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CERVICAL CORD INJURY COMPARISSION OF CLINICO-RADIOLOGICAL PICTURE WITH MODE OF INJURY

CERVICAL CORD INJURY COMPARISSION OF CLINICO-RADIOLOGICAL PICTURE WITH MODE OF INJURY. Dr Mohamed E;l Safwany, MD. Intended Learning Outcomes. The student should be able to understand role of medical imaging in the evaluation of cervical cord injuries. CERVICAL CORD INJURY.

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CERVICAL CORD INJURY COMPARISSION OF CLINICO-RADIOLOGICAL PICTURE WITH MODE OF INJURY

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  1. CERVICAL CORD INJURYCOMPARISSION OF CLINICO-RADIOLOGICAL PICTURE WITH MODE OF INJURY Dr Mohamed E;l Safwany, MD.

  2. Intended Learning Outcomes • The student should be able to understand role of medical imaging in the evaluation of cervical cord injuries.

  3. CERVICAL CORD INJURY • Mostly involve cervical spine, include fracture dislocations • 5% of TOTAL Roadside accidents (RSA). • Cervical cord injury have lasting, neurological deficit & disability • The prognosis of cord injury has direct relation with mode of injury. • Number of patients may have cervical spine injury without cord injury.

  4. CERVICAL CORD INJURY The most common types of cord injury include Contusion Compression Lacerations Central cord syndrome Simple whiplash injury.

  5. CERVICAL CORD INJURY NO STUDY TILL DATE WHICH CORELATES SEVERITYOF INJURY WITH MODE OF TRAUMA / INJURY

  6. CERVICAL CORD INJURY Categorize the mode of injury into four Groups- A) Road side accidents, (RSA) B) Fall from height (FFH), C) Accidental injury due to carrying heavy weight over head D) Trivial Trauma in Pre-existing Spondylotic spine

  7. Imaging protocol of cervical cord injury • Minimum 2-view cervical spine x-rays done in every patient and it is first investigation after entering emergency Department ------ preceded by clinical assessment. • ONLY Lateral view is most informative in all Cases. • If required dynamic x-ray Lateral view. • Followed by MRI of cervical spine.

  8. Sagittal T2 weighted Image

  9. Fractured C5 cervical vertebral body with associated posterior subluxation

  10. Sagittal T2 weighted image of the Cervical spine demonstrating focal cord compression at fracture site and displaying cord T2 hyper intensity due to cord contusion.

  11. Internal fixation involving vertebrae above and below site of fracture

  12. Lateral x-ray view demonstrating posterior fracture dislocation Cv5

  13. Sagittal T2 MRI showing complete interruption of the cervical cord opposite C5 level

  14. Sagittal T2 weighted MRI of the cervical spine demonstrating Cv5 fracture dislocation and related complete cervical cord interruption.

  15. Anterior subluxation Cv3-4

  16. Re-alignment and internal plate-screw fixation

  17. Cv5-6 forward spondylolithesis

  18. Post traumatic interrupted neural arch with focal cord compression at Cv3-4 level

  19. Post traumatic posterior disc bulge Cv5-6

  20. Fracture dislocation Cv6 with associated marked related cervical cord contusion

  21. Cervical canal stenosis , Posterior disc bulge Cv6-7 and cord malacia. Not related to trauma

  22. CERVICAL CORD INJURY • Spinal cord injury is frequently occurring and is a preventable problem. The severity of which depends upon the mode of injury. • High-speed Accidents in RSA leads to complete cord injury • In other categories the severity of disability is easily manageable with relatively good outcome.

  23. Question State the most commonm types of cervical cord injuries?

  24. Assignments 5 Students will be selected for assignments.

  25. Suggested Readings Sutton’s Radiology

  26. THANK YOU

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