FollowUp to "Was I Out Of Line?" - Walking C Spine Injuries

[TrudyRN]

Wow, I am really out of touch, I guess, with C spine injuries.

Is there really such a thing as walking C spine injuries? It sounds incredibly dangerous and sound like it could have devastating consequences.

How is it determined that a C spine (or any spine injury, really) could be considered stable and able to walk about.

Thanks for any teaching on this topic.

[RNDude]

Anecdotally, I heard of a trail mortorbiker who fractured his c-spine in a high-g landing. Supposedly, he parked his bike gently against a tree and walked for a short distance before the fracture completed and transected his cord. Poor guy.

[Christie RN2006]

A friend of mine fell running down a hill (the clothesline he hit sure didn't help matter either) and landed on his head/neck. He walked to the ER and after getting checked in he went and sat in the waiting room. When they called his name and he went to stand up, he no longer had any movement in the left side of his body! They did a Tazzi moment and someone held c-spine and yelled for help. They slapped a collar on him and boarded him right away. Turns out he did a number on his spine!! I don't remember which ones is was for sure, but he is still paralyzed on the left side. The strange thing is he has feeling, he just can't move it.

[vampiregirl, BSN, RN]

I have had serious disc herniation and am s/p cervical discectomy with fusion at c 6-7. I still have protrusion at c 5-6 and 4-5. Any inflammation--even a cold virus--can bring on some horrible nerve pain/function issues. Let me warn you that my neck never did hurt--not at all. People with nerve impingment in the neck will have sx in their arms and shoulder blades. My elbow and wrist were very painful as was my shoulder blade on the one side where the nerve was affected. Just because there is no neck pain doesn't mean there aren't serious things going on in the neck.

Wow, I really hadn't considered referred pain for neck injuries. I check for numbness, tingling and cms in the extremities when evaluating for c-spine precautions, but I'll keep this in mind.

Also, has anyone dealt with c-spining someone with protrusion? This is something I've never encountered.

[woody62, RN]

Wow, I really hadn't considered referred pain for neck injuries.

Also, has anyone dealt with c-spining someone with protrusion? This is something I've never encountered.

When I herniated my three cervical disc, I herniated two of them towards my spinal cord. The FDNY responded to my accident and did put me in a hard cervical collar. The herniated disc were missed in the ER. I returned to SW Florida, via Amtrack. And drove in to see my neurologist. He never did a MRI until December. Then I was restricted from any driving until after my surgery. I saw the myelogram, which demonstrated two of them mere centimeters from my spinal cord. I thank God every day that he watched over me.

Woody:balloons:

[MassED, BSN, RN]

I had 4 thoracic vertebral fractures before and thank God I didn't have devastating consequences after seeing the x-rays. In fact, I had driven myself in (lonnng story in archives of this msg board). Anyways, without the cord inpinged on at that immediate time, I was a walking wounded myself.

Now what used to (still does) frustrate me; when I worked EMS and now ski patrol, on pt.'s w/spinal precautions we put the collar on, etc. Why is it the minute they get to the ER, time and time again I've watched the ER doc palpate "ok, does that hurt here? No, good, here? No, ok, I'm taking the collar off, just lay still"

this might be a very old board, but in the ER, docs (while maintaining C-spine precautions) check the neck and back, and "if" there's neck pain, the collar stays on until images are done to show no injury - then, and only then, are collars removed. This is standard.

[MassED, BSN, RN]

I have had serious disc herniation and am s/p cervical discectomy with fusion at c 6-7. I still have protrusion at c 5-6 and 4-5. Any inflammation--even a cold virus--can bring on some horrible nerve pain/function issues. Let me warn you that my neck never did hurt--not at all. People with nerve impingment in the neck will have sx in their arms and shoulder blades. My elbow and wrist were very painful as was my shoulder blade on the one side where the nerve was affected. Just because there is no neck pain doesn't mean there aren't serious things going on in the neck.

which is why those questions are asked "do you have numbness/tingling in your arms, legs, etc." If any of those answers are affirmative, depending on the location of the numbness/tingling, the pt will remain on the backboard and collared. Again, this post is old, but hey, it's still on here, so I'm responding!!!!