SlideShare a Scribd company logo
1 of 40
Assessment of Spinal Injury Stephen Schutts, Master Sergeant, WA ANG National Registry Emergency Medical Technician - Paramedic
Objectives ,[object Object],[object Object],[object Object],[object Object],[object Object]
Objectives ,[object Object],[object Object],[object Object],[object Object]
Introduction ,[object Object],[object Object],[object Object],[object Object]
Mechanism based assessment (the current method) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Anatomy & Physiology- General Structure & Function ,[object Object],[object Object],[object Object],[object Object]
 
Anatomy & Physiology-“Long Bone” ,[object Object],[object Object],[object Object],[object Object]
Anatomy & Physiology- Cervical Spine (7) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
C-1 “Atlas” C-2 “Axis” ,[object Object],[object Object],[object Object]
Anatomy & Physiology- Thoracic Spine (12) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Anatomy & Physiology- Lumbosacral Spine ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Anatomy & Physiology- Spinal Cord ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Mechanism of Injury ,[object Object],[object Object],[object Object],[object Object]
Hyperflexion
Hyperextension
Hyperotation
Axial Loading
Axial Distraction
Sudden/Extreme Lateral Bending ,[object Object],[object Object],[object Object],[object Object]
Spinal Column Injury ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Spinal Cord Injury ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Primary Spinal Cord Injury ,[object Object],[object Object],[object Object],[object Object]
Secondary Spinal  Cord Injury ,[object Object],[object Object],[object Object],[object Object]
Incomplete Spinal Cord Injury ,[object Object],[object Object],[object Object]
Spinal Region Overview ,[object Object],[object Object],[object Object],[object Object],[object Object]
Cervical Spine Injuries ,[object Object],[object Object],[object Object],[object Object]
Thoracic Spine Injuries ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Lumbosacral Spine Injuries ,[object Object],[object Object],[object Object],[object Object],[object Object]
Assessment Overview ,[object Object],[object Object],[object Object]
Spinal Immobilization  Algorithm ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Principles of Treatment ,[object Object],[object Object],[object Object],[object Object]
Complete Spinal Immobilization ,[object Object],[object Object],[object Object],[object Object]
Common Treatment/Management Mistakes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Common Treatment/Management Mistakes (cont.) ,[object Object],[object Object],[object Object]
Any Questions???

More Related Content

What's hot

Acl knee Protocol for Football Players
Acl knee Protocol for Football Players Acl knee Protocol for Football Players
Acl knee Protocol for Football Players Djair Garcia
 
Kin 188 Knee Injuries And Evaluation
Kin 188   Knee Injuries And EvaluationKin 188   Knee Injuries And Evaluation
Kin 188 Knee Injuries And EvaluationJLS10
 
Acl Injury Hacks: By Dr. Dhruv Taneja
 Acl Injury Hacks: By Dr. Dhruv Taneja Acl Injury Hacks: By Dr. Dhruv Taneja
Acl Injury Hacks: By Dr. Dhruv Tanejadhruv taneja
 
Ligament injury to knee: ACL
Ligament injury to knee: ACLLigament injury to knee: ACL
Ligament injury to knee: ACLSijan Bhattachan
 
405 acl presentation
405 acl presentation405 acl presentation
405 acl presentationrmhaupert
 
TREATMENT OF INJURED ANTERIOR CRUCIATE LIGAMENT
TREATMENT OF INJURED ANTERIOR CRUCIATE LIGAMENTTREATMENT OF INJURED ANTERIOR CRUCIATE LIGAMENT
TREATMENT OF INJURED ANTERIOR CRUCIATE LIGAMENTMa Wady
 
Introduction orthotics
Introduction  orthoticsIntroduction  orthotics
Introduction orthoticsMayank Anthwal
 
Anterior/Posterior Cruciate ligaments by Shannon Davis
Anterior/Posterior Cruciate ligaments by Shannon DavisAnterior/Posterior Cruciate ligaments by Shannon Davis
Anterior/Posterior Cruciate ligaments by Shannon Davisshann_maree
 
Spinal orthosis dr.aliaa
Spinal orthosis  dr.aliaaSpinal orthosis  dr.aliaa
Spinal orthosis dr.aliaaAliaa El-hady
 
The Common Knee Injuries Experience by Professional Sportsmen
The Common Knee Injuries Experience by Professional SportsmenThe Common Knee Injuries Experience by Professional Sportsmen
The Common Knee Injuries Experience by Professional Sportsmenmeducationdotnet
 
Kin 188 Foot, Ankle And Leg Injuries
Kin 188  Foot, Ankle And Leg InjuriesKin 188  Foot, Ankle And Leg Injuries
Kin 188 Foot, Ankle And Leg InjuriesJLS10
 

What's hot (20)

Acl knee Protocol for Football Players
Acl knee Protocol for Football Players Acl knee Protocol for Football Players
Acl knee Protocol for Football Players
 
Braces
BracesBraces
Braces
 
Kin 188 Knee Injuries And Evaluation
Kin 188   Knee Injuries And EvaluationKin 188   Knee Injuries And Evaluation
Kin 188 Knee Injuries And Evaluation
 
Acl injury
Acl injuryAcl injury
Acl injury
 
Dr tarek orthotic overview
Dr tarek orthotic overviewDr tarek orthotic overview
Dr tarek orthotic overview
 
Ankle Foot Orthosis
Ankle Foot OrthosisAnkle Foot Orthosis
Ankle Foot Orthosis
 
Acl Injury Hacks: By Dr. Dhruv Taneja
 Acl Injury Hacks: By Dr. Dhruv Taneja Acl Injury Hacks: By Dr. Dhruv Taneja
Acl Injury Hacks: By Dr. Dhruv Taneja
 
Ligament injury to knee: ACL
Ligament injury to knee: ACLLigament injury to knee: ACL
Ligament injury to knee: ACL
 
405 acl presentation
405 acl presentation405 acl presentation
405 acl presentation
 
TREATMENT OF INJURED ANTERIOR CRUCIATE LIGAMENT
TREATMENT OF INJURED ANTERIOR CRUCIATE LIGAMENTTREATMENT OF INJURED ANTERIOR CRUCIATE LIGAMENT
TREATMENT OF INJURED ANTERIOR CRUCIATE LIGAMENT
 
Introduction orthotics
Introduction  orthoticsIntroduction  orthotics
Introduction orthotics
 
Anterior/Posterior Cruciate ligaments by Shannon Davis
Anterior/Posterior Cruciate ligaments by Shannon DavisAnterior/Posterior Cruciate ligaments by Shannon Davis
Anterior/Posterior Cruciate ligaments by Shannon Davis
 
ACL rehabilitation
ACL rehabilitationACL rehabilitation
ACL rehabilitation
 
C & p chapter 7
C & p chapter 7C & p chapter 7
C & p chapter 7
 
KNEE INJURIES
KNEE INJURIESKNEE INJURIES
KNEE INJURIES
 
Ligament injuries of knee
Ligament injuries of knee Ligament injuries of knee
Ligament injuries of knee
 
Spinal orthosis dr.aliaa
Spinal orthosis  dr.aliaaSpinal orthosis  dr.aliaa
Spinal orthosis dr.aliaa
 
ACL Protocol
ACL ProtocolACL Protocol
ACL Protocol
 
The Common Knee Injuries Experience by Professional Sportsmen
The Common Knee Injuries Experience by Professional SportsmenThe Common Knee Injuries Experience by Professional Sportsmen
The Common Knee Injuries Experience by Professional Sportsmen
 
Kin 188 Foot, Ankle And Leg Injuries
Kin 188  Foot, Ankle And Leg InjuriesKin 188  Foot, Ankle And Leg Injuries
Kin 188 Foot, Ankle And Leg Injuries
 

Similar to Spinal Injury

Lavc Health 12 First Aid Muscles Bones Joints Injuries Spring 2007
Lavc Health 12 First Aid Muscles Bones Joints Injuries Spring 2007Lavc Health 12 First Aid Muscles Bones Joints Injuries Spring 2007
Lavc Health 12 First Aid Muscles Bones Joints Injuries Spring 2007Patty Melody
 
2017_Brent_Feland_PDF_Presentation.pdf
2017_Brent_Feland_PDF_Presentation.pdf2017_Brent_Feland_PDF_Presentation.pdf
2017_Brent_Feland_PDF_Presentation.pdfHassanJaved694664
 
Lumber disc bulge/ Herniation/ Prolapse
Lumber disc bulge/ Herniation/ ProlapseLumber disc bulge/ Herniation/ Prolapse
Lumber disc bulge/ Herniation/ ProlapseDr. Zunaira Ahmad
 
CME SPINAL INJURY.pptx
CME SPINAL INJURY.pptxCME SPINAL INJURY.pptx
CME SPINAL INJURY.pptxmieyoi
 
dislocation and subluxation 3.ppt
dislocation and subluxation 3.pptdislocation and subluxation 3.ppt
dislocation and subluxation 3.pptsidra234490
 
dislocationandsubluxation3-230302112416-8b54cbd9.pdf
dislocationandsubluxation3-230302112416-8b54cbd9.pdfdislocationandsubluxation3-230302112416-8b54cbd9.pdf
dislocationandsubluxation3-230302112416-8b54cbd9.pdfAugustusCaesar7
 
Spinal cord injuries spinalfractures thoracolumbar fracture
Spinal cord injuries spinalfractures thoracolumbar fractureSpinal cord injuries spinalfractures thoracolumbar fracture
Spinal cord injuries spinalfractures thoracolumbar fractureNabil Khalil
 
Cervical Laminoplasty by Pablo Pazmino MD
Cervical Laminoplasty by Pablo Pazmino MDCervical Laminoplasty by Pablo Pazmino MD
Cervical Laminoplasty by Pablo Pazmino MDPablo Pazmino
 
Sci Presentation
Sci PresentationSci Presentation
Sci Presentationmycomic
 
Knee lowerleginjuries
Knee lowerleginjuriesKnee lowerleginjuries
Knee lowerleginjuriesSimba Syed
 

Similar to Spinal Injury (20)

Hip dislocation
 Hip dislocation Hip dislocation
Hip dislocation
 
Lavc Health 12 First Aid Muscles Bones Joints Injuries Spring 2007
Lavc Health 12 First Aid Muscles Bones Joints Injuries Spring 2007Lavc Health 12 First Aid Muscles Bones Joints Injuries Spring 2007
Lavc Health 12 First Aid Muscles Bones Joints Injuries Spring 2007
 
Back injury
Back injuryBack injury
Back injury
 
2017_Brent_Feland_PDF_Presentation.pdf
2017_Brent_Feland_PDF_Presentation.pdf2017_Brent_Feland_PDF_Presentation.pdf
2017_Brent_Feland_PDF_Presentation.pdf
 
CME Orthopedic.pptx
CME Orthopedic.pptxCME Orthopedic.pptx
CME Orthopedic.pptx
 
Lumber disc bulge/ Herniation/ Prolapse
Lumber disc bulge/ Herniation/ ProlapseLumber disc bulge/ Herniation/ Prolapse
Lumber disc bulge/ Herniation/ Prolapse
 
CME SPINAL INJURY.pptx
CME SPINAL INJURY.pptxCME SPINAL INJURY.pptx
CME SPINAL INJURY.pptx
 
dislocation and subluxation 3.ppt
dislocation and subluxation 3.pptdislocation and subluxation 3.ppt
dislocation and subluxation 3.ppt
 
dislocationandsubluxation3-230302112416-8b54cbd9.pdf
dislocationandsubluxation3-230302112416-8b54cbd9.pdfdislocationandsubluxation3-230302112416-8b54cbd9.pdf
dislocationandsubluxation3-230302112416-8b54cbd9.pdf
 
Low back pain
Low back painLow back pain
Low back pain
 
Spinal cord injuries spinalfractures thoracolumbar fracture
Spinal cord injuries spinalfractures thoracolumbar fractureSpinal cord injuries spinalfractures thoracolumbar fracture
Spinal cord injuries spinalfractures thoracolumbar fracture
 
Spine Powerpoint.ppt
Spine Powerpoint.pptSpine Powerpoint.ppt
Spine Powerpoint.ppt
 
Spine Powerpoint.ppt
Spine Powerpoint.pptSpine Powerpoint.ppt
Spine Powerpoint.ppt
 
Cervical Laminoplasty by Pablo Pazmino MD
Cervical Laminoplasty by Pablo Pazmino MDCervical Laminoplasty by Pablo Pazmino MD
Cervical Laminoplasty by Pablo Pazmino MD
 
Spondylolisthesis neel.pptx
Spondylolisthesis neel.pptxSpondylolisthesis neel.pptx
Spondylolisthesis neel.pptx
 
Sci Presentation
Sci PresentationSci Presentation
Sci Presentation
 
The spine & spinal cord
The spine & spinal cordThe spine & spinal cord
The spine & spinal cord
 
Spine Trauma
Spine TraumaSpine Trauma
Spine Trauma
 
Common pitfalls in orthopedics
Common pitfalls in orthopedicsCommon pitfalls in orthopedics
Common pitfalls in orthopedics
 
Knee lowerleginjuries
Knee lowerleginjuriesKnee lowerleginjuries
Knee lowerleginjuries
 

More from xtrm nurse

Neuro diseases newest
Neuro diseases newestNeuro diseases newest
Neuro diseases newestxtrm nurse
 
Cerebro-Vascular Disorders
Cerebro-Vascular DisordersCerebro-Vascular Disorders
Cerebro-Vascular Disordersxtrm nurse
 
Legal aspects of nursing
Legal aspects of nursingLegal aspects of nursing
Legal aspects of nursingxtrm nurse
 
Cardiovascular diseases modified
Cardiovascular diseases modifiedCardiovascular diseases modified
Cardiovascular diseases modifiedxtrm nurse
 
Controlling and evaluation mechanism
Controlling and evaluation mechanismControlling and evaluation mechanism
Controlling and evaluation mechanismxtrm nurse
 
Directing_2011
Directing_2011Directing_2011
Directing_2011xtrm nurse
 
Cardiovascular emergencies_elective2 Lec
Cardiovascular emergencies_elective2 LecCardiovascular emergencies_elective2 Lec
Cardiovascular emergencies_elective2 Lecxtrm nurse
 
Leadership theories new - MJCN 2012
Leadership theories new - MJCN 2012Leadership theories new - MJCN 2012
Leadership theories new - MJCN 2012xtrm nurse
 
Cardiovascular System
Cardiovascular SystemCardiovascular System
Cardiovascular Systemxtrm nurse
 
Pharma Week 2 Day 1
Pharma Week 2 Day 1Pharma Week 2 Day 1
Pharma Week 2 Day 1xtrm nurse
 

More from xtrm nurse (20)

Neuro diseases newest
Neuro diseases newestNeuro diseases newest
Neuro diseases newest
 
Cerebro-Vascular Disorders
Cerebro-Vascular DisordersCerebro-Vascular Disorders
Cerebro-Vascular Disorders
 
Legal aspects of nursing
Legal aspects of nursingLegal aspects of nursing
Legal aspects of nursing
 
Ethics 2012
Ethics 2012Ethics 2012
Ethics 2012
 
Cv
 Cv Cv
Cv
 
Cardiovascular diseases modified
Cardiovascular diseases modifiedCardiovascular diseases modified
Cardiovascular diseases modified
 
Controlling and evaluation mechanism
Controlling and evaluation mechanismControlling and evaluation mechanism
Controlling and evaluation mechanism
 
Directing_2011
Directing_2011Directing_2011
Directing_2011
 
Cardiovascular emergencies_elective2 Lec
Cardiovascular emergencies_elective2 LecCardiovascular emergencies_elective2 Lec
Cardiovascular emergencies_elective2 Lec
 
Leadership theories new - MJCN 2012
Leadership theories new - MJCN 2012Leadership theories new - MJCN 2012
Leadership theories new - MJCN 2012
 
Cva
CvaCva
Cva
 
Presentation1
Presentation1Presentation1
Presentation1
 
Cardiovascular System
Cardiovascular SystemCardiovascular System
Cardiovascular System
 
Copar
CoparCopar
Copar
 
Pharma 3
Pharma 3Pharma 3
Pharma 3
 
Week 5 Pharma
Week 5 PharmaWeek 5 Pharma
Week 5 Pharma
 
Withsyringe
WithsyringeWithsyringe
Withsyringe
 
Week 2 Pharma
Week 2 PharmaWeek 2 Pharma
Week 2 Pharma
 
Waterlily
WaterlilyWaterlily
Waterlily
 
Pharma Week 2 Day 1
Pharma Week 2 Day 1Pharma Week 2 Day 1
Pharma Week 2 Day 1
 

Recently uploaded

Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort ServicePremium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Servicevidya singh
 
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...vidya singh
 
Top Rated Bangalore Call Girls Mg Road ⟟ 9332606886 ⟟ Call Me For Genuine S...
Top Rated Bangalore Call Girls Mg Road ⟟   9332606886 ⟟ Call Me For Genuine S...Top Rated Bangalore Call Girls Mg Road ⟟   9332606886 ⟟ Call Me For Genuine S...
Top Rated Bangalore Call Girls Mg Road ⟟ 9332606886 ⟟ Call Me For Genuine S...narwatsonia7
 
Top Rated Bangalore Call Girls Richmond Circle ⟟ 9332606886 ⟟ Call Me For Ge...
Top Rated Bangalore Call Girls Richmond Circle ⟟  9332606886 ⟟ Call Me For Ge...Top Rated Bangalore Call Girls Richmond Circle ⟟  9332606886 ⟟ Call Me For Ge...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 9332606886 ⟟ Call Me For Ge...narwatsonia7
 
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...chandars293
 
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...parulsinha
 
VIP Call Girls Indore Kirti 💚😋 9256729539 🚀 Indore Escorts
VIP Call Girls Indore Kirti 💚😋  9256729539 🚀 Indore EscortsVIP Call Girls Indore Kirti 💚😋  9256729539 🚀 Indore Escorts
VIP Call Girls Indore Kirti 💚😋 9256729539 🚀 Indore Escortsaditipandeya
 
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Bangalore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...
Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...
Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...Dipal Arora
 
Call Girls Varanasi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Varanasi Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Varanasi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Varanasi Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...tanya dube
 
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...hotbabesbook
 
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Kochi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Kochi Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Kochi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Kochi Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...indiancallgirl4rent
 
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Top Rated Bangalore Call Girls Ramamurthy Nagar ⟟ 9332606886 ⟟ Call Me For G...
Top Rated Bangalore Call Girls Ramamurthy Nagar ⟟  9332606886 ⟟ Call Me For G...Top Rated Bangalore Call Girls Ramamurthy Nagar ⟟  9332606886 ⟟ Call Me For G...
Top Rated Bangalore Call Girls Ramamurthy Nagar ⟟ 9332606886 ⟟ Call Me For G...narwatsonia7
 
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated  Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...Top Rated  Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...chandars293
 

Recently uploaded (20)

Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort ServicePremium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
Premium Call Girls Cottonpet Whatsapp 7001035870 Independent Escort Service
 
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...
 
Top Rated Bangalore Call Girls Mg Road ⟟ 9332606886 ⟟ Call Me For Genuine S...
Top Rated Bangalore Call Girls Mg Road ⟟   9332606886 ⟟ Call Me For Genuine S...Top Rated Bangalore Call Girls Mg Road ⟟   9332606886 ⟟ Call Me For Genuine S...
Top Rated Bangalore Call Girls Mg Road ⟟ 9332606886 ⟟ Call Me For Genuine S...
 
Top Rated Bangalore Call Girls Richmond Circle ⟟ 9332606886 ⟟ Call Me For Ge...
Top Rated Bangalore Call Girls Richmond Circle ⟟  9332606886 ⟟ Call Me For Ge...Top Rated Bangalore Call Girls Richmond Circle ⟟  9332606886 ⟟ Call Me For Ge...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 9332606886 ⟟ Call Me For Ge...
 
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 6297143586 𖠋 Will You Mis...
 
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
 
VIP Call Girls Indore Kirti 💚😋 9256729539 🚀 Indore Escorts
VIP Call Girls Indore Kirti 💚😋  9256729539 🚀 Indore EscortsVIP Call Girls Indore Kirti 💚😋  9256729539 🚀 Indore Escorts
VIP Call Girls Indore Kirti 💚😋 9256729539 🚀 Indore Escorts
 
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Bangalore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Bangalore Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...
Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...
Call Girls Visakhapatnam Just Call 9907093804 Top Class Call Girl Service Ava...
 
Call Girls Varanasi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Varanasi Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Varanasi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Varanasi Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Faridabad Just Call 9907093804 Top Class Call Girl Service Available
 
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
 
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
 
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Ludhiana Just Call 9907093804 Top Class Call Girl Service Available
 
Call Girls Kochi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Kochi Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Kochi Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Kochi Just Call 9907093804 Top Class Call Girl Service Available
 
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
(Rocky) Jaipur Call Girl - 09521753030 Escorts Service 50% Off with Cash ON D...
 
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
 
Top Rated Bangalore Call Girls Ramamurthy Nagar ⟟ 9332606886 ⟟ Call Me For G...
Top Rated Bangalore Call Girls Ramamurthy Nagar ⟟  9332606886 ⟟ Call Me For G...Top Rated Bangalore Call Girls Ramamurthy Nagar ⟟  9332606886 ⟟ Call Me For G...
Top Rated Bangalore Call Girls Ramamurthy Nagar ⟟ 9332606886 ⟟ Call Me For G...
 
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Siliguri Just Call 9907093804 Top Class Call Girl Service Available
 
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated  Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...Top Rated  Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 6297143586 ⟟ Call Me For Genuine ...
 

Spinal Injury

Editor's Notes

  1. Policy # 6016.1