成人急性颈椎创伤

最后审阅: 19 四月 2022
最后更新: 02 十一月 2020

小结

定义

病史和体格检查

关键诊断因素

  • 复合损伤机制
  • 颈疼痛
  • 危险因素
完整详情

其他诊断因素

  • 意识水平降低
  • 肢体感觉异常
  • 运动无力
  • 感觉缺失
  • 直肠或膀胱功能障碍
  • 阴茎异常勃起
  • 颅神经功能缺失
  • 霍夫曼征
  • 巴宾斯基征
完整详情

危险因素

  • 男性
  • 女性(颈椎挥鞭伤)
  • 18 至 25 岁或 >65 岁
  • 存在危险性损伤机制
  • 分散注意力的(distracting)外伤
  • 缺乏准备或无意识状态下发生碰撞事故
  • 在发生碰撞事故时头部出现扭转
  • 颈椎损伤史或手术史
  • 之前有脊柱、头颅或其他发育性异常者
完整详情

诊断性检查

首要检查

  • 高分辨率颈椎 CT
完整详情

需考虑的检查

  • 全脊柱 CT
  • 颈椎 MRI
完整详情

治疗流程

初步治疗

疑似颈椎损伤

急症处理

已确诊颈椎损伤

单纯颈部扭伤或挥鞭伤

撰稿人

专家顾问

Muhammad Dherijha, MBBS, MRCS

ST8 Neurosurgery

Health Education Northwest

Manchester Clinical Neuroscience Centre

Salford

UK

利益声明

MD 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

利益声明

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.

同行评议者

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

利益声明

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

编辑

Helena Delgado-Cohen,

Section Editor, BMJ Best Practice

利益声明

HDC declares that she has no competing interests.

Susan Mayor,

Lead Section Editor, BMJ Best Practice

利益声明

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

利益声明

RW declares that she has no competing interests.

Julie Costello,

Comorbidities Editor, BMJ Best Practice

利益声明

JC declares that she has no competing interests.

Adam Mitchell,

Drug Editor, BMJ Best Practice

利益声明

AM declares that he has no competing interests.

  • 成人急性颈椎创伤 images
  • 鉴别诊断

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  • 指南

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  • 医学计算器

    格拉斯哥昏迷量表

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  • 患者教育信息

    Whiplash

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