Clinical Pathways
Clinical Pathways
High suspicion for ligamentous injury, central cord syndrome, or other spinal cord injury
High suspicion for ligamentous injury, central cord syndrome, or other spinal cord injury

High suspicion for ligamentous injury, central cord syndrome, or other spinal cord injury

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Action

  • Obtain MRI to evaluate for ligamentous injury or cord injury (Class II)
  • Assess stability with flexion/extension films (Class III)

Decision

Is a spinal injury identified?

Yes

  • Do NOT administer methyl-prednisolone unless recommended by consultant (Class I)
  • Transfer to acute specialized SCI center (Class III)
  • Obtain neurosurgical or orthopedic spine consultation
  • Consider MRI to aid in defining injury (Class III)
  • Consider CTA in cases of:
    • Cervical spine fracture, especially C1-C3 or involving transverse foramen (Class II) or
    • If high risk by Denver criteria (see Table 9) (Class II)
  • Complete remainder of trauma evaluation. Admit or transfer to ICU (Class II) or spinal injury center (Indeterminate)

No

  • Continue observation and reassess (Indeterminate)

Background

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References
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    91. ®

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