A 50-year-old man was the victim of an accidental arrow shooting while hunting. The arrow entered his posterolateral neck and came to rest in the space between the C1/C2 vertebrae in his cervical spine. He was able to maintain his own cervical immobilization. His hunting partners drove him to meet emergency medical technicians, who stabilized the arrow shaft, transferred him to a backboard and ...

BACKGROUND Severe and moderate head injury can cause misdiagnosis of a spinal cord injury, leading to devastating long-term consequences. The objective of this study is to identify risk factors involving spine trauma and moderate-to-severe brain injury. METHODS A prospective study involving 1617 patients admitted in the emergency unit was carried out. Of these patients, 180 with moderate or s...

OBJECTIVES The objectives were to identify patient and hospital characteristics associated with the use of computed tomography (CT) imaging of the cervical spine (c-spine) in the evaluation of injured children and, in particular, to examine the influence of hospital setting. METHODS This was a retrospective cohort of children younger than 19 years of age from the Massachusetts Hospital Emerge...

Injuries to the cervical spine occur in 2.0 to 6.6% of blunt trauma patients, with the co-existence of head injury increasing the incidence of cervical spine injury to 10%. Injury to the cervical spinal cord in the absence of fracture occurs in 0.07 to 0.7% of trauma admissions. Missed or delayed diagnosis of cervical spine injury occurs in 4 to 8% of patients, whereas for the whole spine, miss...

Cervical spine assessment is an important step in patients who sustained trauma. Klippel-Feil syndrome (KFS) a complex with abnormal fusion of cervical vertebrae at C2 and C3, which caused by failure the division or normal segmentation early fetal development. This condition leads to characteristic appearance short neck, low hairline, facial asymmetry, limited neck mobility. People congenital d...

STUDY OBJECTIVE Although many adult algorithms for evaluating cervical spine injury use computed tomography (CT) as the initial screening modality, this may not be appropriate in low-risk children, considering radiation risks. We determine the optimal initial evaluation strategy for cervical spine injury in pediatric blunt trauma. METHODS We constructed a decision analysis tree for a hypothet...

1. Santoni BG, Hindman BJ, Puttlitz CM, Weeks JB, Johnson N, Maktabi MA, Todd MM: Manual in-line stabilization increases pressures applied by the laryngoscope blade during direct laryngoscopy and orotracheal intubation. ANESTHESIOLOGY 2009; 110:24–31 2. Nolan JP, Wilson ME: Orotracheal intubation in patients with potential cervical spine injuries. An indication for the gum elastic bougie. Anaes...

Any 14 Cervical spine 40 Thoracic spine 10 Thoracolumbar junction 35 Lumbar spine 3 A patient with serious multiple injuries is rarely able to provide a coherent history. Injuries that carry a risk of death or severe disability must, therefore, be suspected from the outset so that correct early management can be instituted. Any patient with trauma who is not fully conscious should be assumed to...

Spine immobilization in trauma patients suspected of having a spinal injury has been a cornerstone of prehospital treatment for decades. Current practices are based on the belief that a patient with an injured spinal column can deteriorate neurologically without immobilization. Most treatment protocols do not differentiate between blunt and penetrating mechanisms of injury. Current Emergency Me...

Fear of failure to identify cervical spine injury has led to extremely liberal use of radiography in patients with blunt trauma and remotely possible neck injury. A number of previous retrospective and small prospective studies have tried to address the question of whether any clinical criteria can identify patients, from among this group, at sufficiently low risk that cervical spine radiograph...