Tampa Bay Personal Injury Lawyer - Spinal Cord Injuries

One Vote For Spinal Immobilization

Bob Carroll — Thu, 03 Aug 2006 07:26:59 GMT

The title of the correspondence in a medical journal was not particularly dramatic or catchy. The Evidence for Spinal Immobilization: An Estimate of the Magnitude of the Treatment Benefit, Annals of Emergency Medicine, Volume 48 â€¢ Number 2 â€¢ August 2006 But, it attracted my attention because of the number of spinal cord injuries experienced by my clients over the years. And, because of some personal experiences.

Apparently, there is an ongoing debate in the medical literature over the benefits of immobilizing the spine after a traumatic event, such as an motor vehicle crash. Some authors are questioning the benefit of doing this on a regular basis at accident scenes. There are no really comprehensive studies of the matter.

The letter published in the Annals of Emergency Medicine contained the following observations:

A systematic review of the MEDLINE literature from 1966 to January 2006 Week 2 allows an estimate of the potential benefit of spinal immobilization. Multiple reports show that approximately 5% of trauma patients have a spinal fracture; only 20% of this 5% have a cord injury. There are 10 independent reports of secondary deterioration without spinal immobilization, many "suddenly" and temporally related to "inappropriate management" while not immobilized.
Three of these give precise data for calculations: up to 3% to 16% of these cord-injured groups had deterioration out-of-hospital.

I vote to continue immobilization of the spine. What's your vote?

The letter published in the Annals of Emergency Medicine contained the following observations:

A systematic review of the MEDLINE literature from 1966 to January 2006 Week 2 allows an estimate of the potential benefit of spinal immobilization. Multiple reports show that approximately 5% of trauma patients have a spinal fracture; only 20% of this 5% have a cord injury. There are 10 independent reports of secondary deterioration without spinal immobilization, many "suddenly" and temporally related to "inappropriate management" while not immobilized.
Three of these give precise data for calculations: up to 3% to 16% of these cord-injured groups had deterioration out-of-hospital.

I vote to continue immobilization of the spine. What's your vote?

Originally posted at InjuryBoard by Bob Carroll

Focus On Spinal Cord Injury

Bob Carroll — Sun, 30 Jul 2006 05:39:01 GMT

Spinal cord injury (SCI) is most often caused by motor vehicle accidents. That is the primary reason our firm has an MD Neurosurgeon on its staff. Our clients with SCI require special handling and special knowledge.

We also make use of extensive online medical libraries of specialized journals. One of these libraries is MDConsult.com which also provides very focused clinical topic tours on subjects related to SCI.

Excerpts from an MDConsult article:

SCI occurs when vertebrae fracture or dislocate and cause traumatic injury to the spinal cord. Injuries can occur at any level of the spinal cord. The segment of the cord that is injured and the severity of the injury will determine which body functions are compromised or lost. Because the spinal cord acts as the main information pathway between the brain and the rest of the body, SCI can have significant physiologic consequences
An estimated 10,000 to 12,000 SCIs occur every year in the United States, and about 250,000 Americans are currently living with SCIs. Fifty-five percent of affected persons are between 16 and 30 years old, and >80% are men.
The cost of managing the care of patients with SCIs approaches $4 billion each year.
Catastrophic falls, being thrown from a horse or through a windshield, or any kind of physical trauma that crushes and compresses the vertebrae in the neck can cause irreversible damage at the cervical level of the spinal cord and below. Other kinds of injuries that directly penetrate the spinal cord can either completely or partially sever the spinal cord and create lifelong disabilities.
Of all SCIs, 38.5% happen during car accidents, and 24.5% are the result of injuries related to violent encounters, often involving guns and knives. The rest are caused by sporting accidents, falls, and work-related accidents.
In injured persons, SCI is not always obvious. Any injury that involves the head (especially with trauma to the front of the face), pelvic fractures, penetrating injuries in the area of the spine, or injuries that result from falling from heights should be suspect for spinal cord damage.
SCIs are classified as either complete or incomplete, depending on how much cord width is injured. In an incomplete injury, the ability of the spinal cord to convey messages to or from the brain is not completely lost. Persons with incomplete injuries retain some motor or sensory function below the injury. A complete injury is indicated by a total lack of sensory and motor function below the level of injury.
Paralysis of most of the body including the extremities indicates quadriplegia, a condition that occurs as a result of injury to the cervical level of the spinal cord and below. In contrast, spinal cord damage in the thoracic or lumbar area can cause paralysis of the lower trunk and lower extremities and result in the condition known as paraplegia.

We highly recommend MDConsult as a thorough and well-organized provider of medical information and literature. It is a fee-based service, however.

Originally posted at InjuryBoard by Bob Carroll