脊柱患者急诊检查及处理.pdf

Review Article The Spine-injured Patient: Initial Assessment and Emergency Treatment Abstract Rowan Schouten, FRACS, Failure to recognize spinal column or spinal cord injuries, or MBChB, BSc improper treatment of them, can have catastrophic and often Todd Albert, MD irreversible neurologic consequences. Although the initial Brian K. Kwon, MD, PhD, assessment is often shared with emergency care personnel, an FRCSC orthopaedic surgeon’s perspective can elevate the priority of spinal care to the level that is warranted. An accurate early appraisal, including complete neurologic assessment, is critical. All aspects of emergent care, including optimal immobilization precautions, resuscitation, and choice of imaging modalities, should be systematically reviewed, and practice guidelines should be adopted by each institution. Increased vigilance is required in patients with underlying ankylosing spinal conditions. The use of CT in the symptomatic patient is established, but the use of cervical MRI in the obtunded individual is contentious. By informing decisions around appropriate preliminary treatment, particularly