Key Points

• Approximately 55% of spinal injuries occur in the cervical region, with the most common levels at the middle and low cervical levels, with C5 followed by C4 and C6 as the segments usually injured. Injuries to the thoracic, thoraco-lumbar and lumbo-sacral areas are equally distributed in terms of incidence.

• For spinal cord injury, intravenous infusion of MPSS at 30 mg/kg over 1 hour as a loading dose, followed by a continuous infusion of 5.4 mg/kg/hour over 23 hours if this regimen is started within 3 hours of the injury or continued for 48 hours if it is started within 3 and 8 hours of the injury, is the recommended standard of care. The NASCIS II and III trials have established a benefit in outcome at 6 weeks, 6 months and 1 year in patients with both complete and incomplete injuries.

• After clinical and radiographic assessment has been completed, unstable or displaced cervical injuries should be promptly treated with cervical traction by applying GW skull tongs. The pins are applied 1 cm cephalad to the pinna in line with the external auditory meatus after careful cleansing of the skin in the area and infiltration of a local anesthetic. Closed reduction can then continue until definitive treatment with either operative fixation or treatment with external orthosis.

• The thoracic, thoracolumbar and lumbar fractures are treated as distinct entities because of their anatomy: biomechanical function and neurological function are different from the cervical spine. Although the fracture patterns that occur at each of these segments are similar, the clinical presentation, treatment and prognosis vary according to the level of the injury.

Cure Your Yeast Infection For Good

Cure Your Yeast Infection For Good

The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.

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