Distribution and patterns of blunt traumatic cervical spine injury

Goldberg, William; Mueller, Charles F.; Panacek, Edward A.; Tigges, Stefan; Hoffman, Jerome R.; Mower, William R.

doi:10.1067/mem.2001.116150

Cited by 245 publications

(143 citation statements)

References 15 publications

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“…Particularly, 58.7% of all vertebral fractures found on X-rays occurred in the thoracolumbar region (T11-L2), similar to previous stud- ies on patients with traumatic vertebral fractures [18,19]. In the cervical region, C2 was most frequently found in X-rays, and in MRI, C2 and C6 were identically commonly found, also like previous studies [20][21][22]. In case of the lumbar region, the number of fractures was the largest in L1, and was decreased as it was close to the sacral region.…”

Section: Discussionsupporting

confidence: 74%

“…Vertebral body fracture, when analyzed according to the fractured vertebral structure, revealed similar patterns of results compared to results for entire vertebral fractures identified earlier, which caused by the fact that frequency of vertebral body fracture was most frequently found in vertebral fractures. Goldberg et al [22] stated that vertebral body and odontoid fractures were significant because these fractures account for the largest fraction of injuries to specific part of the vertebrae and they are frequently related to spinous instability in the study conducted on 818 patients with radiographic cervical spine injuries whereas spinous and transverse process fractures were often clinically insignificant and unlikely to be associated with spinous instability. In this study, the transverse process fracture was analyzed only in the lumbar region, and diagnostic accuracy of X-rays was lower than that of the entire vertebral fracture or vertebral body fracture described above.…”

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confidence: 99%

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The Value of X-ray Compared with Magnetic Resonance Imaging in the Diagnosis of Traumatic Vertebral Fractures

Lee

Jang

Kim

et al. 2017

Journal of Trauma and Injury

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Purpose: The purpose of this study was to evaluate the diagnostic accuracy of X-rays in patients with acute traumatic vertebral fractures visiting the emergency department and to analyze the diagnostic value of X-rays for each spine level. Methods: We retrospectively analyzed basal characteristics by reviewing medical records of 363 patients with adult traumatic vertebral fractures, admitted to the emergency center from March 1, 2014 to February 28, 2017. We analyzed spine X-rays and magnetic resonance imaging (MRI) scans to determine distribution according to the vertebral level, and we evaluated the efficacy of X-rays by comparing discrepancies between X-rays and MRI scans. Results: For a total of 363 patients, the mean age was 56.65 (20-93) and 214 (59%) were males. On the basis of X-rays, 67 cases (15.1%) were of the cervical spine, 133 cases (30.0%) were of the thoracic spine, and 243 cases (54.9%) were of the lumbar spine. In particular, the thoracolumbar region (T11-L2) was the most common, with 260 cases (58.7%). In X-rays, fractures were the least in the upper thoracic region (T1-T3), whereas MRI scans revealed fairly uniform distribution across the thoracic spine. Sensitivity of X-rays was lowest in the upper thoracic spine and specificity was almost always greater than 98%, except for 94.7% in L1. Positive predictive value was lower in the mid-thoracic region (T4-T9) and negative predictive value was slightly lower in C6, T2, and T3 than at other sites. Diagnostic accuracy of X-rays by vertebral body, transverse process, and spinous process according to fractured vertebral structures was significantly different according to vertebral level. Conclusions: Diagnostic accuracy of X-rays was lower in the upper thoracic region than in other parts. Further studies are needed to identify better methods for diagnosis considering cost and neurological prognosis.

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Section: Discussionsupporting

confidence: 74%

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confidence: 99%

The Value of X-ray Compared with Magnetic Resonance Imaging in the Diagnosis of Traumatic Vertebral Fractures

Lee

Jang

Kim

et al. 2017

Journal of Trauma and Injury

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“…There are 2 approaches to MILI: (1) an assistant standing at the head of the bed grasps the patient's mastoid process with the fingertips and then cradles the occiput in the palms of the hands; or (2) an assistant standing at the side of the bed cradles the mastoids and grasps the occiput with the fingers. Once the head and neck are stabilized by one of these methods, the front of the cervical collar can be removed to increase mouth opening and visualization by direct laryngoscopy.…”

Section: Airway Managementmentioning

confidence: 99%

Evaluation and Management of Acute Cervical Spine Trauma

Pimentel

Diegelmann

2010

Emergency Medicine Clinics of North America

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“…One-third of injuries occur at the level of C2, and one-half of injuries occur at the level of C6 or C7. Fractures affecting the lower cervical spine most commonly affect the C6, C7 and C5 vertebra with them accounting for 20.2%, 19.1% and 15% of cervical spine fractures, respectively [3]. Most fatal cervical spine injuries occur in upper cervical levels, either at the cranio-cervical junction C1 or C2.…”

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confidence: 99%

A traumatic, high-energy and unstable fracture of the C5 vertebra managed with kyphoplasty: a previously unreported case

Quraishi

Elsayed

2011

Eur Spine J

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Unstable cervical fractures commonly require fusion surgery. We present a case of an unstable cervical fracture (AO classification A2.2) affecting the fifth cervical vertebra which was managed by kyphoplasty to achieve a painfree, functional and stable outcome. The decision to undertake a kyphoplasty procedure was made in the hope of preserving motion and limiting the degree of future adjacent segment disease. We believe this to be the first case of the use of kyphoplasty to be published in the literature in relation to a traumatic cervical fracture. Additionally, at one-year follow-up the patient reports no pain, a near full range of motion in the cervical spine and no neurological deficit. Case presentationA 22-year-old man was admitted complaining of neck pain having been involved in a road traffic accident while riding his motorcycle. Initial radiographs and computed tomography scanning revealed an unstable cervical spine fracture (AO classification A2.2). There was no neurological deficit, and he was managed with cervical immobilisation pending definitive surgical management.After counselling the patient, a decision was made to perform kyphoplasty of the affected vertebra to preserve motion and limit the degree of adjacent segment disease. The alternative method of managing such a fracture would have been to perform an anterior corpectomy and fusion either by an iliac crest graft or a cage with local bone and plating from C4 to C6. There is, of course, the likely problem of early degeneration of the adjacent levels related to a fusion procedure. We believe this to be the first case of the use of kyphoplasty to be published in the literature in relation to a traumatic cervical fracture. One year postoperatively, the patient complains of no neck pain and a near normal range of cervical motion.Historical review of the condition, epidemiology, diagnosis, pathology, differential diagnosisThe annual incidence of spinal cord injury is 5-40 per million, 49-55% of which results from cervical spine injury [1,2]. Most cervical spine fractures occur

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Distribution and patterns of blunt traumatic cervical spine injury

Cited by 245 publications

References 15 publications

The Value of X-ray Compared with Magnetic Resonance Imaging in the Diagnosis of Traumatic Vertebral Fractures

The Value of X-ray Compared with Magnetic Resonance Imaging in the Diagnosis of Traumatic Vertebral Fractures

Evaluation and Management of Acute Cervical Spine Trauma

A traumatic, high-energy and unstable fracture of the C5 vertebra managed with kyphoplasty: a previously unreported case

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