Ahmed Muhammed Monjur, Kiani Shehryaar, Shah Mohammed Tanvir, El-Zanaty Ayman, Ali Muhammad Subed
Trauma and Orthopaedics, Royal London Hospital, London, GBR.
Trauma and Orthopaedics, Aintree University Hospital, Liverpool, GBR.
Cureus. 2025 Jul 3;17(7):e87217. doi: 10.7759/cureus.87217. eCollection 2025 Jul.
Cervical spine trauma represents a critical subset of blunt injuries, accounting for 2-3% of cases and over half of spinal cord injuries. This retrospective narrative review from the Royal London Hospital analyses the initial management of such injuries, emphasising protocol-led care involving spinal protection (British Orthopaedic Association Standards for Trauma (BOAST), Advanced Trauma Life Support (ATLS), National Institute for Health and Care Excellence (NICE)), clinical assessments (Glasgow Coma Scale (GCS), American Spinal Injury Association (ASIA)), and imaging (multidetector computed tomography (MDCT), magnetic resonance imaging (MRI)). Multidisciplinary involvement, particularly anaesthetics, intensivists, and spinal surgeons, was key to optimising outcomes. MDCT showed excellent diagnostic accuracy, and early surgical decompression within 24 hours, as supported by the Surgical Treatment of Acute Spinal Cord Injury Study (STASCIS), correlated with better neurological recovery. Steroids and other pharmaceuticals have either ceased use or are currently avoided due to adverse effects. Overall, timely imaging, coordinated care, and evidence-based interventions are central to effective cervical spine trauma management.
颈椎创伤是钝性损伤中的一个关键亚组，占病例的2%-3%，且脊髓损伤病例中有一半以上是颈椎创伤。伦敦皇家医院的这篇回顾性叙述性综述分析了此类损伤的初始处理，强调以方案为导向的护理，包括脊柱保护（英国骨科协会创伤标准（BOAST）、高级创伤生命支持（ATLS）、英国国家卫生与临床优化研究所（NICE））、临床评估（格拉斯哥昏迷量表（GCS）、美国脊髓损伤协会（ASIA））以及影像学检查（多排螺旋计算机断层扫描（MDCT）、磁共振成像（MRI））。多学科参与，尤其是麻醉科、重症监护医生和脊柱外科医生，是优化治疗结果的关键。MDCT显示出极佳的诊断准确性，并且如急性脊髓损伤手术治疗研究（STASCIS）所支持的，在24小时内进行早期手术减压与更好的神经功能恢复相关。由于存在不良反应，类固醇和其他药物已停止使用或目前避免使用。总体而言，及时的影像学检查、协调的护理以及基于证据的干预措施是有效处理颈椎创伤的核心。
