Evaluation and treatment of spinal injuries in the patient with polytrauma

Spinal injuries occur frequently in the patient with polytrauma making the knowledge of the evaluation and treatment of these injuries invaluable to the trauma team. In the immediate moments after these injuries, critical steps can be taken to prevent additional injury and insure maximum neurologic and functional recovery of the patient. A simple, standardized approach to treating the patient at the scene, examining the patient in the trauma admitting area, ordering appropriate radiographic studies, and instituting early treatment can markedly influence a patient's maximal recovery. Furthermore, background knowledge in the classification and ultimate treatment goals allows for an effective communication between the initial treating team and the spinal surgeons involved. The work on indicators of potential spinal instability by White and Panjabi and the three-column classification of spinal injuries of Denis lends insight to the potential consequences of spinal trauma. A thorough appreciation of these concepts puts evaluation and treatment of these injuries into a logical framework with which spinal injuries initially can be approached.