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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