Spinal fractures Quiz: Ace Your Exams

A 45-year-old man is brought to the emergency department after a motor vehicle collision. The patient was riding his motorcycle when he struck a light pole, landing directly on his back. The patient was helmeted and did not lose consciousness. He has no significant past medical history and does not take any medication. A cervical collar was applied in the field. Temperature is 37°C (98.6°F), blood pressure is 92/64 mmHg, heart rate is 52 beats per minute, respiratory rate is 20 breaths per minute, and oxygen saturation is 99% on room air. On primary survey, the patient is yelling and endorsing mid-back pain. Bilateral breath sounds are present, and there is no evidence of obvious bleeding. The patient is not able to move his lower extremities bilaterally. The secondary survey reveals point tenderness and a bony-step off at the T10 level and scattered abrasions over the chest, abdomen, and pelvis. Which of the following is the best next step in management?