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Updated: Dec 1 2021

Cervical Spine Injury

  • Snapshot
    • A 27-year-old man presents to the emergency department after being involved in a motor vehicle accident. He was an unrestrained driver. When the emergency medical services arrived, the patient's airway, breathing, and circulation was maintained and his cervical spinal cord was immobilized on the field. In the emergency department he was arousable and answering questions appropriately. He reports severe neck pain. A CT scan of the neck demonstrates traumatic spondylosis of C2.
  • Introduction
    • Definition
      • injury to the cervical spine
    • Associated conditions
      • traumatic brain injury
  • Epidemiology
    • Incidence
      • the cervical spine is the most common site of spinal column injury
  • Etiology
    • Motor vehicle accidents
    • Violent trauma
    • Fall
    • Sports-related injury
    • Pathoanatomy
      • anatomy
        • the cervical spine consists of 7 cervical bony vertebrae which are separated by intervertebral disks and connected by a myriad of ligaments
          • the cervical spine is more exposed than the thoracic and vertebral spine
            • also, it is inherently flexible, making it the most commonly injury part of the spine
      • pathogenesis
        • there are a number of causes of cervical spine injury and include
          • transection
            • seen with penetrating or massive blunt trauma
          • compression
            • seen in cervical osteoarthritis and spondylosis
          • vascular compromise
            • seen in cervical dislocation
          • synringomyelia
  • Presentation
    • Symptoms
      • neck pain
    • Physical exam
      • neurological deficits may or may not be present
  • Imaging
    • CT of the cervical spine
      • indication
        • in patients getting CT imaging of the head, chest, and abdomen
        • in hemodynamically unstable patients after they have had operative intervention
  • Studies
    • Making the diagnosis
      • a clinical diagnosis supported by radiographic imaging
  • Treatment
    • Conservative
      • spinal immobilization
        • indication
          • to prevent further injury to the cervical spinal cord until an unstable injury is ruled out
      • maintaining airway, breathing, and circulation
        • indication
          • a component of initial management of cervical spinal cord injury
    • There are a number of interventions of cervical spinal cord injury such as neurosurgical intervention and steroid administration
  • Complications
    • Respiratory failure
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