2009 Volume 23 Issue 2 Pages 238-242
Objective : In the basic management of spinal cord injury, systematic evaluation and support take precedence. Accordingly, the authors focus on the respiratory and circulatory failure that often follows cervical spine injury.
Methods : Sixty-one cases of cervical spine injury treated over the past 5 years were analyzed retrospectively. All cases received a comprehensive and systematic examination as an initial evaluation, followed by neurological and radiological assessment. Five cases were further classified as Frankel A, 4 cases and B, 1 case. These patients were 3 males and 2 females with a mean age of 48.6 years old.
Results : Three cases of Frankel A and 1 case of Frankel B were accompanied by either respiratory or circulatory failure resulting from spinal cord injury at the initial evaluation. The sinus bradycardia due to the sympathetic denervation of neurogenic shock was found in 3 of these 4 cases. Four patients received surgical stabilization of their cervical spine. At the late follow-up 1 case died of cardiac failure, and 1 case died of respiratory arrest due to pulmonary embolism.
Conclusion : It is vitally important to attempt to differentiate neurogenic shock from hypovolemic shock in these injured cases. We emphasize the importance of a comprehensive and systemic management of the accompanying respiratory and circulatory failure after severe cervical spine injury.
