Recommendations

Document Overview

Design and created by Guideline Central in participation with the Congress of Neurological Surgeons.

Acute Cervical Spine And Spinal Cord Injuries

Congress of Neurological Surgeons

Publication Date: Feb 28, 2013

Page Last Updated: May 6, 2026

Level of Evidence

Document Overview

Document Title: Acute Cervical Spine And Spinal Cord Injuries

Authoring Society: Congress of Neurological Surgeons

Document Publication Date: Feb 28, 2013

Page Last Reviewed/Updated: May 6, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: www.doi.org/10.1227/01.neu.0000430319.32247.7f

Source Citation: Neurosurgery, Volume 60, Issue CN_suppl_1, August 2013, Pages 82–91, https://doi-org.ezproxylocal.library.nova.edu/10.1227/01.neu.0000430319.32247.7f

Document Scope, Criteria, and Use Cases

Document Objectives: The purpose of this article is to provide an overview of the changes in the recommendations for the management of patients with acute cervical spinal cord injuries (SCIs) as a result of new evidence or broadened scope

Scope: Assessment and Screening, Diagnosis, Management, Treatment

Diseases/Conditions (MeSH)

D013119 - Spinal Cord Injuries

D013131 - Spine

D013116 - Spinal Cord

D066193 - Cervical Cord

Keywords: cervical spine, spinal cord injury, spine

Target Patient Population: Patients with acute spinal cord injuries

Inclusion Criteria: Female, Male, Adolescent, Adult, Older Adult

Health Care Settings: Emergency Care, Hospital, Radiology Services

Intended Users: Nurse, Nurse Practitioner, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Supplemental Methodology Resource: Methodology Supplement

Number of Source Documents: 65

Includes peer/external review process?: Yes

Includes public comment process?: No

Methodologist involvement?: Yes

Patient involvement?: No

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Includes benefits/harms analysis with recommendations?: No

Grade	Definition
Level of Evidence
Level I	Based on good and consistent scientific evidence.
Level II	Based on limited or inconsistent scientific evidence.
Level III	Based primarily on consensus and expert opinion.

Acute Cervical Spine And Spinal Cord Injuries

Recommendations

Immobilization

Transportation

Clinical assessment neurological status

Clinical assessment functional status

Clinical assessment pain

Radiographic assessment asymptomatic patient

Radiographic assessment symptomatic patient

Radiographic evaluation in obtunded (or unevaluable) patients

Closed reduction

Cardiopulmonary management

Pharmacology management corticosteroids

Pharmacology management GM- 1 ganglioside

Occipital condylar fractures diagnostic

Occipital condylar fractures treatment

AOD diagnostic

AOD treatment

Atlas fractures

Odontoid fracture

Axis fractures odontoid

Axis fractures hangman fracture

Axis fractures miscellaneous body

Atlas/axis combination fractures

Os odontoideum diagnostic

Os odontoideum management

Classification of subaxial injuries

Subaxial cervical spinal injuries

Central cord syndrome

Pediatric injuries diagnostic

Pediatric injuries treatment

SCIWORA diagnostic

SCIWORA treatment

VAI diagnostic

VAI treatment

Venous thromboembolism prophylaxis

Nutritional support

Level of Evidence

Document Overview

Document Scope, Criteria, and Use Cases

Recommendation Development Processes & Methodology