Department of  Neurosurgery
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Spinal Trauma

Spinal Trauma
Spinal Trauma

Washington University Neurosurgeons provide comprehensive treatment for all traumatic spine and spinal cord injuries. Our spine providers are fellowship-trained in complex spinal surgery and have additional expertise in the management of all traumatic spine injuries. Our Level I trauma center is dedicated to providing coordinated care to severely injured patients.Working closely with trauma surgeons, emergency room physicians and neuroradiologists, our spine providers are able to treat complex fractures involving all areas of the spine.

Conditions & Treatments

A spinal cord injury usually results from sudden trauma to the spine that fractures or dislocates the bones surrounding the spinal cord (vertebrae). Most injuries to the spinal cord don’t sever it. Rather, injury is more likely to cause fractures and compression of the vertebrae. This trauma crushes and destroys axons, which are extensions of nerve cells that carry signals along the spinal cord between the brain and the rest of the body.

Injuries to vertebrae or soft tissue of the spine can cause a wide range of neck or back problems. These injuries often occur after high-energy events such as car accidents, ATV accidents or falls. Depending on the timing and severity of injury, patients may require operative fixation or non-operative bracing to treat their injuries. Washington University neurosurgeons treat all types of spine trauma, from long-standing injuries to acute-life threatening emergencies.

The clinical management of patients with acute spinal and/or spinal cord injuries draws upon the expertise of multiple sub-specialties at Washington University and Barnes-Jewish Hospital. Admitting services typically include neurosurgery, orthopedic surgery and trauma surgery. Depending on the level and severity of injury, patients are admitted to the hospital intensive care unit or taken directly for surgical decompression of the vertebrae and stabilization.

Emergency department physicians and trauma surgeons initially manage the patient, providing airway protection, respiratory support and treatment of spinal shock. Severity of injury is classified according to the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) scale or American Spinal Injury Association (ASIA) scale. Injury is broadly divided into two categories: complete (ASIA A) versus incomplete (ASIA B-D). The need for surgical stabilization is usually indicated by radiographic evidence of instability and/or ongoing spinal cord compression. Depending on other injuries, operative intervention is usually performed within 24 - 48 hours. The most common in-hospital complications from spinal cord injury are secondary, and include pressure sores, respiratory complications, urinary tract infections and deep venous thrombosis.

For conservative care and the non-operative treatment of spinal disorders, spine surgeons collaborate with physical and occupational therapy, rehabilitation and physiatry services, and pain management. The Spine Division is associated with The Rehabilitation Institute of St. Louis, providing world-leading rehabilitation services for patients with spinal disorders.


Neurosurgery Providers

Orthopedic Surgery Providers

  • Michael Kelly, MD
  • Lukas P. Zebala, MD

Trauma Surgery

  • Grant V. Bochicchio, MD, MPH
  • Douglas J.E. Schuerer, MD

Neurology/Rehabilitation Providers

  • Neringa Juknis, MD
  • Rimma Ruvinskaya, MD