Cervical Spine Injuries

Question 1

Common MOI for Cervical Injuries

Answer 1

Cervical spine injury is commonly associated with axial loading with the neck in flexion.

In flexion of the neck to 30*, the normal lordosis of the cervical spine is obliterated and axial loading of the head is dissipated through a straight spine.

“Spear Tackler’s Spine”

Question 2

Odontoid Fracture

Answer 2

The typical MOI is traumatic in nature.

This is considered a medical emergency due to instability and risk or the presence of neurological signs and symptoms.

Question 3

Cervical Spine Dislocation/Subluxation

Answer 3

Subluxation without fracture, with of without neurologic injury.

Dislocations, with or without neurologic injury.

Fractures, with or without neurologic injury.

Question 4

Cervical Fracture

Answer 4

Fracture to any of the bony segments of the cervical spine.

The most important consideration when discussing cervical fractures and dislocations is the concept of stability.

Question 5

Spinal Cord Injuries: High-Cervical Nerve Injury (C1-C4)

Answer 5

These are the most severe types of spinal cord injury levels.
Paralysis in the arms, hands, trunk and legs
Pt may not be able to breathe on their own, cough, or control bowel or bladder movements.

Question 6

Spinal Cord Injuries: Low-Cervical Nerve Injury (C5-C8)

Answer 6

Corresponding nerves control arms and hands.

A person with this level of injury may be able to breathe on their own and speak normally.

Question 7

Spinal Cord Injuries: C5 Injury

Answer 7

The person can raise their arms and bend elbows.
Likely to have some or total paralysis or wrist hands, trunk and legs.
Can speak and use diaphragm, but breathing will be weakened.
Will need assistance with most ADLs but once in a power wheelchair, can move from one place to another independently.
Little or no voluntary control of bowel or bladder, but ma be able to manage their own with special equipment.

Question 8

Spinal Cord Injuries: C6 Injury

Answer 8

Nerves affect wrist extension.
Paralysis in hands, trunk and legs, typically.
Can speak and use diaphragm, but breathing will be weakened.
Can move in and out of wheelchair and bed with assistive equipment.
May also be able to drive an adapted vehicle.
Little or no voluntary control of bowel or bladder, but ma be able to manage their own with special equipment.

Question 9

Spinal Cord Injuries: C7 Injury

Answer 9

Nerves control elbow extension and some finger extension.
Most can straighten their arms and have normal movement of their shoulders.
Can do most ADLs by themselves, but may need assistance with more difficult tasks.
May also be able to drive an adapted vehicle.
Little to no voluntary control of bowel o bladder, but may be able to manage on their own with special equipment.

Question 10

Spinal Cord Injuries: C8 Injury

Answer 10

Nerves control some hand movement.
Should be able to grasp and release objects.
Can do most ADLs by themselves, but may need assistance with more difficult tasks.
May also be able to drive an adapted vehicle.
Little to no voluntary control of bowel o bladder, but may be able to manage on their own with special equipment.

Question 11

Cervical Sprain/Strain

Answer 11

Also known as “Whiplash Associated Disorder” WAD

The common MOI is a forceful motion into the extremes o motion.

Question 12

Treatment of Cervical Sprain/Strain

Answer 12

Decrease pain and inflammation:
RICE
NSAID

re-establish ROM
Soft-tissue management
PROM

Improve neuromuscular control.

Question 13

Treatment of Spinal Cord Injuries

Answer 13

Requires immediate immobilization.
Acute cervical stabilization
Internal/external Fixation.

Question 14

External Fixation (HALO) for Spinal Cord Injuries

Answer 14

The halo is a device for treatent of unstable cervical and upper thoracic fratures and dislocations from C1 to T3.

Question 15

Cervical Radiculopathy

Answer 15

A condition caused by compression of a nerve root in the cervical spine.
Pathology:
-Lateral disc herniation
-Osterophyte formation in joint of Lushka
-Spinal stenosis

Frequency of nerve root compressed C7>C6>C8>C5

Question 16

Symptoms of Cervical Radiculopathy

Answer 16

Symptoms

• Unilateral neck pain
• Radiating arm pain
• Dysthesia in the upper extremities (abnormal sensation)

Signs

• Motor weakness
• Diminished DTRs
• Sensory disturbance

Question 17

Cervical Vertev=bral Artery Dissection/Occlusion

Answer 17

The vertebral artery is a key artery located in the back of the neck that carries blood from the heart to the brain.

Vertebral Artery dissection (VAD)
Injury to this artery leads to a compromise in the vital blood flow to the brain and is considered a medical emergency and should be treated by calling 911 or the local emergency.

Question 18

MOI of VAD

Answer 18

A traumatic VAD is typically caused by a traumatic blow to the head leading to vigorous motion of the cervical spine.

This motion in turn causes a traumatic rupture of the VA.

Question 19

Presentation of VAD

Answer 19

C/O dizziness and light headedness
Nausea and vomitting
Changes in personality, emotions, or mental abilities.
Speech and language problems
Loss of sensation, hearing,vision, taste or smell
Seizures
Paraylsis
Coma

Question 20

herniated Cervical disc

Answer 20

Slipped/Disc bulge. An annular tear without herniation of the nucleus pulposa.

HNP: Involves annular tears with herniation of the nucleus pulposa.

“Sequestered disc”