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Chapter 17 - Traumatic and Nontraumatic Spinal Cord Disorders

from Section 3 - Specific Neurological Disorders in Emergency Medicine

Published online by Cambridge University Press:  10 January 2024

By
Thomas F. Scott ,
Nestor Tomycz  and
David Jho
Edited by
Thomas P. Campbell  and
Kevin M. Kelly
Thomas P. Campbell
Affiliation:
Allegheny Health Network, Pittsburgh
Kevin M. Kelly
Affiliation:
Allegheny Health Network, Pittsburgh
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Summary

Traumatic spinal cord injury requires urgent imaging and decision-making involving a team approach. Causes of nontraumatic spinal cord injury are protean and can be roughly divided into compressive and non-compressive disease states. In general, it is the scenario of compressive spinal injury that needs to be identified quickly for possible urgent surgical decompression, whereas non-compressive injury requires a systematic work-up, which is somewhat less urgent. MRI is the imaging modality of choice for essentially all acute spinal cord disorders presenting to the ED, and the physician is charged with expeditious performance of this testing whenever spinal cord compression is deemed a likely possibility.

Keywords

spinal cord infarctioncentral cord syndromeanterior cord syndromeposterior cord syndromeBrown–Sequard syndromecauda equina syndrometransverse myelitismyelopathyLlermitte signspinal shock
Type
Chapter
Information
Handbook of Emergency Neurology , pp. 246 - 268
Publisher: Cambridge University Press
Print publication year: 2023

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References

Biello, JF, Davis, JW, Cunningham, MA, et al. Cervical spinal cord injury and the need for cardiovascular intervention. Arch Surg 2003;138:1127–1129.CrossRefGoogle Scholar
Casha, S, Christie, S. A systematic review of intensive cardiopulmonary management after spinal cord injury. J Neurotrauma 2010;27:1–17.Google Scholar
Denis, F. The three column spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine 1983;8(8):817–831.Google Scholar
Denis, F. Spinal instability as defined by the three-column spine concept in acute spinal trauma. Clin Orthop Relat Res 1984;189:65–76.CrossRefGoogle Scholar
Hagedorn, JC 2nd, Emery, SE, France, JC, et al. Does CT angiography matter for patients with cervical spine injuries. J Bone Joint Surg Am 2014;4(96):951–955.Google Scholar
Hoffman, JR, Schriger, DL, Mower, W, Luo, JS, Zucker, M. Low-risk criteria for cervical-spine radiography in blunt trauma: a prospective study. Ann Emerg Med 1992;21(12):1454–1460.Google Scholar
Hurlbert, RJ. The role of steroids in acute spinal cord injury: an evidence-based analysis. Spine 2001;26(24 Suppl.):S39–S46.CrossRefGoogle ScholarPubMed
Krassioukov, A, Karlsson, A, Wecht, JM, et al. Assessment of autonomic dysfunction following spinal cord injury: rationale for additions to international standards for neurological assessment. J Rehab Res Dev 2007;44(1):103–112.CrossRefGoogle ScholarPubMed
Mack, EH. Neurogenic shock. Open Pediatr Med J 2013;7(1):16–18.CrossRefGoogle Scholar
Madsen III, PW, Eismont, FJ, Green, BA. Diagnosis and management of thoracic spine fractures. In Winn, HR, Sonntag, VKH, Vollmer, DG (eds.) Youmans Neurological Surgery, 5th ed. Elsevier, 2003.Google Scholar
Mathen, R, Inaba, K, Munera, F, et al. Prospective evaluation of multislice computed tomography versus plain radiographic cervical spine clearance in trauma patients. J Trauma 2006;61:1427–1431.Google Scholar
Mirza, SK, Mirza, AJ, Chapman, JR, Anderson, PA. Classifications of thoracic and lumbar spine fractures: rationale and supporting data. J Am Acad Orthop Surg 2002;10(5):364–377.CrossRefGoogle ScholarPubMed
Molligaj, G, Payer, M, Schaller, K, et al. Acute traumatic central cord syndrome: a comprehensive review. Neurochirurgie 2014;60(1–2):5–11.Google Scholar
Nockels, RP, York, J. Diagnosis and management of thoracolumbar and lumbar spine injuries. In Winn, HR, Sonntag, VKH, Vollmer, DG (eds.) Youmans Neurological Surgery, 5th ed. Elsevier, 2003.Google Scholar
Oyinbo, CA. Secondary injury mechanism in traumatic spinal cord injury: a nugget of this multiply cascade. Acta Neurobiol Exp 2011;71:281–299.Google Scholar
Panacek, EA, Mower, WR, Holmes, JF, et al. Test performance of the individual NEXUS low-risk clinical screening criteria for cervical spine injury. Ann Emerg Med 2001;38:22–25.Google Scholar
Panczykowski, DM, Tomycz, ND, Okonkwo, DO. Comparative effectiveness of using computed tomography alone to exclude cervical spine injuries in obtunded or intubated patients: meta-analysis of 14, 327 patients with blunt trauma. J Neurosurg 2011;115(3):541–549.CrossRefGoogle ScholarPubMed
Parizel, PM, van der Zijden, T, Gaudino, S, et al. Trauma of the spine and spinal cord: imaging strategies. Eur Spine J 2010;19:S8–S17.CrossRefGoogle ScholarPubMed
Sabiston, CP, Wing, PC, Schweigel, JF, et al. Closed reduction of dislocations of the lower cervical spine. J Trauma 1988;28:832–835.Google Scholar
Savic, G, Bergstrom, EM, Frankel, HL, et al. Inter-rater reliability of the motor and sensory examinations performed according to American Spinal Injury Association standards. Spinal Cord 2007;45:444–451.CrossRefGoogle ScholarPubMed
Scott, TF. Nosology of idiopathic transverse myelitis syndromes. Acta Neurol Scand 2007;115:371–376.CrossRefGoogle ScholarPubMed
Scott, TF, Frohman, EM, De Seze, J, Gronseth, GS, Weinshenker, BG. Evidence-based guideline: clinical evaluation and treatment of transverse myelitis: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology 2011;77:2128–2134.CrossRefGoogle Scholar
Shlamovitz, GZ, Mower, WR, Bergman, J, et al. Poor test characteristics for the digital rectal examination in trauma patients. Ann Emerg Med 2007;50:25–33.Google Scholar
Sohn, M, Culver, DA, Judson, MA, et al. Spinal cord neurosarcoidosis. Am J Med Sci 2014;347:195–198.CrossRefGoogle ScholarPubMed
Stiell, IG, Wells, GA, Vandemhen, KL, et al. The Canadian C-spine rule for radiography in alert and stable trauma patients. JAMA 2001;286(15):1841–1848.Google Scholar
Tomycz, ND, Okonkwo, DO, Anderson, PA. Closed skeletal reduction and bracing of cervical, thoracic, and lumbar spinal injuries. In Vaccaro, AR, Fehlings, MG, Dvorak, MF (eds.) Spine and Spinal Cord Trauma: Evidence-Based Management. Thieme, 2011.Google Scholar
Traynelis, VC, Marano, GD, Dunker, RO, et al. Traumatic atlanto-occipital dislocation: case report. J Neurosurg 1986;65:863–870.Google Scholar

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