Dr. Donald Corenman (http://neckandback.com 970.479.5895) is a spine surgeon and spinal cord expert practicing at the Steadman Clinic in Vail, CO. He created this Power Point presentation on cervical spine injury and the evaluation of the cervical spine with an injury. The cervical spine (C spine) represents the neck area of the upper spine. This presentation--clearing the cervical spine--offers an in-depth look at cervical spine injury of the neck (C spine) including fractures, cervical nonskeletal injuries, and also offers a 3-view radiograph approach into the exam. Dr. Corenman is a spine expert and treats nonskeletal injuries such as ligamentous instability, sciwora and central cord injury. He is an expert in myelopathy, sciatica, degenerative disc disease, scoliosis and slipped disc.

5. CLEARING THE CERVICAL SPINE THE 2002 ORTHOPAEDICS AND SPINE LECTURE SERIES

12. Classification of Scientific Evidence and Formulation of Recommendations

14. DISTRACTING INJURY?

16. VVMC MANAGEMENT GUIDELINES

17. Awake & Alert Awake & Alert Altered Mental Status with Neurological deficit No neuro deficit Possible C-Spine Injury Immobilize 3 or 5 View C-Spine X – rays Abnormal Consult Spine/Ortho Service Continue hard collar Cervical spine CT and/or MRI Traction /Alignment per Spine/Ortho. Service Normal

18. Awake & Alert No neuro deficit Significant Neck Pain CT Cervical Spine Positive Negative Consult Spine/Ortho Service C-spine Cleared C-spine Cleared Flexion Extension Films No neck pain or tenderness with full range of motion Positive Negative Consult Spine/Ortho Service Normal C-Spine X-rays

19. Consult Spine/Ortho Service Continue hard collar CT or MRI C-Spine Awake & Alert With neurological deficit Normal C-Spine X-rays

20. Continue hard collar If patient becomes awake and cooperative proceed with Awake & Alert Guidelines If patient remains uncooperative obtain cervical spine CT scan Positive Negative Consult Spine Ortho C-spine Cleared when Awake & Alert Normal C-Spine X-rays Altered Mental Status

23. “ THE ETIOLOGY OF MISSED OR DELAYED DIAGNOSIS” - J. O F T RUAMA , 1993

24. “ THE ETIOLOGY OF MISSED OR DELAYED DIAGNOSIS” - J. O F T RUAMA , 1993

25. “ THE ETIOLOGY OF MISSED OR DELAYED DIAGNOSIS” - J. O F T RUAMA , 1993

31. LATERAL C-SPINE: A-ALIGNMENT

36. #13, P. 6 FIG 2

39. #28 FIG 2-36 -

53. WHAT IS IT?

58. WHAT IS IT?

62. WHAT IS IT?

89. PSEUDOSUBLUXATION

99. Thank You!