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MULTIPLE TRAUMA ASSOCIATED
WITH SPINAL INJURY
Destriyanti Rukmana Sari
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INTRODUCTION
Multiple trauma patients with severe spinal
cord injuries have a high mortality rate and
survivors can face significant long-term
disability with poor outcome.
What is the aims?
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PATIENT AND METHODS
November 2006 to October 2009
Queen Elizabeth National Spinal Cord InjuriesCentre
375 patients 150 patients with andwithout neurological damage
From medical record and radiological
investigations : age, gender, mechanisminjury, vertebral level and neurological degreeof spinal injury and assosiated injuries
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RESULTS
1. There were 93 males and 57 females2. The age group ranged from 16-78 years (mean 37 yo)
3. Mechanism or etiology of spinal injuries
Etiology of spinal
injuries
Number Percentage
Road traffic accident 56 37.4%
Fall from height 36 24%
Fall from stairs 19 12.6%
Sporting injuries 18 12%
Assaults 12 8%
Cycling accidents 6 4%
Suicide attempts 3 2%
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4. Associated injuries with spinal cord injuries
Associated
Injuries
Cervical
Spine
Lumbal
Spine
Thoracic
Spine
Sacral
Spine
Totals
Chest injury 8 (12.5%) 11 (26.2%) 17 (44.7%) 0 36 (24%)
Abdominal
injury
6 (9.4%) 14 (33.3%) 10 (26.3%) 4 (66.7%) 34 (22.7%)
Limb injury 13 (20.3%) 9 (21.4%) 8 (21.1%) 2 (33.3%) 32 (21.3%)
Head injury 19 (29.7%) 5 (11.9%) 1 (2.6%) 0 25 (16.7%)
Facial injury 18 (28.1%) 3 (7.2%) 2 (5.3%) 0 23 (15.3%)
Total 64 42 38 6 150
44.7% of patients with thoracic spinal injuries had severe chest injuries that
included multiple rib fracture, hemothorax, pneumothorax, lung injury, and
injuries to the heart and great vessels.
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5. Pattern of spinal cord injuries
The most common level of injury was C5-C6 fracture dislocation.
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CONCLUSION
There is a close relationship between spine andassociated injuries. Acute spinal injury victims
require prompt assessment and resuscitation and
they should be admitted in a centre with all the
resources and trained personnel to recognize and
treat their associated problems.
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WE MUST KNOW ..
Multiple Trauma is the condition of a person who has been
subjected to multiple traumatic injuries, such as a serious
head injury in addition to a serious burn.
Spinal cord injury (SCI) is an insult to the spinal cord resulting
in a change, either temporary or permanent, its normal
motor, sensory, or autonomic function.
Primary survey
Airway with cervical spinal control, Breathing and keep
ventilation, Circulation with control haemoragic, Disability.
Exposure/Environment control
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ASIA IMPAIRMENT SCALE
ASIA American Spinal Injury Associations5 grades :
A Complete. No motor or sensory function in the lowest
sacral segment (S4-S5)
B Incomplete. Sensory function below neurologic level andin S4-S5, no motor function below neurological level
C Incomplete. Motor function is preserved below
neurological level and more than half of the key muscle
groups below neurologic level have a muscle grade lessthan 3
D Incomplete. Motor function is preserved below neurologic
level and at least half of the key muscle groups below
neurologic level have a muscle grade 3 or moreE Normal. Sensor and motor function is normal
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Thank you for your attention