Raquimedular trauma

Abstract

The spinal trauma is defined as a traumatic injury that affects different cartilaginous, muscular, vascular, meningeal, radicular and spinal structures of the spine at any level; it is more common in men than in women. Vehicle accidents, work accidents, violent crimes and sports are the main causes of this trauma; the cervical region being the most frequent where the injury occurs. Its pathophysiology divides it according to the hours in which the trauma occurs: immediate trauma, occurs less than two hours, with a release of proinflammatory factors; acute early trauma, occurs in the first 48 hours where there is already a vasogenic and cytotoxic edema; sub-acute trauma, produced in 14 days; intermediate, less than 6 months; and chronic, greater than 6 months. However, the episode that most interests us is the acute one, that is, the first hours the patient enters the hospital. The pathophysiology of acute trauma has two types of injuries: primary lesions, where there is cell death at the level of the axons; secondary lesions, there is delayed or progressive damage, speaking of metabolic issues, a patient with a spinal trauma at the time of the anamnesis refers, paralysis of extremities, alterations of sensitivity, difficulty of breathing; the vital signs present bradycardia, hypotension, pain or deformity of the spine, paresthesias or priapism. The dermatomes that the human body possesses are used to evaluate the sensorial and motor level of a patient with this type of trauma, if it is absent or diminished. The basic treatment consists of having an airway, maintaining blood pressure and administering fluids; we proceed with a neurological and mnemonic examination, and a surgical treatment.