[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-505937-105":59,"doc-detail-505937-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","acute-spine-consultation-guidelines-stabilization-and-management","Acute Spine Consultation Guidelines - Stabilization and Management","","Acute Spine Consultation Guidelines provide step-by-step recommendations for triage, stabilization, and management of acute spinal pathologies before consultation and transfer. The guidance emphasizes ABC evaluation prior to using the protocol, early pain control, careful attention to ventilation in C-spine injury, maintaining MAP ≥ 85, and specific support for neurogenic shock. It covers thresholds for hypotension avoidance, frequent neurovital checks, sedation and coagulopathy reversal targets, and imaging pathways using CT and emergent gadolinium-enhanced MRI, including criteria for suspected cervical, thoracolumbar, metastatic compression, spinal cord injury without CT abnormalities, and cauda equina syndrome.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/acute-spine-consultation-guidelines-stabilization-and-management/505937/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/acute-spine-consultation-guidelines-stabilization-and-management/505937.png","ImageObject",300,407,{"name":92,"@type":93},"awa","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-07","2026-10-04",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What must be evaluated before applying these acute spine consultation guidelines?","Question",{"text":112,"@type":113},"In all cases, ABC’s should be evaluated and treated prior to applying the guidelines.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What imaging is recommended when CT is negative but suspicion for spinal cord injury remains?",{"text":117,"@type":113},"When cervical neck pain after trauma has a normal CT scan, patients require MRI to rule out spinal cord injury without radiographic abnormality.",{"name":119,"@type":110,"acceptedAnswer":120},"How should cauda equina syndrome be diagnosed and confirmed before referral?",{"text":121,"@type":113},"Diagnosis is guided by keys such as post-void residual >150cc, saddle anesthesia, decreased rectal tone, and bilateral motor weakness. Once clinical diagnosis is established, it must be corroborated by MRI to establish the diagnosis prompting referral.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},505937,1791562295,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":8,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":81,"preview_page_count":4},3985747858093,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","Acute Spine Consultation Guidelines  \nDeveloped by Dr. Sunjay Sharma, Dr. Michael Fehlings, and Dr. James Rutka for Provincial Neurosurgery Ontario  \nIn all cases, ABC’s should be evaluated and treated prior to the application of these guidelines.  \n Proceed with next step before contacting CritiCall  \n1 Stabilization and management  \n3  \nFor all pathology, in preparation for transfer:  \n Attend to ABC’s  Aggressive pain control  \n Be mindful of FVC and ventilation in C-Spine injury  \n MAP ≥85  \n For neurogenic shock use Dopamine 5-10mcg  \n Avoid hypotension  \n Perform neurovitals frequently (q1h)  \n Judicious use of sedation (short acting drugs preferred)  \n Reverse coagulopathy (INR \u003C1.5)  \n2  \nIf no CT scanner but clinical/radiographic suspicion arises, arrange urgent transfer for proper imaging to closest facility.  \nx-rays, consultation with neurosurgeon recommended prior to CT scan.  \nCT scan demonstrating at least 1 of the following  \nSpinal column fracture Subluxation/dislocation of facet joints in cervical spine Collapse of vertebral body  \n Lumbar disc herniation  \ncompromise  \n Spinal cord compression secondary to new mass  \nSpecial considerations  \nshould be evaluated by gadolinium enhanced MRI emergently  \nMRI despite negative CT  \nFor all pathologies, images should be reviewed  \nwith an available radiologist prior to CritiCall referral.  \nSpinal Cord Injury (SCI)  \nCervical  \nneck pain after trauma with normal CT scan.  \nThese patients require MRI to rule out spinal cord injury without radiographic abnormality.  \n Immobilize in hard collar  \nThoracolumbar  \n Assess bowel and bladder  Investigate for associated function spinal and systemic injuries  \n(e.g. bowel injury, occult  \n Keep on bedrest with spinal injury)  \nAcute (\u003C48hrs) spinal cord compression (metastatic)  \nEarly symptoms and signs  \n Neurologic dysfunction  Severe unremitting spinal pain  \n Localized tenderness  Nocturnal pain  \nManagement  \n Delineate primary lesion  Dexamethasone 16mg IV x 1† if applicable  \n Look for lesions, the whole  \n Avoid hypotension * spine must be imaged (SBP \u003C 100) with MRI + gadolinium  \nCaudaequina syndrome  \nKeys to diagnosis  \nPost void residual >150cc * Saddle anesthesia  \n Decreased rectal tone  \n Bilateral motor weakness  \nNext steps  \nOnce clinical diagnosis established, must be corroborated by MR I to establish diagnosis prompting referral.  \nOptimize laboratory values (i.e. coagulation) for operative intervention.  \nOnce all steps have been completed,  \nurgently contact CritiCall at 1-800-668-4357  \n* † Adjust dosage for paediatric patients.","cbCaiiXkapliz7F0","https://ap.wps.com/l/cbCaiiXkapliz7F0","pdf",161698,"English","# Stabilization and management\n## Pathology preparation for transfer\n## Imaging and transfer steps\n## Special considerations\n# Spinal cord injury (SCI)\n## Cervical\n## Thoracolumbar\n## Acute (\u003C48hrs) spinal cord compression (metastatic)\n# Cauda equina syndrome\n## Diagnostic keys\n## Next steps","[{\"question\":\"What must be evaluated before applying these acute spine consultation guidelines?\",\"answer\":\"In all cases, ABC’s should be evaluated and treated prior to applying the guidelines.\"},{\"question\":\"What imaging is recommended when CT is negative but suspicion for spinal cord injury remains?\",\"answer\":\"When cervical neck pain after trauma has a normal CT scan, patients require MRI to rule out spinal cord injury without radiographic abnormality.\"},{\"question\":\"How should cauda equina syndrome be diagnosed and confirmed before referral?\",\"answer\":\"Diagnosis is guided by keys such as post-void residual \\u003e150cc, saddle anesthesia, decreased rectal tone, and bilateral motor weakness. Once clinical diagnosis is established, it must be corroborated by MRI to establish the diagnosis prompting referral.\"}]","Acute Spine Consultation Guidelines - Stabilization and Management | PDF",1791156009]