Acute and chronic trauma to the spine can result in two forms of spinal cord injury: primary injury at the time of the accident, and secondary injury from compression or spinal instability. Secondary injury prevention begins immediately at the site the injury takes place and continues after the patient arrives at the hospital. The Spine Center at Johns Hopkins strives to minimize potential secondary injury and optimize the patient's functional outcome. This is accomplished in several ways:
Proper Diagnosis of the Problem
Diagnosis begins with our well trained team in the emergency room. This team consists of emergency room physicians, neurosurgeons, general surgeons, orthopedic surgeons and highly skilled nurses and technicians. After an initial survey of the injury, safe and expeditious investigation into the stability of the spine and any damage to the spine and spinal cord are undertaken. This can involve radiographs, computed tomography (CT), magnetic resonance imaging (MRI) and angiography (a combination of CT, MRI, and conventional imaging). Coordinating this effort allows a safe and rapid diagnosis to be achieved.
Stabilizing the Patient
Treatment of an injury requires stabilization of the patient. At times, this can be achieved with bracing or traction. However, some injuries require more aggressive surgical intervention. Our team specializes in every aspect of surgical stabilization.
Surgical Intervention
True to the Johns Hopkins history of deep collaboration, we take a coordinated approach to surgical intervention. Safely placing a patient under anesthesia and positioning them in the operating room is achieved through the use of highly trained neuroanesthesiologists, neurosurgical operating room personnel and spinal surgeons. We utilize the latest technology available as well. Electrophysiological monitoring may be used during surgery to monitor motor evoked potentials, EMG, and somatosensory evoked potentials. We tailor surgical decompression and stabilization techniques to the type of fracture the patient has experienced.
Postoperative Care
Postoperative care is critical to allowing optimal recovery. After surgical decompression and stabilization, our goal is to rapidly mobilize the patient. Deep collaboration is also integral to achieving mobility. Neurointensivists, neurosurgical nurses and physical, occupational, physical medicine and rehabilitation therapists participate in this stage of recovery.
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