Screening and diagnosis

Published: April 24, 2005
59

Paramedics and emergency workers are trained to treat people who have suffered a traumatic head or neck injury as if they have a spinal cord injury or an unstable spinal column, until a thorough screening and diagnosis can be completed. A key step in the initial treatment is immobilizing the spine.

Immobilizing the spine can prevent injury to the spine or prevent worsening of any injury that is already present. For this reason, emergency personnel receive training in handling an injured person without moving the neck and back. They use rigid collars around the injured person’s neck and place the injured person on a rigid board, until a complete evaluation can take place.

In the emergency room, a doctor may be able to rule out spinal cord injury by carefully inspecting an injured person, testing for sensory function and movement, and asking some questions about the accident. But if the injured person complains of neck pain, isn’t fully awake, or has obvious signs of weakness or neurologic injury, emergency diagnostic tests may be needed.

These tests may include:

* X-rays. Medical personnel typically order these tests on all trauma victims suspected of having a spinal cord injury. X-rays can reveal Vertebrae problems, tumors, fractures or degenerative changes in your spine.

* Computerized tomography (CT) scan.

A CT Scan may provide a better look at abnormalities seen on an X-ray. This scan uses computers to form a series of cross-sectional images that can define bone, disk and other problems.

* Magnetic resonance imaging (MRI). MRI uses a strong magnetic force and radio waves to produce computer-generated images. This test is extremely helpful for looking at the spinal cord and identifying herniated disks, blood clots or other masses that may be compressing the spinal cord. But MRI can’t be used on people with pacemakers or on trauma victims who need certain life-support machines or Cervical traction devices.

* Myelography. Myelography allows your doctor to visualize your Spinal nerves more clearly. After a special dye is injected into your spinal canal, X-rays or CT scans of your vertebrae can suggest a herniated disk or other lesions. This test is used when MRI isn’t possible or when it may yield important additional information that isn’t provided by other tests.