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Trauma Multidisciplinary Case Review: Spinal Cord Injuries


By Gwyneth Hughes, MD, Pediatric Neurosurgeon and Adam Bartlett, MD, Pediatric Physiatrist , Akron Children's Hospital, Akron, OH

Neurosurgery , Physical Medicine and Rehabilitation

More about Gwyneth Hughes, MD
More about Adam Bartlett, MD

Objectives (Educational Content) :

1. Recognize basic indications for operative intervention on spine injuries. 2. Classify the types of spinal cord injuries. 3. Describe the motor/sensory testing using the International Standards for the neurologic classification of Spinal Cord Injury (ISNCSCI). 4. Recognize some of the secondary medical complications associated with a spinal cord injury.

Target Audience:

General pediatricians, family physicians, nurse practitioners, physician assistants, social workers, psychologists, and nurses.

Identified Gap:

The American College of Surgeons Committee on Trauma requires a structured effort by trauma programs to demonstrate a continuous process for improving care for injured patients and states that an evidence-based rather than an empiric approach presents more meaningful criteria against which trauma care can be measured. A standardized approach to recurring care issues minimizes unnecessary variation, allow better outcome assessment, and makes changes in care easier to implement and more uniform. They further recommend that all members of the trauma team are knowledgeable about current practices in trauma care, that multidisciplinary education should be ongoing in all trauma centers, and that performance improvement programs should be an important part of educational activities.

Estimated Time to Complete the Educational Activity:

1 hour(s)

Expiration Date for CE/CME Credit:


Method of Participation in the Learning Process:

The learner will view the presentation, successfully complete a post-test and complete an activity evaluation.

Evaluation Methods:

All learners must successfully complete a post-test, as well as an activity evaluation, to claim CE/CME credit.


Drs. Hughes and Bartlett have indicated that they have no relevant financial interest in any pharmaceutical or medical device company and that this activity was developed independent of commercial interest.

Accreditation Statement:

Children’s Hospital Medical Center of Akron is accredited by the Ohio State Medical Association to provide continuing medical education for physicians.

CHMCA designates this enduring material activity for a maximum of 1.0 AMA PRA Category 1 Credit TM.  Physicians should only claim the credit commensurate with the extent of their participation in the activity.


Vaccaro AR, Hulbert RJ, Patel AA, et al. The subaxial cervical spine injury classification system: a novel approach to recognize the importance of morphology, neurology, and integrity of the disco-ligamentous complex. Spine (Phila Pa 1976). 2007;32(21):2365-2374. doi:10.1097/BRS.0b013e3181557b92​

Vaccaro AR, Baron EM, Sanfilippo J, et al. Reliability of a novel classification system for thoracolumbar injuries: the Thoracolumbar Injury Severity Score. Spine (Phila Pa 1976). 2006;31(11 Suppl):S62-S104. doi:10.1097/01.brs.0000218072.25964.a9 ​

Walters BC, Hadley MN, Hurlbert RJ, et al. Guidelines for the management of acute cervical spine and spinal cord injuries: 2013 update. Neurosurgery. 2013;60(CN_suppl_1):82-91. doi:10.1227/01.neu.0000430319.32247.7f  ​

Patel AA, Vaccaro AR. Thoracolumbar spine trauma classification. J Am Acad Orthop Surg. 2010;18(2):63-71. doi:10.5435/00124635-201002000-00001​

Lustrin ES, Karakas SP, Ortiz AO, et al. Pediatric cervical spine: normal anatomy, variants, and trauma. Radiographics. 2003;23(3):539-560. doi:10.1148/rg.233025121​

Rozzelle CJ, Aarabi B, Dhall SS, et al. Management of pediatric cervical spine and spinal cord injuries. Neurosurgery. 2013;72 Suppl 2:205-226. doi:10.1227/NEU.0b013e318277096c​

Alexander, M. A., & Matthews, D. J. (2010). Pediatric rehabilitation: Principles and practice. New York: Demos Medical.​

Braddom, R. (2007). Physical medicine and rehabilitation (3rd ed.). Philadelphia, PA: Saunders Elsevier.​

Cheng, J., Armento, M., Fantasia, M., & Kirshblum, S. (2016). Kessler Institute PM&R Board Review Course. Retrieved from​

“American Spinal Injury Association.” International Standards for Neurological Classification of SCI (ISNCSCI) Worksheet,  The American Spinal Injury Association, 2021,​

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