Cervical Spine Injuries Flashcards
Common MOI for Cervical Injuries
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”
Odontoid Fracture
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.
Cervical Spine Dislocation/Subluxation
Subluxation without fracture, with of without neurologic injury.
Dislocations, with or without neurologic injury.
Fractures, with or without neurologic injury.
Cervical Fracture
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.
Spinal Cord Injuries: High-Cervical Nerve Injury (C1-C4)
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.
Spinal Cord Injuries: Low-Cervical Nerve Injury (C5-C8)
Corresponding nerves control arms and hands.
A person with this level of injury may be able to breathe on their own and speak normally.
Spinal Cord Injuries: C5 Injury
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.
Spinal Cord Injuries: C6 Injury
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.
Spinal Cord Injuries: C7 Injury
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.
Spinal Cord Injuries: C8 Injury
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.
Cervical Sprain/Strain
Also known as “Whiplash Associated Disorder” WAD
The common MOI is a forceful motion into the extremes o motion.
Treatment of Cervical Sprain/Strain
Decrease pain and inflammation:
RICE
NSAID
re-establish ROM
Soft-tissue management
PROM
Improve neuromuscular control.
Treatment of Spinal Cord Injuries
Requires immediate immobilization.
Acute cervical stabilization
Internal/external Fixation.
External Fixation (HALO) for Spinal Cord Injuries
The halo is a device for treatent of unstable cervical and upper thoracic fratures and dislocations from C1 to T3.
Cervical Radiculopathy
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
Symptoms of Cervical Radiculopathy
Symptoms
- Unilateral neck pain
- Radiating arm pain
- Dysthesia in the upper extremities (abnormal sensation)
Signs
- Motor weakness
- Diminished DTRs
- Sensory disturbance
Cervical Vertev=bral Artery Dissection/Occlusion
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.
MOI of VAD
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.
Presentation of VAD
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
herniated Cervical disc
Slipped/Disc bulge. An annular tear without herniation of the nucleus pulposa.
HNP: Involves annular tears with herniation of the nucleus pulposa.
“Sequestered disc”
