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Chapter-10 Neglected Spinal Trauma

BOOK TITLE: Neglected Musculoskeletal Injuries

Author
1. Rajasekaran S
2. Sengupta Dilip K
3. Basu Saumyajit
4. HD Kamath Vijay
ISBN
9788184488890
DOI
10.5005/jp/books/11171_10
Edition
1/e
Publishing Year
2011
Pages
18
Author Affiliations
1. Ganga Hospital, Coimbatore, Tamil Nadu, India, Ganga Medical Centre and Hospitals Pvt. Ltd., Coimbatore, Tamil Nadu, India, Ganga Medical Centre and Hospitals, Coimbatore, Tamil Nadu, India, Tamil Nadu Medical University, Coimbatore, Tamil Nadu, India, Dr MGR Medical University, Coimbatore, Tamil Nadu, India, Ganga Hospital, 313 Mettupalayam Road Coimbatore: 641043, Ganga Hospital, Coimbatore, Ganga Hospital Mettupalayam Road, Coimbatore, India, Ganga Hospital, Coimbatore - 641009, India
2. Dartmouth-Hitchcock Medical Center, Lebanon, NH, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, USA, Spine Center, Dartmouth-Hitchcock Medical Center, Lebanon, USA
3. Park Clinic, Kolkata, West Bengal, India, Park Clinic and Kothari Medical Center, Kolkata, India, Park Clinic; Kothari Medical Centre; Institute of Child Health, Kolkata, West Bengal, India, Kothari Medical Centre, Kolkata, West Bengal, India
4. Ganga Hospital, Mettupalayam Road, Coimbatore, India
Chapter keywords

Abstract

Neglected spinal injuries carry serious medicolegal implications for the physician and risks of chronic pain, deformity and neurological deficit to the patient. Although the reported incidence ranges from 4 to 10%, the true incidence may really be more as there is a tendency to under report such incidences. The risk of overlooking spinal injuries can be avoided by following strict guidelines and protocols. Clinical and radiological assessment of untreated/ inadequately treated injuries include a thorough analysis of the real disability of the patient that includes pain, deformity and neural deficit. Clinico-radiological correlation is mandatory before proceeding for treatment. Surgery for neglected spinal injuries, when indicated, is often a more major undertaking than when they are treated as fresh cases. Surgery involves decompression, deformity correction, stabilization with the proper instrumentation and fusion with various approaches and combinations. The surgeon and the patient need to be aware of the potential risk benefit equations of the surgical outcome and occasionally sub-optimal results have to be accepted by both.

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