Traumatismo agudo de la columna cervical en adultos

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Última revisão das evidências: 15 Apr 2026
Última atualização do tópico: 13 Feb 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • mecanismo concordante de la lesión
  • dolor cervical
  • Factores de riesgo
Detalhes completos

Outros fatores diagnósticos

  • Nivel de consciencia reducido
  • parestesia en las extremidades
  • debilidad motora
  • pérdida sensorial
  • disfunción intestinal o de la vejiga
  • Priapismo
  • déficit de pares craneales
  • signo de Hoffman
  • Signo de Babinski
  • shock neurogénico
  • sección medular
Detalhes completos

Fatores de risco

  • sexo masculino
  • sexo femenino (lesión por latigazo cervical)
  • Edad 18-40 o >65 años
  • un mecanismo peligroso de lesión
  • lesiones traumáticas que distraen
  • falta de preparación o de consciencia respecto del riesgo de choque
  • rotación de la cabeza en el momento del choque
  • cirugía o traumatismo previo de la columna cervical
  • alteración craneal, espinal o de otro tipo preexistente
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • tomografía computarizada de alta resolución de la columna cervical
Detalhes completos

Investigações a serem consideradas

  • TC de toda la columna vertebral
  • resonancia magnética (IRM) de la columna cervical
Detalhes completos

Algoritmo de tratamento

Inicial

sospecha de lesión de la columna cervical

AGUDA

lesión confirmada de la columna cervical

lesión simple por esguince de cuello o latigazo cervical

Colaboradores

Consultores especialistas

Dr Ram Hariharan, FRCP

Consultant

Yorkshire Regional Spinal Injuries Centre

Pinderfields Hospital

Aberford road

Mid Yorkshire Teaching Hospitals NHS Trust

Wakefield

UK

Declarações

RH declares that he has no competing interests.

Acknowledgements

BMJ Best Practice would like to gratefully acknowledge the previous expert contributors, whose work has been retained in parts of the content:

Christopher S. Ahuja, MD

Research Fellow

Division of Neurosurgery

Department of Surgery

University of Toronto

Ontario

Canada

Michael G. Fehlings, MD, PhD, FRCS(C), FACS

Professor Division of Neurosurgery

Director of Neuroscience Program

University of Toronto

Krembil Chair in Neural Repair and Regeneration

Medical Director

Krembil Neuroscience Center

Toronto Western Hospital

Ontario

Canada

Muhammad Dherijha MBBS, MRCS

ST8 Neurosurgery

Health Education Northwest

Manchester Clinical Neuroscience Centre

Salford

UK

Declarações

CSA declares that he has no competing interests. MGF served as a consultant for Zimmer, In Vivo Therapeutics, and Pfizer. He receives institutional fellowship grant support from AOSpine, Medtronic, and Depuy-Synthes. MD declares that he has no competing interests.

Revisores

Jonathan Lucas, MBBS, FRCS (Eng), FRCS (Orth&Tr)

Head of Service - Paediatric Spinal and Orthopaedic Surgery

Consultant Spinal Surgeon

Guys and St Thomas’ NHS Foundation Trust

Evelina London Children’s Hospital

Guys Hospital

London

UK

Declarações

JL is an Education Consultant to Nuvasive Inc. in the subject of paediatric spinal deformity surgery.

Créditos aos pareceristas

Os tópicos do BMJ Best Practice são constantemente atualizados, seguindo os desenvolvimentos das evidências e das diretrizes. Os pareceristas aqui listados revisaram o conteúdo pelo menos uma vez durante a história do tópico.

Declarações

As afiliações e declarações dos pareceristas referem--se ao momento da revisão.

Editores

Helena Delgado-Cohen

Section Editor, BMJ Best Practice

Declarações

HDC declares that she has no competing interests.

Susan Mayor

Lead Section Editor, BMJ Best Practice

Declarações

SM works as a freelance medical journalist and editor, video editorial director and presenter, and communications trainer. In this capacity, she has been paid, and continues to be paid, by a wide range of organisations for providing these skills on a professional basis. These include: NHS organisations, including the National Institute for Health and Care Excellence, NHS Choices, NHS Kidney Care, and others; publishers and medical education companies, including the BMJ Group, the Lancet group, Medscape, and others; professional organisations, including the British Thoracic Oncology Group, the European Society for Medical Oncology, the National Confidential Enquiry into Patient Outcome and Death, and others; charities and patients’ organisations, including the Roy Castle Lung Cancer Foundation and others; pharmaceutical companies, including Bayer, Boehringer Ingelheim, Novartis, and others; and communications agencies, including Publicis, Red Healthcare and others. She has no stock options or shares in any pharmaceutical or healthcare companies; however, she invests in a personal pension, which may invest in these types of companies. She is managing director of Susan Mayor Limited, the company name under which she provides medical writing and communications services.

Rachel Wheeler

Lead Section Editor, BMJ Best Practice

Declarações

RW declares that she has no competing interests.

Annabel Sidwell

Comorbidities Editor, BMJ Best Practice

Declarações

AS declares that she has no competing interests.

Adam Mitchell

Drug Editor, BMJ Best Practice

Declarações

AM declares that he has no competing interests.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

National Institute for Health and Care Excellence. Spinal injury: assessment and initial management. Feb 2016 [internet publication].Texto completo

National Institute for Health and Care Excellence. Spinal injury: assessment and initial management. Methods, evidence and recommendations. Feb 2016 [internet publication].Texto completo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.

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