Chapter 10 - Spine trauma management issues: C-spine

Abstract

This chapter discusses the clinical concerns of cervical spinal trauma and its management. Imaging should be used judiciously and guide surgical decision-making and prognostication, without delaying proper urgent surgical management. Preoperative management should include emergency transport to a level 1 trauma center with excellence in spinal cord injury. Nonsurgical management should include specialized neurointensive care as appropriate, blood pressure control, and immobilization. Surgical management should be performed with evidence-based indication, and early to prevent morbidity. Timely and selected surgical intervention permits greater neurologic recovery in cervical trauma than corresponding thoracic or lumbar injury. Anterior and posterior approaches are equally appropriate for cervical trauma based on the nature of spinal column injury, structural instability, neurologic compromise, and patient-specific considerations. Emerging options for surgical and nonsurgical intervention are being assessed to further reduce mortality, and return neurological function, thereby improving patient independence and quality of life.