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Universitätsmedizin Greifswald Universität Greifswald


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Spinal trauma

In consequence of the high rate of road accidents and leisure accidents in our federal state the Neurosurgical Clinic of Greifswald University has particularly great experience in the treatment of patients with spinal injuries. Spinal fractures occur in all segments of the spine. Cervical spine and lumbar spine injuries are particularly often biomechanically induced.

 

Since the spine serves the spinal cord as a bony protective cover, it often also becomes injured during fractures of the spine: in about 25% of cases, fractures of the spine cause accompanying injuries of the spinal cord as far as to complete paraplegia.

 

Depending on the kind and stability of the spinal fracture the treatment of spinal fractures is either conservative or surgical. The aim of the treatment is stable bony healing of the fracture in the most optimal position with the maintenance of spinal cord function.

 

The Neurosurgical Clinic of the University of Greifswald is equipped for the treatment of spinal injuries and spinal cord injuries of all degrees of severity.

 

Fig. 1. Fracture of the 1st and 3rd lumbar vertebral body with substantial narrowing of the spinal cord canal (presentation in spiral CT).

 

Primary care, diagnostics:

A call centre and helicopter landing site for patients with fresh injuries are in the clinical centre. The primary care is given by the Clinic for Anaesthesiology and the surgical clinic in a central emergency trauma room. The interdisciplinary primary care for patients takes place here. For special diagnostics there are available around the clock apart from the normal X-ray diagnostics a modern spiral CT scanner and MRI scanner (Clinic for Radiology).

 

Surgical treatment:

The surgical care of spinal injuries is a particular top priority of our Clinic. Since 1992 over 200 injuries of the thoracic spine and the lumbar spine, and over 100 injuries of the cervical spine have been surgically treated partly with our own instruments and implants developed for this purpose.

 

Apart from the modern operating microscopes and image converting equipment the intraoperative monitoring of the spinal cord function (Neuromonitoring) during the surgery is of great importance.

 

Fig. 2. Intraoperative finding after relief of strain of the spinal cord and insertion of titanium implants.

 

Intensive treatment:

Uncomplicated spinal injuries are treated in the own clinic. The interdisciplinary treatment of multiply injured patients and of patients with severe paraplegia takes place in the intensive care unit of the Clinic for Anaesthesiology. Also here there is round-the-clock availability of a neurosurgeon for specific therapy for our area of expertise.

 

Early rehabilitation:

The Neurological Rehabilitation Centre Greifswald, in the direct vicinity, is a modern equipped early rehabilitation facility where patients can be moved immediately for further treatment after completion of the acute treatment.

 

Fig. 3. Postoperative X-ray images on 2 levels with almost ideal position of the fracture.

 



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