Common Disorders
Herniated disc: nucleus pulposus protrudes through annulus, compresses nerve root. Symptoms: radicular pain, numbness, weakness. Scoliosis: lateral curvature >10°. Spinal stenosis: narrowing of spinal canal, neurogenic claudication. Spondylolisthesis: vertebra slips forward. Compression fracture: osteoporotic or traumatic. Spinal cord injury: see neurology guide.
Traction Types
Skin traction: Buck (straight leg), Russell (sling with knee flexion), pelvic traction. Skeletal traction: pins/wires through bone (tibial, femoral, cervical/halo). Weights must hang free — never rest on bed. Maintain proper alignment. Assess neurovascular status q1-2h. Pin site care: sterile technique, assess for infection. Halo vest: special care, wrench at bedside.
Nursing Management
Assess: neurovascular checks (5 Ps), pin sites (redness, drainage, loosening), skin integrity, pain, bowel/bladder function. Maintain traction: weights hanging free, proper alignment, do not lift or release weights without order. Turn q2h using logrolling technique. DVT prophylaxis. Pain management. Monitor for complications: infection, nerve damage, fat embolism, pressure injuries.
Important Notes
- Never lift, release, or adjust traction weights without a provider order — disrupting alignment can cause further injury.
- Assess pin sites for infection: redness, drainage, loosening — skeletal traction pin sites are direct pathway to bone infection.
Clinical Tips
- Logroll patients with spinal precautions — maintain neutral spinal alignment at all times.
- Halo vest: keep Allen wrench at bedside at all times for emergency removal if CPR needed.
Summary
Spinal disorder management requires neurovascular checks, pin site care, maintaining traction alignment, logrolling, and monitoring for complications.
