Spine Injury: Cervical, Adult
Basics
Description
Description
- Injury to the neck that results in injury to the spinal cord, cervical spine, or ligaments supporting the cervical spine
- May have >1 mechanism concurrently
- Flexion injuries:
- Simple wedge fracture: Usually a stable fracture
- Anterior subluxation: Disruption of the posterior ligament complex without bony injury; potentially unstable injury
- Clay shoveler's fracture: Avulsion fracture of the spinous process of C7, C6, or T1; stable fracture
- Flexion teardrop fracture: Extremely unstable fracture; may be associated with acute anterior cervical cord syndrome
- Atlanto-occipital dislocation: Unstable injury
- Bilateral facet dislocation: Can occur from C2–C7; unstable injury
- Flexion/rotation injuries:
- Unilateral facet dislocation (“locked” vertebra): Stable injury
- Rotary atlantoaxial dislocation: Unstable injury
- Extension injuries:
- Extension teardrop fracture: An avulsion fracture of the anteroinferior corner of the involved vertebral body; unstable in extension and stable in flexion
- Posterior arch of C1 fracture: Arch is compressed between the occiput and the spinous process of the axis during hyperextension; unstable fracture
- Avulsion fracture of the anterior arch of the atlas: Horizontal fracture of C1 and prevertebral soft tissue swelling on the lateral C-spine
- Hangman fracture: Traumatic spondylolisthesis of the axis involving the pedicles of C2; unstable fracture
- Hyperextension dislocation: Described as the syndrome of the paralyzed patient with a radiographically normal-appearing C-spine
- Extension–rotation injury:
- Pillar fracture: Generally stable fracture
- Vertical compression (axial loading) injuries:
- Jefferson fracture: Burst fracture of both the anterior and posterior arches of C1; extremely unstable fracture
- Burst fracture: A comminuted fracture of the vertebral body with variable retropulsion of the posterior body fragments into the spinal canal
Etiology
Etiology
- Blunt trauma is the major cause of neck injuries:
- Automobile accidents account for >50%
- Falls account for ∼20%
- Sporting accidents account for 15%
- Minor trauma in patients with severe arthritis may result in cervical injuries
- Penetrating trauma
There's more to see -- the rest of this topic is available only to subscribers.
Citation
Schaider, Jeffrey J., et al., editors. "Spine Injury: Cervical, Adult." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307374/all/Spine_Injury:_Cervical__Adult.
Spine Injury: Cervical, Adult. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307374/all/Spine_Injury:_Cervical__Adult. Accessed December 9, 2024.
Spine Injury: Cervical, Adult. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307374/all/Spine_Injury:_Cervical__Adult
Spine Injury: Cervical, Adult [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2024 December 09]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307374/all/Spine_Injury:_Cervical__Adult.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Spine Injury: Cervical, Adult
ID - 307374
ED - Barkin,Adam Z,
ED - Shayne,Philip,
ED - Rosen,Peter,
ED - Schaider,Jeffrey J,
ED - Barkin,Roger M,
ED - Hayden,Stephen R,
ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307374/all/Spine_Injury:_Cervical__Adult
PB - Lippincott Williams & Wilkins
ET - 6
DB - Emergency Central
DP - Unbound Medicine
ER -