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Related Concept Videos

Secondary Spinal Cord Injury llI: Pathophysiology01:25

Secondary Spinal Cord Injury llI: Pathophysiology

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Early Ischemia and Ionic ImbalanceWithin minutes of spinal cord injury, a secondary cascade begins, progressing over hours to weeks. Vascular damage reduces blood flow, causing ischemia and mitochondrial dysfunction. ATP depletion leads to ion pump failure, membrane depolarization, sodium influx, potassium efflux, and water accumulation, resulting in cellular swelling. Increased intracellular calcium further disrupts mitochondria and accelerates cellular injury.Excitotoxicity and Neuronal...
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Spinal Cord Injury ll: Pathophysiology01:14

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Spinal cord injury progresses through two interconnected phases: primary injury and secondary injury.Primary InjuryPrimary injury happens at the moment of trauma and involves immediate mechanical damage to the spinal cord.Compression happens when broken vertebrae, herniated discs, or accumulating blood (such as a hematoma) press directly against the spinal cord, distorting its normal shape and function. In cases of contusion, the cord is bruised by a blunt force (like penetrating injuries or...
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Risk Factors for Multiregional Spinal Column Injury: A Western Pediatric Surgery Research Consortium and Western

Natasha Hongsermeier-Graves1, Christina Dantam2, Anastasia M Kahan3

  • 1Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA.

Spine
|May 5, 2026
PubMed
Summary

In pediatric trauma patients, specific injuries like rib fractures and mechanism of injury increase the risk of thoracolumbar injury (TLI). Prehospitalization intubation and rib fractures are key indicators for cervical spine injury (CSI) plus TLI.

Keywords:
Cervical spinehalomechanism of injurymotor vehicle accidentspinal column injurythoracolumbar injurythoracolumbar spinetrauma

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Area of Science:

  • Trauma Surgery
  • Pediatric Orthopedics
  • Spinal Cord Injury Research

Background:

  • Traumatic spinal injuries pose significant morbidity and mortality risks in children.
  • Early identification and management of multi-region spinal injuries are critical.

Purpose of the Study:

  • To identify trauma-related and patient-level risk factors for multiregional spinal column injury in pediatric trauma patients.
  • To define multiregional spinal column injury as concurrent cervical spine injury (CSI) requiring treatment and thoracolumbar injury (TLI).

Main Methods:

  • Prospective, multicenter observational study involving children under 18 with blunt multisystem trauma.
  • Clinically significant CSI defined by surgery or halo placement; TLI incidence recorded.
  • Primary outcome: multiregional spinal column injury (CSI+TLI).

Main Results:

  • Of 19,651 children, 7.5% had TLI, 0.81% had CSI, and 0.15% had CSI+TLI.
  • Mechanism of injury, rib fractures, hemothorax/pneumothorax, bowel injury, pelvic fracture, and CSI were associated with TLI.
  • Prehospitalization intubation and rib fractures were independently associated with CSI+TLI.

Conclusions:

  • 19% of pediatric patients with CSI requiring treatment also had TLI.
  • Specific trauma factors (MOI, rib fractures, etc.) predict TLI; intubation and rib fractures predict CSI+TLI.
  • Recommended screening for multiregional injury based on identified risk factors and targeted imaging.