When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Traumatismo agudo de la columna cervical

Última revisão: 20 Aug 2025
Última atualização: 26 Jun 2025

Resumo

Definition

History and exam

Key diagnostic factors

  • mecanismo concordante de la lesión
  • dolor cervical
  • preservación del sacro
  • lesión traumática asociada
  • sensibilidad cervical posterior
Full details

Other diagnostic factors

  • Nivel de consciencia reducido
  • adormecimiento, hormigueo o debilidad en las extremidades
  • debilidad motora
  • pérdida sensorial
  • disfunción intestinal o de la vejiga
  • Priapismo
  • rango de movimiento (ROM) cervical reducido o con dolor
  • pérdida de tono anorrectal y sensación perianal
  • accidente cerebrovascular
  • déficit de pares craneales
  • hiperreflexia
  • Signo de Babinski
  • signo de Hoffman
  • shock neurogénico
  • sección medular
  • cambio respiratorio
Full details

Risk factors

  • de 18 a 25 años o >65 años
  • un mecanismo de lesión peligroso
  • lesiones traumáticas que distraen
  • intoxicación por drogas o alcohol
  • 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
  • accidente cerebrovascular
Full details

Diagnostic tests

1st tests to order

  • tomografía computarizada multidetector (TCMD)
Full details

Tests to consider

  • TC de toda la columna vertebral
  • serie de radiografías de la columna cervical
  • resonancia magnética (IRM) de la columna cervical
  • mielograma por TC
  • Angiografía por TC y angiografía por RM (ARM)
  • radiografías de columna cervical en flexión-extensión (F/E)
  • estudios de conducción nerviosa
  • electromiografía
Full details

Treatment algorithm

INITIAL

sospecha de lesión de la columna vertebral en C: en la presentación inicial

ACUTE

probabilidad baja de lesión neurológica: tras la evaluación inicial

probabilidad alta de lesión neurológica: tras la evaluación inicial

Contributors

Authors

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

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

Declarações

MGF has served as a consultant for Fortuna Fix. MGF is an author of a reference cited in this topic.

Karlo M. Pedro, MD

Clinical Spine Fellow

Division of Neurosurgery

Department of Surgery

University of Toronto

Ontario

Canada

Declarações

KMP declares that he has no competing interests.

Agradecimentos

Dr Michael G. Fehlings, and Dr Karlo M. Pedro would like to gratefully acknowledge Dr Narihito Nagoshi, Dr Hiroaki Nakashima, Dr David W. Cadotte, Dr Jefferson R. Wilson, Dr Christopher S. Ahuja, and Dr Fan Jiang, previous contributors to this topic.

Declarações

NN, HN, DWC, JRW, CSA, and FJ declare that they have no competing interests.

Revisores

Jwalant Mehta, MS Orth, D Orth, MCh Orth, FRCS (Tr & Orth)

Consultant Orthopaedic and Spinal Surgeon

BMI Werndale Hospital

Carmarthen

Carmarthenshire

UK

Declarações

JM has been provided with educational support for attending conferences by Medtronic, Depuy Spine UK, and Nuvasive.

Alpesh Patel, MD

Assistant Professor

Orthopedic Surgery Operations

Department of Orthopedics

University of Utah

Salt Lake City

UT

Declarações

AP is an author of a reference cited in this topic.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

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

American College of Surgeons. Best practices guidelines: spine injury. Mar 2022 [internet publication].Texto completo

Fischer PE, Perina DG, Delbridge TR, et al. Spinal motion restriction in the trauma patient - a joint position statement. Prehosp Emerg Care. 2018 Nov-Dec;22(6):659-61.Texto completo  Resumo

American College of Radiology. ACR appropriateness criteria: acute spinal trauma. 2024 [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.
  • Traumatismo agudo de la columna cervical images
  • Diagnósticos diferenciais

    • Dolor cervical no traumático
    • Enfermedad degenerativa de columna cervical
    • Tortícolis adquirida
    Mais Diagnósticos diferenciais
  • Diretrizes

    • ACR appropriateness Criteria: acute spinal trauma
    • Head injury: assessment and early management
    Mais Diretrizes
  • Folhetos informativos para os pacientes

    Latigazo cervical

    Mais Folhetos informativos para os pacientes
  • Calculadoras

    Escala de Coma de Glasgow

    Mais Calculadoras
  • padlock-lockedConectar-se ou assinar para acessar todo o BMJ Best Practice

O uso deste conteúdo está sujeito ao nosso aviso legal