Management of Cervical Spine Fractures: A Literature Review

Abstract

The unique anatomy and flexibility of the cervical spine predispose it to a risk of injury. Trauma to the cervical spine encompasses a wide range of injuries from minor muscular strains to life-threatening fracture-dislocations associated with spinal cord lesions. Initial assessment and management should follow the Advanced Trauma Life Support (ATLS) protocols with adequate protection of the cervical spine through triple immobilisation to prevent any unnecessary movement, which can make the patient susceptible to further neurological injuries. Although the presence of cervical spine injury is very often overt, reliance on clinical examination alone is sometimes not sufficient and potentially requires further imaging. Clinical decision rules such as the Canadian C-Spine Rule are frequently used to risk-stratify patients needing radiography. The level of cervical spine instability and knowledge of their unique classification systems is of paramount importance and assists in the decision-making process to guide definitive management. In this review, we also propose an algorithm to aid the initial management of a patient with suspected cervical spine injury in the emergency department.

Traumatic Rotatory Atlantoaxial Subluxation

“…The timing of the trauma, the mechanism of the trauma (traffic accident, falling), the movement of the neck during the trauma (hyperextension, hyperflexion, rotational movement), the type of trauma (low/high energy) should be asked during anamnesis. If a patient has any neurological symptoms, when it started and how its course changed should be questioned in detail (8). After taking a detailed anamnesis, a physical examination should be performed.…”

Influence of socioeconomic factors on discharge disposition following traumatic cervicothoracic spinal cord injury at level I and II trauma centers in the United States

“…We were also able to include information on the fracture location within the spine, which lends pertinent information as spinal fractures at different levels carry unique motor and sensory deficits, differing outcomes, and differing long-term sequalae [ 46 , 47 ]. Still, the NTDB does not contain an ideal set of variables to objectively assess in which instances non-home discharge was indicated and justified and in which cases home discharge would have been appropriate.…”

Physiotherapy Rehabilitation for Restoring Function in Quadriparesis After Cervical Spine Trauma: A Case Report

“…SCI is often caused by a sudden, intense hit to the spine, causing fractures or dislocations of vertebrae. Primary damage occurs when displaced bone fragments, disc materials, or ligaments tear into spinal cord tissue [ 4 ]. There are four key harm characteristic processes that have been identified: (1) impact + continuous compression, (2) impact alone with temporary compression, (3) distraction, and (4) tearing or severing [ 5 ].…”