Ch61 Management of Spinal Cord Injury

Question 1

What are the NEXUS low risk criteria for SCI?

Answer 1

Absent posterior midline cervical tenderness,
No evidence of intoxication,
Normal level of alertness and consciousness,
Absence of any focal neurological deficit,
Absence of any distracting injuries

Question 2

What is the chance of a non-contiguous spinal injury in the presence of a known injury already?

Answer 2

20%

Question 3

Would you administer high dose steroids in SCI?

Answer 3

No, Although the NASCIS trials have suggested that high dose MethylPred improves outcome if given early this is widely criticised and there is good evidence for adverse effects of steroids

Question 4

What did the STASCIS trial show?

Answer 4

Early decompression (< 24 h) was associated with significantly more patients with a ≥ 2 grade improvement in ASIA impairment scale at 6-month follow-up

Question 5

When would you use 3-view plain XR in C-spine trauma?

Answer 5

When CT not available!

Question 6

What is the normal soft tissue dimensions on plain C-spine XR?

Answer 6

Retropharyngeal <7mm

retrotracheal <14mm (22mm in paeds)