Initial pre-referral workup

Clinical history

Patients should be referred to their local emergency department if acute spinal trauma is suspected.

GP management

Mild vertebral endplate fractures of the thoracolumbar spine or compression fractures with less than 10 per cent loss of vertebral body height usually require no specific intervention and do not require specialist review.

Indications for specialist referral

Emergency

Patients should be referred to their local emergency department if acute spinal trauma is suspected.

Urgent

Trauma patients from the RCH ED

• patients not requiring spine consultant intervention (i.e. hard collar for neck pain, thoracic compression fracture) should be referred to the fracture clinic when spine surgeon in hospital (Monday, Tuesday and Friday)
• patients requiring spine consultant intervention (i.e. halo, operative spinal fixation) will be reviewed in outpatient spine clinic

Patients from non-RCH ED

• patients who have not attended RCH ED require local orthopaedic consultation and then direct Ortho to Ortho consultation from peripheral site (03 9345 5522)