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Trauma agudo da coluna cervical

Last reviewed: 19 Jun 2025
Last updated: 26 Jun 2025

Summary

Definition

History and exam

Key diagnostic factors

  • mecanismo de lesão concordante
  • dor cervical
  • preservação sacral
  • lesão traumática associada
  • sensibilidade cervical posterior
Full details

Other diagnostic factors

  • nível de consciência reduzido
  • dormência, parestesia ou fraqueza dos membros
  • fraqueza motora
  • perda sensitiva
  • disfunção do intestino ou da bexiga
  • priapismo
  • amplitude de movimento (ADM) cervical reduzida ou dolorosa
  • perda do tônus anorretal e da sensibilidade perianal
  • acidente vascular cerebral (AVC)
  • deficit do nervo craniano
  • hiper-reflexia
  • sinal de Babinski
  • sinal de Hoffman
  • choque neurogênico
  • choque medular
  • alteração respiratória
Full details

Risk factors

  • idade 18 a 25 anos ou >65 anos
  • um perigoso mecanismo de lesão
  • lesões traumáticas que causam distração
  • intoxicação
  • falta de preparo ou consciência da colisão
  • cabeça rotacionada no momento da colisão
  • trauma ou cirurgia da coluna cervical prévios
  • anormalidade preexistente na espinha, crânio ou em outra parte do corpo
  • acidente vascular cerebral (AVC)
Full details

Diagnostic tests

1st tests to order

  • tomografia computadorizada com múltiplos detectores (TCMD)
Full details

Tests to consider

  • TC da coluna vertebral inteira
  • série de raios-x da coluna cervical
  • ressonância nuclear magnética (RNM) da coluna cervical
  • mielografia por tomografia computadorizada (TC)
  • Angiotomografia (ATG) e angiografia por RM (ARM)
  • radiografias em flexão/extensão (F/E) da coluna cervical
  • estudos da condução nervosa
  • eletromiografia
Full details

Treatment algorithm

INITIAL

suspeita de lesão na coluna cervical: na apresentação inicial

ACUTE

baixa probabilidade de lesão neurológica: após avaliação inicial

alta probabilidade de lesão neurológica: após avaliação 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

Disclosures

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

Disclosures

KMP declares that he has no competing interests.

Acknowledgements

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.

Disclosures

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

Peer reviewers

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

Consultant Orthopaedic and Spinal Surgeon

BMI Werndale Hospital

Carmarthen

Carmarthenshire

UK

Disclosures

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

Disclosures

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

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

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

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.Full text  Abstract

American College of Radiology. ACR appropriateness criteria: acute spinal trauma. 2024 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Trauma agudo da coluna cervical images
  • Differentials

    • Dor cervical não traumática
    • Doença degenerativa da coluna cervical
    • Torcicolo adquirido
    More Differentials
  • Guidelines

    • ACR appropriateness Criteria: acute spinal trauma
    • Head injury: assessment and early management
    More Guidelines
  • Patient information

    Lesão por chicote

    More Patient information
  • Calculators

    Escala de coma de Glasgow

    More Calculators
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