This is the second Paucis Verbis card on cervical spine fractures. Part 1 covered C1 and C2 fractures. This card covers the lower cervical spine fractures. These two tables are part of my chapter on "Spine and Spinal Cord Injury" in the textbook Emergency Medicine by Dr. Jim Adams (Northwestern EM Chair).
Feel free to download this card and print on a 4'' x 6'' index card.
Nice summary table Michelle. I was under the impression that a burst fx was unstable as it disrupts the anterior & middle columns of the spine. Am I wrong?
ReplyDeleteYou know, I now try to avoid the terms "stable" vs "unstable" because the literature is pretty inconsistent because you are dealing with both the orthopedic spine and neurosurgical literature. As a GENERAL rule, a single column fracture is "stable", and a multiple-column fracture is " unstable. That being said, some say that burst fractures with <25% loss of height, no neuro deficits, and no retropulsed fragments in the spinal canal are "stable".
DeleteHow confusing, right? Yea, I now just describe the injury and neurologic exam. People can argue labels. The management is still the same. Cervical spine immobilization, CT, possible MRI, serial neurologic exams, and assessment for additional injuries.
Good points, just didn't want people thinking the burst fracture was always stable. I note that the card is a couple of years old now and approaches change, not to mention that to put all the provisos & conditions on it would mean changing the name from Paucis Verbis to Verbosus Verbis...
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