Initial Management of the Patient With Cervical Spine Injury

Initial management, beginning at the scene of the accident, plays a pivotal role in determining the long-term prognosis of patients with cervical spine injury. Early and appropriate measures increase the likelihood of neurological recovery and subsequently reduce complications from prolonged immobilization and recumbency. This manuscript discusses the prehospital and hospital management of a patient with cervical spine injury, including the techniques of immobilization, initial clinicoradiographic evaluation, the current consensus on “clearance” of the cervical spine, medical management of spinal cord injuries, and the issue of timing of surgery.