Summary

Spine injuries include injuries to the spinal column and also injuries to the neural structures including the spinal cord and nerve roots. The incidence of spinal cord injury is estimated at 30 to 40 per 1,000,000 persons. Spinal injuries are classified according to location and pattern of disruption of the ligaments and bony elements. Spinal cord injuries are classified according to the level and degree of function using the Frankel or ASIA score. Treatment of spine and spinal cord injuries includes the principles of realignment of the spine and protection of the spinal cord and nerve roots from injury or further injury. A combination of reduction, immobilization and often operative fixation are required to treat the gamut of injuries to the spine. It is important for physicians treating these patients to be familiar with the common and classic patterns of spinal column and spinal cord injuries and the treatment options for each. Pediatric patients represent a group at risk for certain types of injuries, due to unique biomechani-cal differences between the adult and the pediatric spine.

the significant morbidity and mortality associated with injuries to the spine and spinal cord, along with the economic, social and psychological consequences, it is of utmost importance that these injuries are recognized, classified and managed expeditiously.

The incidence of spinal cord injury is estimated at 30-40 per 1,000,000 persons, with about 10,000 new cases per year in the USA. The prevalence is approximately 900-950 per 1,000,000. The mortality rate has been estimated at approximately 48%, with about 80% of victims dying at the scene of the accident and an additional 4-15% dying upon admission to the hospital. It is estimated that approximately 250,000 patients with spinal cord injuries are alive now in the USA [1].

Approximately 55% of spinal injuries occur in the cervical region [2]. The most common levels are the middle and low cervical levels, with C-5, followed by C-4 and C-6 as the segments usually injured, due to their mobility and flexibility. Injuries to the thoracic, thoracolum-bar and lumbosacral area are equally distributed in terms of incidence. If an injury is located at one level of the spine, it is of utmost importance that the whole spine be evaluated, both clinically and radiographically, since 10-15% of patients will have an injury at another level.

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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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