stone formation, and renal failure. Early rehabilitation interventions and psychosocial intervention should begin with acute medical and surgical management.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Ahn H, Singh J, Nathens A, et al. Pre-hospital care management of a potential spinal cord injured patient: a systematic review of the literature and evidence-based guidelines. J Neurotrauma. 2011;28:1341–61.
Bach JR. Non-invasive respiratory management of high level spinal cord injury. J Spinal Cord Med. 2012;35:72–80.
Ball PA. Critical care of spinal cord injury. Spine (Phila Pa 1976). 2001;26(24 Suppl):S27–30.
Christie S, Thibault-Halman G, Casha S. Acute pharmacological DVT prophylaxis after spinal cord injury. J Neurotrauma. 2011;28:1509–14.
Cole J, Weller R. Introduction to the clinical presentations of spinal cord disease from a pathophysiological perspective. In: Engler GL, Cole J, Merton WL, editors. Spinal cord diseases. Diagnosis and treatment. New York: Marcel Dekker, Inc; 1998. p. 1–1.
Consortium for Spinal Cord Medicine. Prevention of thromboembolism in spinal cord injury. 2nd ed. Washington, DC: Paralyzed Veterans of America; 1999.
Consortium for Spinal cord Medicine. Early acute management in adults with spinal cord injury: a clinical practice guidelines for health-care professionals. J Spinal Cord Med. 2008a;31:403–78.
Consortium for Spinal Cord Medicine. Early acute management in adults with spinal cord injury. Clinical practice guidelines for health-care professionals. Washington, DC: Paralyzed Veterans of America; 2008b.
Cook N. Respiratory care in spinal cord injury with associated traumatic brain injury: bridging the gap in critical care nursing interventions. Intensive Crit Care Nurs. 2003;19:143–53.
Dhall SS, Hadley MN, Aarabi B, et al. Deep venous thrombosis and thromboembolism in patients with cervical spinal cord injuries. Neurosurgery. 2013a;72(Suppl 2):244–54.
Dhall SS, Hadley MN, Aarabi B, et al. Nutritional support after spinal cord injury. Neurosurgery. 2013b;72(Suppl 2):255–9.
Fehlings MG, Vaccaro A, Wilson JR, et al. Early versus delayed decompression for traumatic cervical spinal cord injury: results of the Surgical Timing in Acute Spinal Cord Injury Study (STASCIS). PLoS One. 2012;7:e3203.
Fehlings MG, Tetreault LA, Aarabi B, et al. A clinical practice guideline for the management of patients with acute spinal cord injury: recommendations on the type and timing of anticoagulant thromboprophylaxis. Global Spine J. 2017;7(3 Suppl):212S–20S.
Furlan JC, Fehlings MG. Cardiovascular complications after acute spinal cord injury: pathophysiology, diagnosis and management. Neurosurg Focus. 2008;25:E13.
Hadley MN, Walters BC. Introduction to the guidelines for the management of acute cervical spine and spinal cord injuries. Neurosurgery. 2013;72(Suppl 2):5–16.
Hadley MN, Walters BC, Aarabi B, et al. Clinical assessment following acute cervical spinal cord injury. Neurosurgery. 2013;72(Suppl 2):40–53.
Hughes MC. Critical care nursing for the patient with a spinal cord injury. Crit Care Nurs Clin N Am. 1990;2:33–40.
Hull RD, Merali T, Mills A, Stevenson AL, Liang J. Venous Thromboembolism in Elderly High-Risk Medical Patients. Clinical and Applied Thrombosis/Hemostasis. 2013;19(4):357–62.
Hurlbert RJ, Hadley MN, Walters BC, et al. Pharmacological therapy for acute spinal cord injury. Neurosurgery. 2013;72(Suppl 2):93–105.
Jia X, Kowalski RG, Sciubba DM, et al. Critical care of traumatic spinal cord injury. J Intensive Care Med. 2013;28:12–23.
Jones T, Ugalde V, Franks P, et al. Venous thromboembolism after spinal cord injury: incidence, time course, and associated risk factors in 16,240 adults and children. Arch Phys Med Rehabil. 2005;86:2240–7.
Kato H, Kimura A, Sasaki R, et al. Cervical spinal cord injury without bony injury: a multicenter retrospective study of emergency and critical care centers in Japan. J Trauma. 2008;65:373–9.
Liu JC, Patel A, Vaccaro AR, Lammertse DP, et al. Methylprednisolone after traumatic spinal cord injury: yes or no? PM R. 2009;1:669–73.
Lo V, Esquenazi Y, Han MK, et al. Critical care management of patients with acute spinal cord injury. J Neurosurg Sci. 2013;57:281–92.
Matthias CJ, Frankel HL, Turner RC, et al. Physiological responses to insulin hypoglycaemia in spinal man. Paraplegia. 1979;17:319–26.
McMahon D, Tutt M, Cook AM. Pharmacological management of hemodynamic complications following spinal cord injury. Orthopedics. 2009;32:331.
National Spinal Cord Injury Statistical Center. The 2017 annual statistical report for the spinal cord injury model systems. Birmingham: National Spinal Cord Injury Statistical Center; 2018a.
Ryken TC, Hurlbert RJ, Hadley MN, et al. The acute cardiopulmonary management of patients with cervical spinal cord injuries. Neurosurgery. 2013;72(Suppl 2):84–92.
Saboe LA, Reid DL, Davis LA, et al. Spinal trauma and associated injuries. J Trauma. 1991;31:43–8.
Squair JW, Bélanger LM, Tsang A, et al. Spinal cord perfusion pressure predicts neurologic recovery in acute spinal cord injury. Neurology. 2017;89:1660–7.
Stevens RD, Bhardwaj A, Kirsch JR, et al. Critical care and perioperative management in traumatic spinal cord injury. J Neurosurg Anesthesiol. 2003;15:215–29.
Tee JW, Altaf F, Belanger L, et al. Mean arterial blood pressure management of acute traumatic spinal cord injured patients during the pre-hospital and early admission period. J Neurotrauma. 2017;34:1271–7.
Vale FL, Burns J, Jackson AB, et al. Combined medical and surgical treatment after acute spinal cord injury: results of a prospective pilot study to assess the merits of aggressive medical resuscitation and blood pressure management. J Neurosurg. 1997;87:239–46.
Walters BC, Hadley MN, Hurlbert RJ, et al. Guidelines for the management of acute cervical spine and spinal cord injuries: 2013 update. Neurosurgery. 2013;60:82–91.
Wirtz KM, La Favor KM, Ang R. Managing chronic spinal cord injury: issues in critical care. Crit Care Nurse. 1996;16:24–35.
Yue JK, Winkler EA, Rick JW, et al. Update on critical care for acute spinal cord injury in the setting of polytrauma. Neurosurg Focus. 2017;43:E19.
Suggested Reading
Buchanan LE, Nawoczenski DA, editors. Spinal cord injury-concepts and management approaches. Baltimore: Williams & Wilkins; 1987.
Byrne TN, Benzel EC, Waxman SG. Diseases of the spine and spinal cord. Oxford: Oxford University Press; 2000.
Cairo JM, editor. Pilbeam’s mechanical ventilation. Physiological and clinical applications. St Louis: Elsevier; 2015.
Cardenas DD, Dalal K, editors. Spinal cord injury rehabilitation. Phys Med Rehabil Clin N Am. Philadelphia: Elsevier; 2014.
Cardenas DD, Hooton TM, editors. Medical complications in physical medicine and rehabilitation. New York: Demos Medical Publishing, LLC; 2015.
Chhabra HS, editor. ISCoS textbook on comprehensive management of spinal cord injuries. New Delhi: Wolters Kluwer; 2015.
Durrant DH, True JM. Myelopathy, Radiculopathy, and peripheral entrapment syndromes. Boca Raton: CRC Press; 2002.
Eagler GL, Cole J, Merton WL, editors. Spinal cord diseases: diagnosis and treatment. New York: Marcel Dekker Inc.; 1998.
Eltorai IM, Schmit JK, editors. Emergencies in chronic spinal cord injury patients. New York: Eastern Paralyzed Veterans Association; 2001.
Green D, Olson DA, editors. Medical management of long-term disability. 2nd ed. Boston: Butterworth-Heinemann; 1996.
Harrison P. Managing spinal injury: critical care. The international management of people with actual or suspected spinal cord injury in high dependency and intensive care unit. London: The Spinal Injury Association; 2000.
Hattingen E, Klein JC, Weidauer S, Vrionis F, Setzer M, editors. Diseases of the spinal cord. Heidelberg: Springer; 2015.
Lin VW, editor. Spinal cord medicine. Principles and practice. 2nd ed. New York: Demos Medical; 2010.
Preston RA. Acid-base, fluids and electrolytes: made ridiculously simple. 2nd ed. Miami: MedMaster, Inc.; 2011.
Russel C, Matta B. Tracheostomy a multiprofessional handbook. Cambridge: Cambridge University Press; 2004.
Sabharwal S. Essentials of spinal cord medicine. New York: Demos Medical; 2014.
Sykes K, Yong JD. Respiratory support in intensive care. London: BMJ Books; 1999.
Thron AK. Vascular anatomy of the spinal cord. Neurological investigations and clinical syndromes. New York: Springer; 1988.
Vaccaro AR, Fehlings MG, Dvorak MF, editors. Spine and spinal cord trauma, evidence-based management. New York: Thieme Medical Publishers; 2011.
Vinken PJ, Bruyn GW, editors. Injuries of the spine and spinal cord. Part II, Handbook of clinical neurology, vol. 25. Oxford: North-Holland Publishing Company; 1976.
Vodusek DB, Boller F. Neurology of sexual and bladder disorders. In: Aminoff MJ, Boller F, Swaab DF, editors. Handbook of clinical neurology, third series, vol. 130. London: Elsevier; 2015.
Vogel LC, Zebracki K, Betz RR, Mulcahey MJ, editors. Spinal cord injury in the child and young adult. London: Mac Keith Press; 2014.
Weaver LC, Polosa C, editors. Autonomic dysfunction after spinal cord injury. In: progress in brain research, vol. 152. Elsevier, New York; 2006.
Weidner N, Rupp R, Taney KE, editors. Neurological aspects of spinal cord injury. Cham: Springer; 2017.
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Ko, HY. (2019). Acute Management of Spinal Cord Injury. In: Management and Rehabilitation of Spinal Cord Injuries. Springer, Singapore. https://doi.org/10.1007/978-981-10-7033-4_10
Download citation
DOI: https://doi.org/10.1007/978-981-10-7033-4_10
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-10-7032-7
Online ISBN: 978-981-10-7033-4
eBook Packages: MedicineMedicine (R0)