Injuries to the lower cervical nerves and/or the spinal cord can have severe consequences, including paralysis of both upper and lower extremities and impacting bowel and bladder functions. These types of injuries are most common in adolescents and young adults aged 16-24 years. They result from deformations to the cervical spinal column, which can damage the spinal cord. Specifically, damage to the C5 vertebrae or higher can be life-threatening as it may impair central nervous system-controlled ventilation.
In the critical 24-72 hours following a spinal cord injury, numerous complications can arise. For older blunt trauma patients, up to 20% of cervical spine fractures are missed. This is particularly significant as open mouth views are often inadequate for unconscious patients, and visualizing the C7-T1 junction frequently requires multiple imaging attempts. Current guidelines aim to aid inexperienced radiologists in the diagnostic evaluation of patients at high risk for cervical spine injuries.
The cervical spine (C-Spine) encompasses C1 to the upper border of T1. Clearing the C-Spine involves a clinical decision indicating the absence of acute bone-related injuries. In the initial recovery phase (Phase 1, approximately 1 to 12 weeks), patients may need to wear a C-Collar for about 6 weeks, especially if they have associated c-spine fractures. During this time, home physical therapy for transfer training and mobilization is typical, with a goal of walking for 30 minutes twice daily.
At the Children’s Hospital of Philadelphia (CHOP), children with C1 atlas fractures are treated with a neck brace, traction, or cranial tongs, depending on the injury’s severity. In extreme cases, surgery may be required. CHOP surgeons have published research on the treatment and outcomes for traumatic atlanto-occipital dislocation in children.
The basic types of spinal fractures include vertebral compression fractures, vertebral burst fractures, and fracture-dislocations that significantly damage the facet joints. Other minor fractures may involve the lamina, transverse process, or spinous process.
Injuries to the C2 axis vertebra can include various types of fractures (such as lateral mass fractures and odontoid fractures), sprains, dislocations, and rotatory subluxation of the C1-C2 joint.
For more detailed information on lower cervical spine injuries and their treatment, visit the CHOP website here, or explore other resources like KSI Uconn, UTH Radiology, and many more.
