Navigating Cervical Spine Injuries Across Care Settings
In this video, Sharon Bryant, DNP, MSN, ACNP-BC, shares insights from her American Association of Nurse Practitioners 2025 National Conference presentation, The Ins and Outs of Cervical Spine Injury. Drawing on her experience as an acute care nurse practitioner and program director at Vanderbilt University Medical Center, Dr Bryant explores the anatomy and common pathologies of the cervical spine, discusses how to differentiate routine neck pain from emergent conditions, and addresses both inpatient and outpatient care pathways. She also highlights the complexities clinicians face in managing spinal fractures, surgical decision-making, post-operative care, and strategies for pain and bone health management across care settings.
Additional Resource:
- Bryant, Sharon. The ins and outs of cervical spine injury. Talk presented at: American Association of Nurse Practitioners National Conference; June 2025. Accessed June 12, 2025. https://www.aanp.org/events/national-conference
TRANSCRIPTION
Sharon Bryant, DNP, MSN, ACNP-BC: My name is Sharon Bryant. I'm an acute care nurse practitioner. I am an assistant professor and program director at Vanderbilt University Medical Center in Nashville, Tennessee. I am going to be giving a presentation at AANP. It is The Ins and Outs of Cervical Spine Injury.
Consultant360: What are the key themes of your presentation?
Dr Bryant: Yeah, so the themes of the presentation, basically there's going to be an overview of cervical anatomy, and then we're going to go into common pathologies that are seen in the cervical spine. The goal of this presentation is that it can be used for both outpatient and inpatient clinicians, even though it does have somewhat of an inpatient theme to it.
C360: Why is this topic particularly relevant right now?
Dr Bryant: Well, for one, there's not a lot of presentations about cervical spine, neurosurgery or just spine in general. It's not a topic that is discussed very frequently within the nurse practitioner world. It doesn't seem that way. I have done other presentations talking about spinal fractures and spinal cord injury.
And spinal cord injury is really a little bit more of my interest. But fractures lead to spinal cord injury. So that's kind of the reason why I'm talking about this.
C360: What are the most important takeaways from this presentation for clinicians in practice?
Dr Bryant: The most important takeaways from this presentation are going to include recognition of signs and symptoms of the pathology related to spine fracture, but not only that, but looking at other differential diagnoses too. People come in with neck pain and they present to the emergency room sometimes in the absence of a primary care provider. But many times these patients may present to a primary care provider with just pain, just neck pain. And so the primary provider is really challenged with, is this something that I need to get further work up now or is it just regular neck pain? And if so, do I do that evaluation in regards to typical radiology evaluation? Do I send the patient to the ER to have them evaluated?
So it can be a challenging decision in how emergent to the complaint. So saying that, you know, that is a challenge because in the outpatient world they may, you may get an x-ray that day, you may get an x-ray later that week who's going to follow that? And then if you're trying to get someone into the into the consultant world, into a neurosurgery orthopedic practice, it's typically weeks upon weeks. So that one, making sure that you can do a thorough evaluation and making sure that you cover all your bases. You consider all the differential diagnoses, because it doesn't always have to be a spine fracture. And then spine fractures that are not surgically related, how do you manage that? Because patients may be coming to you in the absence of their specialty provider. And then if they do have surgery, they're going to eventually come back to the outpatient world for post-operative care—or not post-operative care but just post-operative follow-up in general. So, what are the things you need to navigate?
And not for the clinician that is working in the hospital that is actually taking care of the patient with a spinal spine fracture, what does the care look like? What are the options for surgery? What are the typical pathway post-surgery and the discharge process for that? So again, just looking at different fractures, some fractures require surgery, some don't require surgery. Why do you do the surgery? What are the postoperative complications and management strategies and then discharging the patient back to the community?
C360: Are there any gaps in knowledge or areas for future research you feel should be pursued around cervical spine injury?
Dr Bryant: You know, I mean, I think definitely pain management strategies are an important piece. Bone health in the use of vitamin D is something that we're seeing become more vogue within the inpatient world and in those cases that elective surgeries are an option. We typically will put patients on vitamins and that include vitamin D prior to surgery to promote bone health. However, you know, after surgery continuing that process, you know, what does that look like?
Also looking at both acute and chronic pain management strategies because pain is just something that is very difficult to treat and it can be treated in a multitude of ways and not always requiring opioids. So looking at the different types of pain surrounding cervical spine fractures and looking at the most beneficial ways to treat pain with the least side effects.