|
Year |
2001 |
|---|---|
|
Question Number |
65. |
|
Category |
Select |
Question
A patient has a GSW to the cervical spine. Which of the following factors is considered the best indication for spinal surgery?
1. Bullet in the spinal canal
2. Bullet in the disk space
3. CSF leak
4. Osteoligamentous instability
5. Bone fragments in the spinal canal
Figures
Answer (click for answer)
The correct answer is (4) Osteoligamentous instability. The main indication for spinal surgery (both traumatic and not) is worsening neurologic function from a surgically correctable/resectable mass or obstruction. Of the factors given, osteoligamentous instability represents the highest risk for further spinal cord injury. The bullet or bone fragments are not necessarily mobile objects within the canal or disk space, and a CSF leak is not an absolute indication for spinal surgery.
Reference: Levine. OKU: Trauma. Rosemont, IL. AAOS. 1996. pp. 329-334.