Principles of Critical Care, 3e > Part X. The Surgical Patient > Chapter 94. Spine Injuries G. E. Johnson

Key Points

"Severely injured patients frequently require ICU admission preoperatively and more commonly postoperatively for monitoring and assessing for change that may require intervention, including surgery. It is estimated that approximately 20% of patients sustaining multiple injuries have associated spinal column trauma that may be the prime reason for ICU admission. More commonly, ICU admission is necessitated by the more immediately life-threatening injuries, and the spinal injury then could be missed or management delayed, leading to significant morbidity or even death. The intensivist plays an important role in determining outcome in these injuries by having a high index of suspicion based on awareness of the mechanisms of spinal injuries and their clinical features. This chapter reviews (1) the mechanism, classification, and clinical picture of spinal injuries and (2) the principles of management of vertebral and spinal neurologic injuries to enable the intensivist to optimize ICU management and recognize the need for early orthopedic and/or neurosurgical consultation...."