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Acute management of spine and spinal cord injury

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image of Trauma Quarterly

Traumatic injuries to the spine and spinal cord are a major cause of disability in the United States. They occur most commonly in young males. Advances during the last twenty years have improved the outlook for many patients in terms of both acute and chronic management. A high index of suspicion for spinal cord injuries (SCI) should be maintained in all trauma patients. Key principles of management include: (1) ABCs (airway, breathing, circulation). (2) Immobilization of the neck. (3) Radiographic assessment. (4) Accurate neurologic assessment using ASIA guidelines. Methylprednisolone (MPS) administration is the only drug demonstrating benefits to SCI patients in a prospective randomized clinical trial and should be given within eight hours of injury. The use of early aggressive closed reduction and the timing of surgical intervention are controversial.


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