Cervical Spine Injury in Patients with Facial Skeletal Trauma

Cervical Spine Injury in Association with Craniomaxillofacial Fractures

“…5, 14 Davidson and Birdsell reviewed the records of 2555 patients with facial fractures and noted a 1.3 percent incidence of cervical spine injury. 6 The incidence rose to 5.5 percent when motor vehicle accidents were examined in isolation as the sole mechanism of injury. In a prospective study from Ireland, Beirne et al examined 582 consecutive patients with facial fractures and discovered only six patients with cervical spine injury (1.04 percent).…”

“…Most injuries of the cervical spine associated with these fractures are attributed to forces transmitted directly or indirectly from the facial skeleton to the cervical bony and connective tissue structures. 5,6 Those suffering high-velocity injuries, such as motor vehicle accidents, are presumed to be at higher risk for cervical spine trauma versus lower velocity injuries as seen in falls and workplace accidents. [7][8][9][10][11][12][13][14] Nevertheless, there is a paucity of corroborating evidence to support the relationship between craniomaxillofacial fractures and spinal injury.…”

“…[1][2][3][4][5][6][7][8][9][15][16][17][18][19][20][21][22] Estimates approaching 24 percent have been reported in large series of trauma deaths. 22 Trauma protocols stress the importance of the association between craniomaxillofacial and cervical spine injuries and the disastrous consequences that can ensue if the diagnosis is missed or its presence or absence ignored; but the incidence, frequency, and type of cervical spinal trauma in various facial fracture patterns have been poorly delineated.…”

Atls –A Systematic Review

“…Approximately 55% of spinal injuries occur in the cervical region, 15% in the thoracic region, 15% at the thoracolumbar junction, and 15% in the lumbosacral area. Approximately 10%of patients with a cervical spine fracture have a second, noncontiguous vertebral column fracture 21 .…”

Advanced Trauma Life Support (ATLS) and facial trauma: can one size fit all?

“…In maxillofacial trauma, cervical spine injuries have been reported to occur in up to 6% 10,19,51,52,118,124 , although this figure has been challenged 53,102 . The incidence of a significant and unstable cervical injury following assault is reported as being much lower 106 .…”