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  • Management of Cervical Spine Injury: DR Bayu Dewanto Spbs Murni Teguh Memorial Hospital 23 FEBRUARI 2019

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    The document discusses the management of cervical spine injuries. It covers the causes of spinal cord injuries including trauma, tumors, and degeneration. It then discusses the anatomy, biomechanics, and pathophysiology of spinal cord injuries. The primary mechanisms of injury are compression of the spinal cord and vertebral deformities. Clinical presentation depends on the level and severity of injury. Diagnosis involves imaging like x-rays, CT scans, and MRI. Treatment involves immobilization, surgery for unstable fractures, rehabilitation, and managing complications. The goal is to prevent further secondary injuries to the spinal cord.

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    cervical spine injury

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    cervical spine injury

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    The document discusses the management of cervical spine injuries. It covers the causes of spinal cord injuries including trauma, tumors, and degeneration. It then discusses the anatomy, biomechanics, and pathophysiology of spinal cord injuries. The primary mechanisms of injury are compression of the spinal cord and vertebral deformities. Clinical presentation depends on the level and severity of injury. Diagnosis involves imaging like x-rays, CT scans, and MRI. Treatment involves immobilization, surgery for unstable fractures, rehabilitation, and managing complications. The goal is to prevent further secondary injuries to the spinal cord.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
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    32 views24 pages

    Management of Cervical Spine Injury: DR Bayu Dewanto Spbs Murni Teguh Memorial Hospital 23 FEBRUARI 2019

    Uploaded by

    bennyrolandnababan
    The document discusses the management of cervical spine injuries. It covers the causes of spinal cord injuries including trauma, tumors, and degeneration. It then discusses the anatomy, biomechanics, and pathophysiology of spinal cord injuries. The primary mechanisms of injury are compression of the spinal cord and vertebral deformities. Clinical presentation depends on the level and severity of injury. Diagnosis involves imaging like x-rays, CT scans, and MRI. Treatment involves immobilization, surgery for unstable fractures, rehabilitation, and managing complications. The goal is to prevent further secondary injuries to the spinal cord.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
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    of 24

    MANAGEMENT OF

    CERVICAL SPINE INJURY

    DR BAYU DEWANTO SPBS


    MURNI TEGUH MEMORIAL HOSPITAL
    23 FEBRUARI 2019
    Spinal cord injury

     Kausa: trauma, neoplasma, degeneratif

     Angka kecacatan tinggi

     Kerusakan irreversible

     Insidensi trauma 40/1.000.000 penduduk (US)

     1 dari 40 pasien trauma center

     Sebab: KLL, jatuh

     Cervical 51%, thoracal 34%, lumbosacral 10%
    Anatomi
    Anatomi
    Anatomi
    Biomekanika trauma
    Patofisiologi

    Spinal cord
     Bagian dari susunan saraf pusat
     Sifat sesuai susunan saraf pusat
     Primary mechanism of spinal cord injury
     Secondary mechanism of spinal cord injury

     Konsep tata laksana sesuai traumatic brain injury


    Patofisiologi

    Primary mechanism
     Kompresi medulla spinalis
     Deformitas columna vertebralis; herniasi diskus
    akut, fraktur corpus vertebra

    Primary injury
     Merangsang kaskade menuju secondary injury
     Proses berlangsung irreversible
      target terapi mencegah secondary injury
    Patofisiologi
    Patofisiologi
    Patofisiologi
    Patofisiologi
    Gambaran klinis


     Defisit neurologis, sesuai level trauma dan
    traktus/jaras yang terlibat

     Nyeri tulang belakang

     Complete injury >< incomplete injury

     Sacral sparing

     Neurogenic shock

     Spinal shock
    Gambaran klinis
    ASIA
     A - Complete; sensorik (-), motorik (-)
     B - Incomplete; sensorik (+), motorik (-)
     C - Incomplete; motorik (+) lebih dari separo otot
    dengan kekuatan <3
     D - Incomplete; motorik (+) lebih dari separo otot
    dengan kekuatan >3
     E - Normal
    Diagnostik

     Foto vertebra cervical lateral cross-table


     Open mouth
     Swimmer’s view
     CT scan
     MRI
    Tata laksana

    Primary survey sesuai ATLS



     Airway + c-spine control

     Oksigenasi adekuat - PaO2 100 mmHg, PaCo2 30-
    35 mmHg

     Hiperventilasi (ventilator)

     Sirkulasi adekuat – sistolik > 90 mmHg

     Tanda syok neurogenik

     Imobilisasi + padding
    Tata laksana
    Operatif (unstable fracture)

     Dekompresi

     Mengurangi deformitas

     Fiksasi internal

     Early surgery <24 jam  LOS <<

    Non operatif (stable fracture)



     Fiksasi eksterna

     Mengurangi nyeri
    Tata laksana

    Medikamentosa

     AB

     Anti trombosis

     Anti nyeri

     Roborantia

    Rehabilitasi

     Mobilisasi awal

     Psikoterapi

     Family terapi
    Tata laksana

    Komplikasi

     Pneumonia 34%

     Ulkus dekubitus 33%

     DVT 15%

     Emboli paru 3,6%
    Instabilitas spinal
    Stabilisasi
    Stabilisasi
    Konservatif
    TERIMA KASIH

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