Best Practice Case Studies-Case 157 Asset 3 Acute Cervical Spine Injury

Video Transcription

Video Summary

This lecture reviewed acute cervical spine injuries in athletes, especially for sideline and pre-hospital care. Dr. Monso emphasized that event coverage requires a “sensitivity” mindset: prioritize catching dangerous injuries rather than making a definitive diagnosis on the field.<br /><br />Key topics included spinal motion restriction, imaging decision rules, helmet/pad removal, and common cervical injuries. He reviewed the NEXUS and Canadian C-spine rules, noting their high sensitivity and usefulness in deciding who needs imaging. He also discussed pediatric considerations and the PECARN work, stressing that children require special attention.<br /><br />The talk detailed practical management of suspected spinal injury, including immediate assessment of airway, breathing, and circulation, when to apply spinal motion restriction, and how to stabilize a prone athlete. A major focus was safe helmet and shoulder-pad removal, recommending the “levitation” method with clear team roles, practiced procedures, and removal of helmet and shoulder pads together. He also noted his preference for this over torso tilt.<br /><br />Dr. Monso reviewed spinal cord injury patterns such as central cord, anterior cord, posterior cord, and Brown-Séquard syndrome, and briefly discussed syringomyelia as a chronic condition related to central cord. He then summarized cervical fractures and instability patterns, including clay-shoveler’s fractures, Jefferson fractures, odontoid fractures, hangman’s fractures, and subaxial injuries.<br /><br />Other important topics included cervical cord neuropraxia, stingers/burners, ligamentous injuries, and return-to-play principles. His main take-home points were: use imaging decision rules wisely, practice emergency procedures, recognize transient neurologic syndromes, and be conservative when clearance is uncertain.

Meta Tag

Edition 4th Edition

Related Case 4th Edition, Case 157

Topic Spine

Keywords

4th Edition

4th Edition, Case 157

Spine

acute cervical spine injuries

sideline care

pre-hospital care

spinal motion restriction

NEXUS criteria

Canadian C-spine rule

PECARN

helmet and shoulder-pad removal

spinal cord injury syndromes

cervical fractures