Lower Cervical Spine Fractures and Dislocations
Lower cervical spine trauma is manifested by a wide variety of lesions from ligament injuries to fractures with large displacement accompanied by severe neurological complications. The causes of lower cervical spine can be divided in two categories depending on the age of the patient.
For patients between 15 and 25 years old, the main cause of this illness is a high trauma because of an high speed vehicle accident (motorcycle accidents lead ).
In case of lower cervical spine fractures the treatment starts immediately, because it is very important how the patient is taken to the hospital. The vital functions have to be under control and afterwards, the cervical spine has to be immobilized in order to prevent other injuries. The consciousness level should also be taken into consideration. Another important thing is to assess whether the patient presented symptoms of paralysis .
The doctor will need a medical history of the patient and a neurologic examination in search for possible cord problems. The reflexes at the tendon level will be tested. In this test will be included, for the low part : S1 and L4 (patella) and for the extremities situated higher : C5( biceps), C6 (brachioradialis), and C7 (triceps).
During the examination, very important is the assessment of sacaral roots because in this way spinal cord injuries may be detected and it gives information about the spinal shock. The perianal sensation test is recommended for sacarl roots testing. Because the spinal shock is continuous for a period of time (may last 24 hours), the test have to be repeated periodically in order to determine the end of it. Also by repeating the test, the doctor can evaluate better if the situation is going from worse to worse or is getting better, and he can choose a proper treatment.
The treatment has to take care simultaneous of all the traumas including the neurologic ones. For this is very common the treatment with steroids.
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