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Traumatology · General Questions of Traumatology and Orthopedics

Spine and back injuries

Traumata columnae vertebralis et medullae spinalis

Spine and spinal cord injuries are severe musculoskeletal traumas requiring strict adherence to biomechanics during first aid, precise diagnostic imaging, and emergency surgery to prevent irreversible neurological deficits.

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Key CT methodsDetection of upper cervical spine and C2 odontoid process fractures
Role of MRIVisualization of soft tissues and spinal cord compression
Pressure ulcer riskOccurs in 20–53% of patients with spinal cord injuries
Surgical strategyEmergency decompression and segment fixation
2 min readFor medical studentsUpdated 10.10.2026
Material prepared by WhiteCoat Pro editorial team based on platform study guidesPending instructor review

Diagnostic Imaging: CT and MRI

Modern imaging modalities are used to accurately determine the nature of the injury and select the management strategy:

  • Computed tomography (CT) is indispensable for examining areas difficult to assess with conventional radiography: the upper cervical spine, craniovertebral junction, and C2 odontoid fractures. CT helps assess injury stability and bone healing time.
  • Magnetic resonance imaging (MRI) visualizes soft tissues, the condition of intervertebral discs, and the relationship of bone fragments to the spinal cord. It allows for the diagnosis of radiculopathy causes and predicts the progression of an uncomplicated fracture to a complicated one due to scar formation.

Pre-hospital care and injury mechanism

Rules for providing first aid at the scene:

  • The primary rule in suspected spinal fracture is strict biomechanical control, as any excessive movement can exacerbate the injury.
  • The date and time of injury must be taken into account: the duration of the trauma (over 2 weeks) critically affects the feasibility of closed dislocation reduction and fragment repositioning.
  • Inadequate care leads to early complications: impaired blood supply, blistering, or skin perforation by bone fragments.
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Complications of traumatic spinal cord disease

Spinal cord injuries are frequently accompanied by severe somatic disorders:

  • Urological complications: impaired urination regulation leads to urinary retention, pyelitis, or urosepsis.
  • Pressure ulcers: develop in 20–53% of victims, serving as a gateway for infection and causing severe hypoproteinemia.
  • Heterotopic ossification: formation of bone bridges in major joint tissues (in 16–53% of patients), resulting in restricted mobility and hindering rehabilitation.

Treatment principles and emergency surgery

Treatment of spinal trauma is based on a strict algorithm:

  1. Life-saving measures and vital function compensation (according to the ABC rule).
  2. Emergency surgery to relieve spinal cord compression and stabilize the spine.
  3. Prevention of pressure ulcers, pneumonia, and urinary tract infections.
  4. Reconstructive interventions in later periods.

The main goal of emergency intervention is the elimination of the primary compression factor caused by displaced vertebrae and bone fragments.

How to memorize

First aid rule in spinal trauma: "No unnecessary movements!" Biomechanical control protects the spinal cord from secondary injury.

Class and exam questions

Why is standard radiography not always effective in neck injuries?

The upper cervical vertebrae, craniovertebral junction, and C2 odontoid fracture are anatomically complex for standard radiography, making computed tomography (CT) mandatory for their visualization.

What is the main clinical difference between CT and MRI in spinal trauma?

CT better visualizes bone structures, determines injury stability, and assesses fusion. MRI is indispensable for evaluating soft tissues, the state of intervertebral discs, and the degree of compression of the spinal cord and nerve roots.

What are the main causes and consequences of pressure ulcers in spinal cord injuries?

Pressure ulcers occur due to trophic disorders and a high level of spinal cord lesion (in 20–53% of cases). They serve as an entry point for infection, cause sepsis, hypoproteinemia, and can be fatal.

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What else to study on this topic

  • Typical mechanisms of musculoskeletal trauma
  • Taking the medical history (anamnesis vitae) in musculoskeletal traumas and diseases
  • Performing lumbar puncture and cerebrospinal fluid dynamics tests
  • Organization of hospitalization and stages of specialized care
  • Performing cardiopulmonary resuscitation according to the ABC rule

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  • Complete study guide on "Spine and Spinal Injuries" and 812 other pages of the subject
  • Assignments and quizzes after every topic — just like in a colloquium
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Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.