CRACKCast E227 - Spinal Injuries

CRACKCast & Physicians as Humans on CanadiEM

Core Questions

1. Outline the Denis Classification system for determining the stability of spinal injuries
2. List 5 flexion, 2 flexion-rotation, 3 extension, and 2 vertical compression spinal injuries (Table 36.1)
   1. Wedge Fracture
   2. Flexion Teardrop Fracture
   3. Clay Shoveler’s Fracture
   4. Spinal Subluxation
   5. Bilateral Facet Dislocation
   6. Altlanto-occipital Dislocation
   7. Anterior Atlanto-axial Dislocation
   8. Unilateral Facet Dislocation
   9. Posterior Neural Arch Fracture
   10. Hangman’s Fracture
   11. Extension Tear Drop Fracture
   12. Burst Fracture
   13. Jefferson Fracture
3. Outline the mechanisms and potential complications of the following injuries:
4. How are odontoid fractures classified and what causes them?
5. Organize the spinal motor, sensory, and reflex examinations based on spinal levels. (Tables 36.3, 36.4, 36.5)
   1. Central Cord
   2. Anterior Cord
   3. Brown-Sequard
6. Detail the following cord syndromes:
7. List the components of the following imaging decision-making tools: Canadian C-Spine Rule, NEXUS C-Spine Rule.

Wisecracks

1. How do you calculate Power’s Ratio and why is it important?
2. What injuries is the open-mouth odontoid radiograph best at visualizing?
3. How are whiplash-associated injuries classified?
4. At what spinal level would you expect an injury to potentially cause Horner's Syndrome?
5. What is spinal shock and what physical exam finding indicates its end?