Spinal injury: diagnosis
Last reviewed: 23.04.2024
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Damage to the spinal cord with trauma is not always obvious. Damage to the spine and spinal cord must be suspected in patients with CCI, pelvic fractures, penetrating wounds of the spine, after most car accidents and always after falling from a height or diving into water bodies.
The motor function is evaluated in all limbs. Sensitivity assessment should include the definition of tactile sensations (function of the posterior spinal cord), tingling with a pin (anterior spinotalamic tract), determining the sensation of the posture. It is better to determine the level of loss of sensitivity from the distal to the proximal or by evaluating the function of the pectoral roots in the patient's position on the back to avoid problems with the cervical spine. In the acute phase of a spine injury, priapism is possible, indicating a spinal cord injury. The tone of the sphincter of the anus can be reduced, the reflexes of the lower extremities either strengthened or reduced.
Perform a direct radiography of all possible damaged areas. To study the most difficult and / or suspicious zones, CT is performed. In some trauma centers with spinal trauma CT is used immediately. MRI helps establish the type and level of damage to the spinal cord. Manifestations of an injury can be characterized by the ASIA damage scale (American Spinal Injury Association) or similar scales.
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