Engineering considerations during the initial management of patients with unstable spine injuries

03/12/2012 - 11:45am to 12:35pm
Dr. Bryan Conrad, UF Orthopaedics & Rehabilitation

The proper prehospital and inpatient management of patients with unstable spinal injuries is of paramount importance. From the time of injury until the spine is adequately stabilized surgically, improper management can result in secondary injury to the neural elements and have catastrophic complications. It has been shown in the literature that further neurologic compromise can occur in 10-29% of patients after arrival at the hospital. It is unknown how much motion through an unstable spinal segment will result in injury to the neural elements, but limiting motion as much as possible is clearly desirable. Log-rolling patients has been repeatedly shown to result in unnecessary motion in the unstable spine, yet it continues to be common practice. Alternative techniques have been proposed, and even proven to decrease the amount of motion that occurs at unstable vertebral segments. The patient with a spine fracture is moved, turned, and transferred numerous times from the moment after injury until the time of definitive surgical stabilization. Catastrophic neurological decline can occur during any of these steps in management. The purpose of this talk is to give an overview of what we have learned through an extensive series of investigations to evaluate motion in an unstable spine during the initial stages of medical management. I will also present several opportunities where engineering solutions could make an impact by minimizing motion in the spine and thereby improving patient safety.

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