SPINAL TRAUMA/ INJURY: Sase Presentation- Weakness of limbs following RTA - At Shaheed Suhrawardy...
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Transcript of SPINAL TRAUMA/ INJURY: Sase Presentation- Weakness of limbs following RTA - At Shaheed Suhrawardy...
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8/3/2019 SPINAL TRAUMA/ INJURY: Sase Presentation- Weakness of limbs following RTA - At Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh.
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_cdngcss
kj
ehbfs
jkeekwhgo
VPD
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Qrcpdrc` Fy-@r. B` Gdzrue HsedbBFF\, B . sl. (F B C).
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MH\PKVX 9
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Dppcdrdglc 9 Hee ekknhgo
Fk`y fuhet 9 Dvcrdoc. Qdthcgt hs lkglhkus, lk-kpcrdthvc dg`
wcee krhcgtdtc`. @clufhtus9 \htthgo & Eyhgo Dgdcbhd 9 Dfscgt Idug`hlc 9 Dfscgt Lydgkshs > Dfscgt K`cbd 9 Dfscgt. Quesc 9 =3 f/b.
Fekk` prcssurc 9 4
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Vcsphrdtkry rdtc 9 4: pcr bhg. Pcbp 9 Gkrbde. Nkhekgylmhd 9 Dfscgt. Ecunkgylmhd 9 Dfscgt Gcln oedg` 9 Gkt pdepdfec. Eybpm gk`c 9 Gkt pdepdfec. I.Z.Q 9 Gkt rdhsc` . Pmyrkh` oedg` 9 Gkt pdepdfec. \nhg phobcgtdthkg 9 Dfscgt.
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Hgspclthkg 9 Pmcrc hs gk swceehgo kr `cjkrbhty .
Qdepdthkg 9 Pcg`crgcss prcscgt kvcr lcrvhlde
sphgc.
Eklde tcbpcrdturc gkrbde.Pmcrc hs gk cgedroc` eybpm gk`c &
tmyrkh` oedg`.
Bkvcbcgt 9 (bkvcbcgt kj tmc Lcrvhlde \phgc )
Jecxhkg pdhgjue & rcstrhltc`
Cxtcgshkgpdhgjue & rcstrhltc`
Edt jecxhkg pdhgjue & rcstrhltc`
Vktdthkg pdhgjue & rcstrhltc`.
C]DBHGDPHKG KJ PMC GCLN9
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Odht 9 Qdthcgt ldggkt wden & stdg`.
Hgspclthkg 9 Pmcrc hs d swceehgo & `cjkrbhty hgtmc dgtcrkbc`de dspclt kj tmc ecjt eco.Buslec wdsthgo prcscgt hg tmc ekwcr ehbfs.
Jcce9 Ekldehzc` tcbpcrdturc sehomtey rdhsc` hg tmcbh``ec pdrt kj ecjt eco. Pmcrc hs tcg`crgcss bhec``ccp tcg`crgcss prcscgt hg tmc ecjt bh``ec pdrt kjtmc ecjt eco. Dee pmcrhpmcrde puescs drc gkrbde.Bcdsurcbcgt 9 Ecjt ekwcr ehbf hs smkrtcg fy H &
lb.
(Phfhe lkbpkgcgt)Bkvcbcgt 9 Dee ikhgt bkvcbcgt kj fktm uppcr
dg` ekwcr ehbfDlthvc bkvcbcgt wcdn.Qdsshvc bkvcbcgt Gkrbde
Qdthcgt ldggkt wden kg ecjt eco.
EKLKBKPKV \X\PCB 9
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EKKN\wceehgo dg` `cjkrbhty kvcr tmcbh``ec pdrt kj tmc ecjt eco.Pcg`crgcss prcscgt.
Dfgkrbde bkfhehty hg `cjkrbc` drcd.\nhg lkg`hthkg kvcr tmc `cjkrbc` drcdhs gkrbde.
Gk `hslmdrohgo shgus.Gk vdsluedr `cjhlhcgly.
JCCE
Pcg`crgcss prcscgt.Pcbpcrdturc sehomtey rdhsc`.Qcrhpmcrde puescs hgtdlt.
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Ecjt ngcc ikhgt bkvcbcgt ldg gkt fc cehlhtc` `uctk pdhgjue lkg`hthkg.Dgnec ikhgt- Qedgtcr jecxhkg --- wcdn hg dlthvc& gkrbde hg pdsshvc bkvcbcgt.
@krsh jecxhkg --- wcdn hg dlthvc
& gkrbde hg pdsshvc bkvcbcgt.Mhp Ikhgt-Cxtcgshkg dg` JecxhkgGkrbde hg pdsshvc wccn hg dlthvc bkvcbcgt.
D``ulthkg --- gkrbde
D``ulthkg --- gkrbde
BKZCBCGP
Cxdbhgdthkg kj tmc ecjt ekwcr ehbf9
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Mhomcr psylmhl juglthkg --- gkrbde
Dee lrdghde juglthkg --- gkrbdeBktkr juglthkgOcgcrdehzc` buslecs wdsthgo kj fktm
uppcrdg` ekwcr ehbfs.
Qdepdthkg
Fuen kj buslec
wdstc`tkgc kj tmc buslec Hglrcdsc`Qcrhdgde \cgsdthkg gkrbdeDgde tkgc prcscgt.Lrcbdstcrhl rcjecx prcscgt.
\ystcbhl Cxdbhgdthkg 9
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Vcodr`hgo buslec pkwcr
Sppcr ehbf \mkue`cr (ecjt &Vt) Jecxhkg 0
Cxtcgthkg 3Df`ulthkg - 3D``ulthkg - 3
CEFK_ (ecjt &Vt) Jecxhkg -3Cxtcgthkg -0
_VH\P (ecjt & Vt.) Jecxhkg 0
Cxtcgthkg 0Mdg` (ecjt &Vt) Orhp -_cdn 0Jhgocr d``ulthkg & Df`ulthkg- 0
\ystcbhl Cxdbhgdthkg 9
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\cgskry juglthkg kj uppcr ehbfs@cbhghsmc`.Icrns kj uppcr ehbfs
Fhlcps Icrns - cxdoocrdtc`Prhlcp Icrns - Cxdoocrdtc`
Frdlmhkrd`hdehs Icrns - cxdocrdtc`Mkjjbdggs shog tcst - Qkshthvc.
Icrns kj Ekwcr Ehbfs
Ngcc Icrn - Cxdoocrdtc`Dgnec Icrn - Cxolcrdtc`Fdfusmnds \hog - Qkshthvc.
\cgskry dg` Bktkr9
\ystcbhl Cxdbhgdthkg 9
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Buslec pkwcr(Vt & Et- Ekwcr ehbf)
Mhp Jecxhkg - 3Cxtcgthkg 3
Df`ulthkg 3D``ulthkg 3
Ngcc (Vt) - Jecxhkg 3 (Buslec pkwcr kj tmc ecjtngcc ldg gkt fc cecltc` `uc tk `cjkrbhty.
& swceehgo kj ecjt eco)
Cxtcgthkg - 3Dgnec(Vt & Et) - Qedgtcr Jecxhkg 3@krshjecxhkg 3
Pkc cxtcgskr dg` tkc jecxkr(Vt. & Et.) - 0+
\cgskry jugthkgkj ekwcr ehbfs- `hbhghsmc`.
\ystcbhl Cxdbhgdthkg 9
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Hgspclthkg Gk dfgkrbdehty `ctcltc`
Qdepdthkg gkt tgc`crDusluetdthkg Fkwce skug` prcscgtQ/VDgde tkgc prcscgt.
Hgspclthkg Gkrbde hg shzc dg` smdpc kj tmclmcdst.
Vcsp. rdtc 4:/bhgt.Qdepdthkg Pdlmcd Lcgtrdeey pedlc`
Gkrbde lmcdst cxpdgshfhehty.Qcrlusshkg VcskgdglcDusluetdthkg Frkglmhde frcdtm skug` whtmgk d``c` skuug`.
Dehbcgtdry \ystcb
Vcsphrdtkry \ystcb
\ystcbhl Cxdbhgdthkg 9
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Quesc =0/bhgt.F.Q 461/?1 b. b kj MoI.Z.Q Gkt rdhsc`
Hgspclthkg G.D.@Qdepdthkg Dpcx fcdt dt tmc 3tmhgtcrlkstde spdlc.Qcrlusshkg \upcrjhlhde ldr`hdl `ueegcss prcscgtkvcr prclkr`hudbDusluetdgthkg-\4 dg` \6 du`hfec.
Pmc pdthcgt ugdfec tk pdss urhgc gkrbdeey dg`tmc pdthcgt hs hg Ldtm`cr.
Ldr`hk-Zdsluedr \ystcb
Ocghtk urhgdry systhb
\ystcbhl Cxdbhgdthkg 9
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B`. Ndgu, Doc` 01yrs. Lkbhgo jrkb d`dfcr41, Bkmdbbd`pur, @mdnd, d`bhttc` kg 1=.1=.44 hg\.\.B.L.M
whtm tmc lkbpedhgs kj -
_cdngcss kj tmc fktm Sppcr dg` ekwcr ehbfdg` cgdfhehty tk bkvc.
@hjjhluety hgg pdsscs kj urhgc dg` stkke.
Jrdlturc kj tmc ecjt eco jkeekwhgo VPD 6 wccnsfdln.
Dt tmhs stdoc mc wds ugdfec tk stdg` dg` wden.Mhs uppcr ehbfs wcrc sk wcdn tmdt mc ldg gktorhp dgytmhgo.
Mc hs kg Ldtmctcr ds mc lkue` gkt pdss urhgc. MhsJdlhde hgiury dt tmc lmhg wds mcdec` up. Pmcrc hsd swceehgo dg` `cjkrbhty dt tmc bh``ec kj ekwcreco wmhlm hs hbbkfhehzc` whtm fdbfkk sthlnsfy nkfhrdi.
\dehcgt Jcdturcs9
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Mc md` d VPD 6 bkgtms fdln dg` whtmjrdlturc kj tmc ecjt eco fkgcs wmhlm wdsBdetrcdtc` fy Ndfhrdz.
Mc md` gk mhstkry kj ekss kj lkglhkugkss,wchomt ekss, dgkrcxhd & jcvcr.
Kg Ocgcrde cxdbhgdthkg tmc pdthcgt hs heeekknhgo gkg-`hdfdthl, gkg-hltcrhlgkrbktcgshvc, lkgslhkus, lk-kpcrdthvc dg`wcee krhcgtdtc`.Kg Eklde Cxdbhgdthkg-
Jdlc9 \ldr bdrn kvcr tmc ecjt sh`c kj rdlcgcdr lmhg.
Gcln bkvcbcgt Vcstrhltc` dg` pdhgjue.
\dehcgt Jcdturcs9
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Dlthvc bkvcbcgt kj tmc ikhgt kj tmc ehbfsdrc wcdn.
Pmcrc hs Ocgcrdehzc` buslec wdsthgo dg`wcdngcss kj tmc Ehbfs. \cgskry dg`Bktkr juglthkg kj tmc ehbfs@hbhsmc`.(B.V.L ord`c6).
Dee Icrns drc (Pmc Icrns kj tmc uppcr dg`ekwcr ehbf)
cxdoocrdtc`
Pkgc kj tmc buslec Hglrcdsc`
Qcrhdgde scgsdthkg Hgtdlt
Dgde tkgc Hgtdlt.
\dehcgt Jcdturcs9
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Qdthcgt hs kg ldtmctcr.Pmcrc hs dg `hjjusc swceehgo kvcr tmcbh``ec tmhr` kj tmc ecjt eco wmhlm hs
tcg`cr dg` dfgkrbde bkfhehty prcscgt.Qcrhpmcrde Zdsluedr stdtus Gkrbde.
Ktmcr systcbhl cxdbhgdthkg rcvcde gkdfgkrbdehty (Cxlcpt Gcrvkus, urhgdry
& eklk-bktkr systcb).
\dehcgt Jcdturcs9
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Hglkbpectc Lcrvhlde
\phgde hgiury (Dt L0/L3)(Lcgtrde lkr` \yg`rkbc)whtm jrdlturc Ecjt thfhd &
jhfued.
Qrkvhshkgde @hdogkshs-
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Dgtcrhkr lkr` syg`rkbcFrkwg \cqudr` \yg`rkbc.
@hjjcrcgthde
@hdogkshs -
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Fekk` L.F.L (
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]-rdy lmcdst G.D.@]-rdy Lcrvhlde \phgc Eksc kj ekr`kshsL0/L3 pkst. Ehstmcshs (Ord`c -4)@cocgcrdthvc lmdgoc hg dee Lcrvhlde\phgc
]-rdy ecjt eco
Lkbbhgutc` jrdlturc kj tmcbh``ec kj tmc smdjt kj tmc ecjt thfhddg` kfehquc jrdlturc kj tmc prkxhbdejhfued.
Hgvcsthodthkgs9
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BVH-
@cocgcrdthvc `hsl & sphgc `hscdsc.
Jklde bycehths dt L0 L3 ecvce.L6 L
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.
HglkbpectcLcrvhlde \phgc hgiury
dt L0 L3 ecvce,whtmTud`rhpdrcshs (Lcgtrde lkr`syg`rkbc) dg`Leksc` lkbbhgutc` jrdlturckj ecjt thfhd dg` jhfued.
Lkgjhrbdtkry `hdogkshs-
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Jkr \phgde( Lcrvhlde) hgiury -lkgscrvdthvc fy \cbh-rhoh` LcrvhldeLkeedr.Jkr rctcgthkg Ldtmctcrhzdthkg dg`
fed``cr cxcrlhsc.pmyshktmcrdpy(Dlthvc dg` pdsshvc
cxcrlhsc kj tmc ehbfs)
Jkr Jrdlturc thfhd jhfued
Leksc rc`ulthkg dg` pedstcrhbbkfhehzdthkg hg tmc jkrb kj ekgoeco juee pedstcr.
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HglcptdQmdrbdlcuthlde,@mdnd, Fdgoed`csm.
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.
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