injuries poisoning
Spinal Trauma
Key Points
In addition to patients with obvious spinal trauma, suspect spinal cord injuries in patients at increased risk for spinal injury, including older patients who may have had a fall and patients with an altered sensorium, neurologic deficits suggesting cord injury, or localized spinal tenderness. To ensure recognition of incomplete spinal cord injuries, test motor function and sensory function (including light touch, pinprick, and position sensation) and check for disproportionate weakness in the upper extremities. Immediately immobilize the spine in patients at risk. Arrange for immediate CT or, if available, MRI. Arrange for surgery within 24 hours of injury if patients have incomplete cord injuries. Treat irreversible spinal cord injury with multimodal rehabilitation and medications that control spasticity. 