颈椎损伤(英文版).pptx

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1、CervicalSpineInjuriesCERVICALSPINECERVICALSPINESevenCervicalVertebraeEightpairsofCervicalspinalnervesCervicalSpineInjuriesMainCauseofthediseaseTRAUMARTA–leadingcauseModeofinjuryRoadsideaccidents(RSA)FallfromheightAccidentalinjuryduetocarryingheavyweightoverheadSportsinjuriesTrivialTraumainPre-exis

2、tingSpondyloticspineModeofinjuryMechanismofInjuryNOSTUDYTILLDATEWHICHCORELATESSEVERITYOFINJURYWITHMODEOFTRAUMA/INJURYCervicalSpineInjuriesCervicalspineinjurieswithcordinjurywithoutcordinjuryCervicalSpineInjuriesPRESENTINGCOMPLAINTSPainQuadriplegiaMyotomeandDermatomeTestingNerveRootLevelSensoryTest

3、ingMotorTestingReflexTestingC1-C2FrontoffaceNeckflexionN/AC3LateralfaceandskullLateralflexionN/aC4SupraclavicularShouldershrugN/AC5Lateralshoulder/upperarmShoulderabductionBicipital(musculocutaneous)C6Laterallowerarmandhand(thumbandindexfinger)ElbowflexionandwristextensionBrachialradial(musculocut

4、aneous)C7Palmaraspectofhand–middle3fingersElbowextensionandwristflexionTriceps(radial)C8MediallowerarmandhandFingerflexionandthumbextensionN/AT1MedialelbowandupperarmFingerabductionN/ADERMATOMEDISTRIBUTIONINVESTIGATIONSRadiologicalX-raysAP,Lat,Swimmersview,odontoidviewCTScanMRImustforpatientswithn

5、eurologicallossDIGNOSTIC–PREOPERATIVEX-RAYSLateralviewTopofT1visibleinidlelatviewThreesmootharcsmaintainedVertebralbodiesofuniformheightOdontoidintactandcloselyappliedtoC1APviewSpinousprocessesstraightandspacedequallyIntervertebralspacesroughlyequalOdontoidviewOdontoidintactEqualspacesoneitherside

6、ofodontoidLateralmarginsofC1andC2alignDIGNOSTIC–PREOPERATIVECTSCANMRISIGNSOFINSTABILITYAPtranslation>3.5mmspinousprocesswideningonlateralrotationoffacetsonlateralfacetjointwideningmalalignmentofspinousprocessonAPviewlateraltiltingofvertebralbodyonAPviewLATVIEW–XRAYLATVIEW–XRAYPrevertebralsofttissu

7、eNasopharyngealspaceRetropharyngealspaceRetrotrachealspaceAPandOdontoidViewInitialTreatmentCABImmobilizationrigidcervicalorthosis-PhiladelphiacollarSpineBoardcervicaltractionwithHaloorGardnerwellstongs.InitialT