The cervical vertebrae are made up of seven bones (neck). They provide support for the head and connect it to the shoulders and the body. A broken neck refers to a fracture or break in one of the cervical vertebrae.
Cervical fractures are typically caused by high-energy trauma, such as car accidents or falls. Ground-level falls, such as falling off a chair, can result in a cervical fracture in the elderly. Athletes are also vulnerable. A cervical fracture can occur if any of the following conditions exist:
- A football player uses his head to “spear” an opponent.
- An ice hockey player is hit from behind and collides with the boards.
- A gymnast falls after missing the high bar during a release move.
- A diver collides with the bottom of a shallow pool.
Because the spinal cord, the central nervous system’s connection between the brain and the body, runs through the center of the vertebrae, any injury to the vertebrae can have serious consequences. Spinal cord damage is extremely serious and can result in paralysis or death. An injury to the spinal cord at the cervical spine level can result in temporary or permanent paralysis of the entire body from the neck down.
Causes of Cervical Fractures
Automobile accidents, slips and falls, physical abuse, and sports are the most frequent causes of cervical fractures and dislocations. The spine bones may crack, the ligaments may rupture, or both as a result of the millisecond-long abrupt impact and/or twisting of the neck that occurs during the trauma.
A cervical fracture and/or instability may result from the initial trauma or event, which may also harm the spinal cord and other neurologic structures. The most devastating aspect of a cervical injury is the potential spinal cord injury and neurologic deficit because it frequently results in irreversible and permanent damage. Injuries to the spinal column and spinal cord primarily affect males between the ages of 15 and 24.
Symptoms of Cervical Fractures
Typical symptoms of patients with cervical fractures include severe, localized neck pain and stiffness. Patients with other injuries, however, might experience pain in other places while oblivious to the severity of their neck pain. Numbness or weakness in the arms and/or legs may occur in patients who have neurologic compression or irritation.
The presence or absence of radiating pain symptoms is debatable. Patients may experience breathing difficulties or an inability to take deep breaths as a result of upper cervical spine fractures and spinal cord injuries that can affect the neurologic control of breathing.
Physical Findings of Cervical Fractures
Patients with cervical fractures may present with a variety of physical findings. Patients typically exhibit severe tenderness, spasms, and a significantly reduced range of motion in their neck. The fracture site in the back of the neck frequently has ecchymosis (bruising) and noticeable swelling.
If the fracture or dislocation is severe, the examiner will be able to see and feel a “step-off,” which denotes that the bones are not properly aligned. Arms and/or legs may experience significant weakness and numbness if the spinal nerves are severely compressed. In the case of a complete spinal cord injury, patients will completely lose their strength and sensation. Deep tendon reflexes could be weak or nonexistent. Arms and legs should have normal pulses and vascularity.
Response to Cervical Fractures
The neck should be immobilized in a trauma situation until X-rays are taken and examined by a doctor. An unconscious person will be treated as having a neck injury by emergency medical personnel. Shock and either temporary or permanent paralysis could affect the victim.
Patients with acute neck injuries who are conscious may or may not experience excruciating neck pain. Additionally, the vertebra may compress a nerve, causing pain to radiate from the neck to the shoulders or arms. The back of the neck may be a little bruised and swollen. To evaluate nerve function, the doctor will conduct a thorough neurological examination. He or she may also ask for additional radiographic tests, like magnetic resonance imaging (MRI) or computed tomography (CT), to ascertain the severity of the wounds.
Diagnosis of Cervical Fractures
When a patient experiences trauma or is in an accident, cervical spine fractures and dislocations should always be considered, especially in those who experience neck pain. When the physical findings or symptoms are unusual, the diagnosis may be difficult to make. Patients who have other fractures or injuries may complain of pain in other areas but not necessarily in their necks.
Patients occasionally minimize the severity of the trauma or auto accident. These scenarios might make the doctor hesitate to request cervical X-rays and imaging tests, which are essential for determining the extent of cervical injuries. To avoid misdiagnosing this condition, the clinician should perform an exhaustive history check and clinical examination (especially inspection and palpation of the spine). To correctly diagnose a cervical injury, every patient who has undergone a severe accident or trauma, especially those who have neck pain, should undergo a thorough examination with X-rays (and any additional imaging studies that may be required).
Treatment of Cervical Fractures
The treatment for a cervical fracture is determined by which cervical vertebrae were injured and the extent of the fracture. A minor (compression) fracture is frequently treated by wearing a cervical collar or brace for six to eight weeks until the bone heals on its own.
Traction, surgical repair, or spinal fusion may be required for a more severe or complex fracture. A cervical fracture may necessitate a lengthy recovery period followed by physical therapy.
Possible treatment options include:
1. Cervical braces
A cervical or neck brace may be used by doctors to treat a minor compression fracture in one vertebra. The brace may be required to be worn for a number of weeks or months. Additionally, they might require either prescription or over-the-counter pain medication (OTC).
When using traction, you must use a device that significantly restricts head and neck motion in comparison to a brace. It might make use of pulleys and weights to position the bones correctly.
A hard vest and a ring (or halo) around the head make up a traction device known as a halo vest. Rods join the vest portion to the halo. Using special screws, doctors fasten the halo to the patient’s skull.
According to some data, using a halo vest can reduce a patient’s length of hospital stay and cost less than alternative treatments.
This type of therapy is debatable, though. It is an invasive procedure that is inappropriate for some people, such as the elderly and some obese people.
A doctor might advise surgery if the broken neck is severe and a brace or traction may not be effective treatments. If the injury has caused bone fragments to break off or the neck is extremely unstable, surgery may be necessary.
A person might require physical therapy and rehabilitation after surgery. To ensure a complete recovery, this treatment may go on for several months or longer.
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