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Orthopaedics
Cervical Spine Trauma
Built from Orthopedic Trauma Essentials
What’s inside
7 sections · 69 slides
Overview
- What this topic answers
- The four questions at a glance
The injured neck
What the spine does, what breaks it, and why getting the diagnosis right early matters
- Why an injured neck is a serious problem
- Three jobs the spine does at once
- A vertebral injury attacks all three jobs
- Bones of the upper neck
- The neck seen from the side
- Inside the cable: the spinal cord
- Cross-section of the spinal cord
- The injury does not stop at the moment of impact
- How the damage spreads
- Holding the neck still
- Neck supported before transfer
Choosing the first scan
Is CT of the cervical spine enough on its own, or must an MRI follow even when the CT looks normal?
- The question being argued
- Why CT goes first
- A fracture of the second neck bone on CT
- What that CT picture teaches
- Where CT falls short
- The radiation problem
- The patient who cannot be examined
- What MRI adds
- Two scans, two strengths
- When to add the MRI
- Bottom line on imaging
Steroids after spinal cord injury
Why high-dose methylprednisolone was tried, what the trials found, and why practice has moved on
- The idea behind giving steroids
- Which steroid, and why that one
- Three trials that defined the debate
- What the NASCIS trials were
- NASCIS I: how much steroid?
- NASCIS II: what it tested
- NASCIS II: what it found
- NASCIS III: what it tested
- NASCIS III: what it found
- The same table in one place
- Studies summarizing the effectiveness of methylprednisolone in neurological improvement for patients with acute spinal cord Injuries — what each study did
- Studies summarizing the effectiveness of methylprednisolone in neurological improvement for patients with acute spinal cord Injuries — what each study found
- What happened after the trials
- Benefit claimed against harm measured
- Bottom line on steroids
When to operate
Early decompression means surgery within 24 hours — but does even faster mean even better?
- Why the clock matters
- What early decompression means
- STASCIS: the anchor trial
- Pushing the clock earlier: two opposite results
- Recent pooled evidence
- The time windows that have been studied
- Bottom line on timing
Central cord syndrome without a fracture
When the cord is injured but no bone is broken, is an operation better than waiting?
- The injury with no broken bone
- Where the cord is squeezed
- What is normally recommended
- Why the controversy exists
- The case for waiting: the early reports
- Two more non-surgical series
- What that historical evidence shows
- The case for operating
- Surgery in the no-fracture group
- Zhou et al.: early surgery versus the rest
- Qin and Yelamarthy: the counterweight
- Two acceptable paths
- Bottom line on central cord syndrome
Putting it together
Four questions, four bottom lines
- The four answers on one slide
- What is still unresolved
- Five things to carry away
- References
- References (continued)
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- Orthopedic Trauma Essentials 2026