Summary
Definition
History and exam
Other diagnostic factors
- reduced level of consciousness
- paraesthesia in the limbs
- motor weakness
- sensory loss
- bowel or bladder dysfunction
- priapism
- cranial nerve deficit
- Hoffman's sign
- Babinski's sign
- neurogenic shock
- spinal shock
Risk factors
- male sex
- female sex (whiplash injury)
- age 18-40 or >65 years old
- a dangerous mechanism of injury
- distracting traumatic injuries
- lack of preparation or awareness of collision
- head rotated at time of collision
- previous cervical spine trauma or surgery
- pre-existing spinal, cranial, or other abnormality
Diagnostic investigations
Treatment algorithm
Contributors
Expert advisers
Dr Ram Hariharan, FRCP
Consultant
Yorkshire Regional Spinal Injuries Centre
Pinderfields Hospital
Aberford road
Mid Yorkshire Teaching Hospitals NHS Trust
Wakefield
UK
Disclosures
RH declares that he has no competing interests.
Acknowledgements
BMJ Best Practice would like to gratefully acknowledge the previous expert contributors, whose work has been retained in parts of the content:
Christopher S. Ahuja, MD
Research Fellow
Division of Neurosurgery
Department of Surgery
University of Toronto
Ontario
Canada
Michael G. Fehlings, MD, PhD, FRCS(C), FACS
Professor Division of Neurosurgery
Director of Neuroscience Program
University of Toronto
Krembil Chair in Neural Repair and Regeneration
Medical Director
Krembil Neuroscience Center
Toronto Western Hospital
Ontario
Canada
Muhammad Dherijha MBBS, MRCS
ST8 Neurosurgery
Health Education Northwest
Manchester Clinical Neuroscience Centre
Salford
UK
Disclosures
CSA declares that he has no competing interests. MGF served as a consultant for Zimmer, In Vivo Therapeutics, and Pfizer. He receives institutional fellowship grant support from AOSpine, Medtronic, and Depuy-Synthes. MD declares that he has no competing interests.
Peer reviewers
Jonathan Lucas, MBBS, FRCS (Eng), FRCS (Orth&Tr)
Head of Service - Paediatric Spinal and Orthopaedic Surgery
Consultant Spinal Surgeon
Guys and St Thomas’ NHS Foundation Trust
Evelina London Children’s Hospital
Guys Hospital
London
UK
Disclosures
JL is an Education Consultant to Nuvasive Inc. in the subject of paediatric spinal deformity surgery.
Editors
Helena Delgado-Cohen
Section Editor, BMJ Best Practice
Disclosures
HDC declares that she has no competing interests.
Susan Mayor
Lead Section Editor, BMJ Best Practice
Disclosures
SM works as a freelance medical journalist and editor, video editorial director and presenter, and communications trainer. In this capacity, she has been paid, and continues to be paid, by a wide range of organisations for providing these skills on a professional basis. These include: NHS organisations, including the National Institute for Health and Care Excellence, NHS Choices, NHS Kidney Care, and others; publishers and medical education companies, including the BMJ Group, the Lancet group, Medscape, and others; professional organisations, including the British Thoracic Oncology Group, the European Society for Medical Oncology, the National Confidential Enquiry into Patient Outcome and Death, and others; charities and patients’ organisations, including the Roy Castle Lung Cancer Foundation and others; pharmaceutical companies, including Bayer, Boehringer Ingelheim, Novartis, and others; and communications agencies, including Publicis, Red Healthcare and others. She has no stock options or shares in any pharmaceutical or healthcare companies; however, she invests in a personal pension, which may invest in these types of companies. She is managing director of Susan Mayor Limited, the company name under which she provides medical writing and communications services.
Rachel Wheeler
Lead Section Editor, BMJ Best Practice
Disclosures
RW declares that she has no competing interests.
Annabel Sidwell
Comorbidities Editor, BMJ Best Practice
Disclosures
AS declares that she has no competing interests.
Adam Mitchell
Drug Editor, BMJ Best Practice
Disclosures
AM declares that he has no competing interests.
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