Master the acute management of spinal cord injury with this comprehensive orthopaedic masterclass. Learn the critical differences between neurogenic and spinal shock, ASIA classificationand why maintaining a mean arterial pressure of 85-90 mmHg is vital for preventing secondary cord injury. ⏱ Chapters 0:00 Intro 0:18 Essentials 0:49 Shock 1:22 Asia 1:45 MRI Signs 2:14 Secondary Injury 2:39 Algorithm 3:17 Map 3:36 Numbers 4:04 Clinical reasoning — Manage 4:43 Clinical reasoning — Pearls This video provides an in-depth, keyword-rich overview of acute spinal cord injury, covering everything from initial ATLS resuscitation and precise neurological classification to surgical timing and prognostic indicators. We explore the pathophysiology of primary versus secondary injury, demystify the controversial use of methylprednisoloneand explain the evidence behind early decompression surgery within 24 hours. 🦴 IN THIS VIDEO YOU'LL LEARN • How to accurately classify spinal cord injuries using the ASIA Impairment Scale from A to E • The crucial difference between neurogenic shock and spinal shockand how they are managed • Why maintaining a mean arterial pressure of 85 to 90 mmHg for up to 7 days prevents secondary ischaemic injury • How to properly assess for sacral sparing at S4-S5 to distinguish complete from incomplete injuries • The role of sagittal T2-weighted MRI in evaluating cord compression, oedemaand haemorrhage • Why current clinical guidelines recommend against the routine use of high-dose methylprednisolone • The clinical significance of the bulbocavernosus reflex in resolving spinal shock • How to differentiate central cord, anterior cordand Brown-Sequard incomplete syndromes • The prognostic implications of MRI signal changes and ASIA grades for patient ambulation potential ⏱️ CHAPTERS 📌 KEY TAKEAWAYS ✔️ Preventing secondary injury is the primary therapeutic target: strictly avoid hypoxia and hypotension. ✔️ Early surgery within 24 hours for incomplete injuries with compression significantly improves neurological outcomes. ✔️ Neurogenic shock causes hypotension and bradycardia above T6, requiring vasopressor support like norepinephrine. ✔️ Always check for sacral sparing: perianal sensation and voluntary anal contraction dictate the prognosis. ✔️ A normal CT scan does not exclude cord injury; MRI is mandatory if neurological deficits are present. 👩⚕️ WHO THIS IS FOR This masterclass is essential viewing for orthopaedic trainees, medical studentsand emergency or trauma clinicians seeking a comprehensive understanding of acute spinal trauma. Interested patients and caregivers looking to understand the mechanics and medical management of spinal cord injuries will also find this clinical breakdown highly informative. 📚 RELATED TOPICS: Central Cord Syndrome Management · Cauda Equina Syndrome vs Conus Medullaris Syndrome · ATLS Principles in Polytrauma · Cervical Spine Fractures and Dislocations · SCIWORA in Paediatric and Adult Populations · Vasopressor Choice in Neurogenic Shock 🔗 More free orthopaedic teaching at Orthovellum.com — subscribe for weekly videos. 🎨 CREDITS • Original Orthovellum production. ⚠️ DISCLAIMER: Educational only — not individual medical advice. Always consult a qualified clinician for diagnosis and treatment. #spinalcordinjury #orthopaedics #trauma #ASIAscale #neurogenicshock #spinalshock #neurosurgery #spinesurgery #medicaleducation #traumasurgery #ASIAclassification #orthopaedictrauma