Hidden flexion injury of the cervical spine

Abstract

This paper describes seven patients who developed late vertebral deformity after fiexion injuries of the cervical spine. In four the clinical and radiological features were subtle and because the patients walked into an emergency department the severity of the injury was not initially appreciated. Certain specific clinical and radiological features of flexion injury are described and emphasis is placed on the importance of correct 14 Male Wrestling C.3-4 C.4 and C.5 Pain and spasm Complete tetraplegia No improvement Late vertebral deformity 7 12 Male Trampoline C.3-4

Spinal Cord Injury without Radiographic Abnormality in Children

“…Hence, con tinued albeit normal spinal movement could result in repetitive cord trauma during cycles of flexion and ex tension. Various authors have implicated damage to the posterior ligaments and have referred to this as 'hidden flexion injury of the cervical spine' [44,50]. Pang and Wilberger [16] felt that this mechanism may have been important in several of their patients [16].…”

Strain rate dependent properties of younger human cervical spine ligaments

“…Damage to these ligaments has been associated with injuries, such as neck strain (Webb et al, 1976;Harris et al, 1992) and whiplash associated disorders Tominaga et al, 2006;Ito et al, 2004). The mechanical properties of the cervical spine ligaments are needed for a younger population, at relevant strain rates, for more accurate predictions of head/neck kinematic response and the prediction of injury using detailed finite element models.…”

Cervical spine flexion patterns

“…(Fig. 2) This pattern is said to represent guarding and/or spasm [15] and is not satisfactory as a stress film because it does not exclude an unstable injury. Follow-up flexion studies are recommended [t5].…”

“…They are used to evaluate for ligamentous injury (most importantly, for unstable ligamentous injury) because a normal-appearing neutral position lateral radiograph does not exclude such injuries [5,8,[13][14][15]. The appearance of a normal flexion (Fig.…”