iThoughts

MRI is reserved for people with focal neurology.
There should be two signatures between the radiologist, surgeon and ITU team
If clinical improvement is likely, the collar can be left on
Helical CT can also suggest evidence of ligamentous injury, though they may be missed. Even so, the risk of them being unstable are low (<0.1%)
If the patient is unconscious, you need to have complete imaging of the c-spine from C1-T1. Need x-rays (ideally) and CT with 3D reconstruction +/- flexion/extension fluroscopy
5% of patients admitted with c-spine injury will deteriorate neurologically
Airway management

No evidence awake procedures results in a better neurological outcome
Probably best to use a familiar technique
Some degree of airway obstruction post-op is common due to haematoma, oedema. It is commoner after combined anterior and posterior approaches. It usually presents in 6hrs.
Warning signs

Aim to maintain a good MAP but not too high so as to promote oedema. Ischaemic damage was though to occur at the cervical-thoracic junction due to precarious blood supply but it is actually commoner at C2/C3.
Clinical deterioration can occur and the cause is not always clear. An anterior or central cord syndrome is most common

Look out for associated conditions (e.g. RhA, Down's) where anterior antlanto-axial instability (AAS) may be subtle in 50%, with mild neurology, occipital, facial and sometimes electric shock pains common. The commonest pathology is due to laxity of the transverse and apical dental ligaments.

C-spine surgery may be needed for root entrapment, tumours, infection, disc protrusions, stenosis