Occult Cervical Spine Injuries in Fatal Traffic Accidents

Bucholz, Robert W.; Burkhead, Wayne Z.; Graham, Wallace; Petty, Charles S.

doi:10.1097/00005373-197910000-00009

Cited by 141 publications

(56 citation statements)

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“…The severity of industrial trauma is due to the involvement of lower cervical spine in majority of the instances C1 and 13% at the craniocervical junction. Bucholz et al 26 also recorded a similar ®nding among the MVC fatalaties with neck injury; 38% occurred at C2, 33% at C1 and 13% at craniocervical junction. Burke et al 14 in a hospital admission study, reported that C4-5 injuries accounted for 61% of all CSCI.…”

Section: Cervical Spinal Column Injurymentioning

confidence: 62%

Characteristics of injuries to the cervical spine and spinal cord in polytrauma patient population: experience from a regional trauma unit

et al. 1999

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Study design: Retrospective analysis of a prospectively collected trauma database of a Level 1 (tertiary) trauma center. Objective: To de®ne the features of the cervical spinal injuries in polytrauma population admitted to the regional trauma unit. Setting: Canada, Ontario Province, Toronto, Sunnybrook Health Sciences Center. Methods: All trauma admissions between 1987 and 1996 entered prospectively into a trauma registry database were studied for incidence, demographic and epidemiological details of cervical spine (cord and column) injuries. Results: A total of 468 patients (66% male) with cervical spinal injury (CSI) from 1198 spinal injuries admitted to the regional trauma center were identi®ed. Seventy-®ve per cent of the CSI involved were aged less than 50 years; nearly 30% were in the third decade alone. Overall, the commonest spinal level injured was C2 (27%) followed by C5 (22%). Older population (above 60 years of age) had C1+2 involved more often than the young (P=0.02). Motor vehicular crashes (MVC) accounted for 71%, followed by pedestrian trauma (10%), sport injuries (7%). Spinal cord injury (SCI) was noted in 27%; complete in 16% and incomplete in 11% and more frequently at C4 or C5 level compared with C1, C2 (P50.00001); the former level had more often a complete SCI (P=0.06). Though MVC produced 74% of SCI, only 27% had neurological de®cits. Recreational trauma produced SCI in 45%, motor cycle crashes (MCC) in 37% and a rear passenger in MVC in 34% that was complete in 78%, 71% and 73% respectively. Front seat passenger and driver in MVC had a C5 level injury while a rear seat passenger had at C4 (P50.001). The C1 level injury had high association with severe and life threatening head and neck and facial injuries compared with the more frequently injured spinal levels; either C2 (P=0.03) or C5 (P=0.004). Similarly C1 injuries had higher ISS compared with C2 (P50.0001) and C5 (P50.008). Conclusions: C2 was the commonest fractured spine while SCI was more frequent at C5. Older and pedestrian population had higher incidences of injuries at C1 and C2. Sport and MCC resulted in severe SCI. The level of spine injured was dierent between a front and a rear seat occupant in MVC.

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Section: Cervical Spinal Column Injurymentioning

confidence: 62%

Characteristics of injuries to the cervical spine and spinal cord in polytrauma patient population: experience from a regional trauma unit

et al. 1999

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“…15 Bucholz et al also studied postmortem radiographs of 112 victims and found the incidence of cervical spine injuries to be 24%, with nine patients (8% of total) having AOD. 16 Davis et al reported five cases of disruption of the AO joint in postmortem radiographic studies of the head and spine among 50 consecutive deaths from acute trauma. 17 In the majority of the cases from these series, the injury was immediately fatal.…”

Section: Incidence Mechanism and Consequences Of Atlantooccipital DImentioning

confidence: 99%

“…The high frequency of submental lacerations, mandibular fractures (as in our patient), and lacerations to the posterior pharyngeal wall emphasize the role of hyperextension in these injuries. 16 Children appear to be more susceptible to sustaining AOD than adults. 16 The child's relatively larger head size, more horizontally oriented-AO joint, smaller occipital condyles, and weaker supporting ligaments all contribute to this increased vulnerability.…”

Section: Incidence Mechanism and Consequences Of Atlantooccipital DImentioning

confidence: 99%

“…16 Children appear to be more susceptible to sustaining AOD than adults. 16 The child's relatively larger head size, more horizontally oriented-AO joint, smaller occipital condyles, and weaker supporting ligaments all contribute to this increased vulnerability. Injuries to the cervical spine also occur more frequently in automobile-pedestrian accidents than in collision accidents, and children are involved in automobile-pedestrian accidents more often than adults.…”

Section: Incidence Mechanism and Consequences Of Atlantooccipital DImentioning

confidence: 99%

“…Injuries to the cervical spine also occur more frequently in automobile-pedestrian accidents than in collision accidents, and children are involved in automobile-pedestrian accidents more often than adults. 16 Therefore, children not only possess a less stable anatomic configuration of their cranio-cervical junction, but also appear to be more predisposed to the most common inciting accident than adults. Recent reports have also noted the potential for AOD in children and small unrestrained adults after airbag inflation.…”

Section: Incidence Mechanism and Consequences Of Atlantooccipital DImentioning

confidence: 99%

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Occult Cervical Spine Injuries in Fatal Traffic Accidents

Cited by 141 publications

References 0 publications

Characteristics of injuries to the cervical spine and spinal cord in polytrauma patient population: experience from a regional trauma unit

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