An 82-year-old male with a history of Parkinson disease and osteoporosis is brought to the emergency department by his son after a fall from standing height. The patient is found to have stridor and labored breathing, as well as reduced strength and sensation in all extremities. A plain radiograph is obtained, and a CT scan confirms additional vertebral fractures of the thoracic and lumbar spine.
Which does not contribute to the SLIC and Severity Scale?
A. Neurologic deficit
B. Patient age
C. Integrity of the disco-ligamentous complex (DLC)
D. Injury morphology
该患者的x线片显示C3-C5骨折-脱位。轴下颈椎创伤手术治疗的决策可以通过使用SLIC来辅助。该量表考虑了形态学(例如:压迫、爆裂、平移)、DLC状态(例如:完整、孤立加宽、破坏)和神经功能缺损水平(例如:神经根损伤、连续脊髓压迫)。
由于平移形态,该患者的形态评分为4,由于其对不完全性脊髓损伤的临床描述,其神经功能缺损评分为3或更高。无论DLC评分如何,该患者的评分均超过5,建议采用手术方法。与加拿大脊柱规则(CCR)等测试前规则不同,SLIC系统的应用不取决于损伤机制或患者年龄。CCR使用年龄、机制和症状建议对可能看似低风险的损伤进行成像。
B
补充内容:
急诊环境中颈椎损伤的评估流程
颈椎损伤低/高风险评估
三种颈椎创伤分类系统
- 1.艾伦和弗格(Al len and Fergusson)分类
- 2. 下颈椎损伤分类系统(SLIC)
- 3. Aosp ine 分类
ACR 适当标准 ACR APPROPR IATENESS CRITERIA。根据患者的临床和神经状态的不同,美国放射学院(ACR)已发布适用标准,用于疑似创伤时颈椎成像。
疑似颈椎损伤的常见情况 ( NEXUS/CR阳性临床症状)包括:
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