![]() ![]() Plain x-rays of the cervical spine are essential to adequately evaluate a cervical fracture and dislocation. Pulses and vascularity of the arms and legs should be normal. Deep tendon reflexes may be diminished or absent. Patients will have complete loss of strength and sensation in the setting of a complete spinal cord injury. If the spinal nerves are severely compressed, there may be significant weakness and numbness in the arms and/or legs. If the fracture/dislocation is severe, there will be a visible and palpable “step-off”, meaning the bones are not lined up properly which can be seen and felt by the examiner. There is often visible swelling and ecchymosis (bruising) over the fracture site in the back of the neck. Patients will typically demonstrate profound tenderness and spasm, with significantly decreased neck range-of motion. The physical findings for patients with cervical fractures are variable. Upper cervical spine fractures and spinal cord injuries can affect the neurologic control of breathing, and patients may complain of difficulty breathing or the inability to take a deep breath. ![]() There may or may not be associated radiating pain symptoms. Patients who have neurologic compression or irritation may have numbness or weakness in the arms and/or legs. However, patients with other injuries may complain of pain in other areas and not notice the severity of neck pain. Patients with cervical fractures typically have significant, localized neck pain and stiffness. ![]() The majority of spinal column and spinal cord injuries occur in males between the ages of 15 and 24 years old. The resultant spinal cord injury and neurologic deficit, if it occurs, is the most devastating aspect of a cervical injury, primarily because it is often irreversible and permanent. The initial trauma or event may cause a cervical fracture and/or instability, which may also cause damage to the spinal cord and neurologic structures. The abrupt impact and/or twisting of the neck that occurs in a millisecond during the trauma can cause the spine bones to crack or the ligaments to rupture, or both. The most common causes of cervical fractures and dislocations are motor vehicle accidents, falls, violence, and sports activities. Compression-Flexion (Teardrop fracture).Distraction-Flexion (Facet fracture/dislocation).Traumatic Spondylolisthesis of the Axis (C2).Within each of these categories, injuries are further stratified according to the specific location of injury and injury/fracture pattern. Because of the unique anatomy of the spine in the region close to the head, cervical injuries are categorized as occipital-cervical (occiput-C2) and subaxial cervical spine (C3-C7) injuries. Although the lumbar (low back) region is most commonly injured during daily laborious, low-energy activities, the neck is most likely to be injured during high-energy trauma such as motor vehicle accidents.Ĭervical fractures and dislocations are typically classified according to their region/location and injury/fracture pattern. The majority of fractures and dislocations of the spinal column occur in the cervical spine because it is the most mobile portion of the spinal column, and understandably, the most vulnerable to injury. According to a study published by Lasfargues in 1995, over 25,000 cervical fractures occur each year in the United States. Fractures and dislocations of the cervical spine are not uncommon, and account for almost half of all spinal column injuries that occur every year. Patients can have a cervical fracture or dislocation, or both. A cervical dislocation means that a ligament injury in the neck has occurred, and two (or more) of the adjoining spine bones have become abnormally separated from each other, causing instability. A cervical fracture means that a bone is broken in the cervical (neck) region of the spine. ![]()
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