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HPI
Pt fell from tree about 30 feet while intoxicated. On arrival was moving b/l extremities. Injuries include 1. L1 and L3 burst fx 2. type 1 hangman's fx 3. non-displaced fx of posterior arch of C6 4. R proximal humerus fx 5. left distal radius fx 6. nonoperative subdural hemorrhage. After 2 days in hospital went into DTs and went into respiratory distress. Pt has pneumothrax and chest tube was placed. Pt was intubated to protect airway due to agitated state. Sedation required. Pt developed right lobe pneumonia, possibly from aspiration. Orthopaedic spine consulted after pt intubated and sedated. While very difficult to determine examine, pt appeared to have slowly increasing weakness on bilateral lower extremity. During state of agitation initially would bring knees off bed. This was slowly lost over course of several days. Difficulty to tell if it was due to a systemic process (sedation, mental status changes) or due to stenosis at L3.
PMH
Diabetes, ETOH.
PE
Patient moving toes and knee. Pt was intubated with mental status changes, not following any command, so difficult to access. With agitation pt flexing elbows and moving hands.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
Earn 0.5 Free CME Credits for each poll by adding a PubMed article to support you clinical decision.
T11 to L5 PSF. L2 and L3 laminectomy, left partial L2/3 facetectomy with best effort to push retropulsed bone anterior via a posterior approach, repair of large traumatic durotomy with extravasation of nerve roots with entrapment in posterior lamina fx at L3.
L3 corpectomy, expandable cage.