Fractures of the spine
Always remember the possibility of cervical spine injury in an unconscious trauma patient (cervical spine x-rays are more important than a skull x-ray; in clear suspicion of a fracture, a CT scan is the primary investigation). Injuries to the spine are most often associated with falling from a height or falling over. Note particularly the risk groups that may suffer a fracture of the spine even after a low-energy trauma: elderly persons, especially if an accidental fall is associated with head injury or if the person falls to a sitting position patients with ankylosing spondylitis or osteoporotic changes in the spine. The patient must be moved in supine position, and if a cervical spine injury is suspected the patient's neck has to be supported with a collar. If the patient is conscious, a muscle spasm will provide some protection to the injured site. Moving an unconscious patient requires particular care.