Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-5f56664f6-kch4j Total loading time: 0 Render date: 2025-05-07T07:30:38.735Z Has data issue: false hasContentIssue false

Chapter 10 - Cervical Spine Trauma

Published online by Cambridge University Press:  23 August 2019

By
Katja Goldflam
Edited by
Alex Koyfman  and
Brit Long
Alex Koyfman
Affiliation:
University of Texas Southwestern Medical Center
Brit Long
Affiliation:
San Antonio Military Medical Center
Get access

Summary

Injury of the cervical spine occurs most commonly due to high impact blunt trauma.1–3 It is the most commonly injured portion of the spine as it is not as well protected as the lower thoracic and lumbar spine. The most commonly injured vertebrae are C2 and C5–7, and injuries are more common in males than females.1,2,4

Type
Chapter
Information
The Emergency Medicine Trauma Handbook , pp. 144 - 153
Publisher: Cambridge University Press
Print publication year: 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Book purchase

Temporarily unavailable

References

Oliver, M, Inaba, K, Tang, A, et al. The changing epidemiology of spinal trauma: a 13-year review from a Level I trauma centre. Injury. 2012;43(8):1296–300.Google Scholar
Hasler, RM, Exadaktylos, AK, Bouamra, O, et al. Epidemiology and predictors of cervical spine injury in adult major trauma patients: a multicenter cohort study. J Trauma Acute Care Surg. 2012;72(4):975–81.Google Scholar
Nelson, DW, Martin, MJ, Martin, ND, Beekley, A. Evaluation of the risk of noncontiguous fractures of the spine in blunt trauma. J Trauma Acute Care Surg. 2013;75(1):135–39.Google Scholar
Greenbaum, J, Walters, N, Levy, PD. An evidenced-based approach to radiographic assessment of cervical spine injuries in the emergency department. J Emerg Med. 2009;36(1):64–71.CrossRefGoogle ScholarPubMed
Denis, F. Spinal instability as defined by the three-column spine concept in acute spinal trauma. Clin Orthop Relat Res. 1984;(189):65–76.Google Scholar
Como, JJ, Diaz, JJ, Dunham, CM, et al. Practice management guidelines for identification of cervical spine injuries following trauma: update from the Eastern Association for the Surgery of Trauma Practice Management Guidelines Committee. J Trauma. 2009;67(3):651–59.Google Scholar
Duane, TM, Dechert, T, Wolfe, LG, et al. Clinical examination and its reliability in identifying cervical spine fractures. J Trauma. 2007;62(6):1405–8, discussion 1408–10.Google ScholarPubMed
ATLS Subcommittee; American College of Surgeons’ Committee on Trauma; International ATLS working group. Advanced trauma life support (ATLS®): the ninth edition. J Trauma Acute Care Surg. 2013;74(5):1363–66.Google Scholar
Hoffman, JR, Mower, WR, Wolfson, AB, Todd, KH, Zucker, MI. Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma. National Emergency X-Radiography Utilization Study Group. N Engl J Med. 2000;343(2):94–99.Google Scholar
Stiell, IG, Wells, GA, Vandemheen, KL, et al. The Canadian C-spine rule for radiography in alert and stable trauma patients. JAMA. 2001;286(15):1841–48.Google Scholar
Stiell, IG, Clement, CM, McKnight, RD, et al. The Canadian C-spine rule versus the NEXUS low-risk criteria in patients with trauma. N Engl J Med. 2003;349(26):2510–18.Google Scholar
Goldberg, AL, Kershah, SM. Advances in imaging of vertebral and spinal cord injury. J Spinal Cord Med. 2010;33(2):105–16.CrossRefGoogle ScholarPubMed
Ackland, HM, Cameron, PA, Varma, DK et al. Cervical spine magnetic resonance imaging in alert, neurologically intact trauma patients with persistent midline tenderness and negative computed tomography results. Ann Emerg Med. 2011;58(6):521–30.CrossRefGoogle ScholarPubMed
Abram, S, Bulstrode, C. Routine spinal immobilization in trauma patients: what are the advantages and disadvantages? Surgeon. 2010;8(4):218–22.Google Scholar
Deasy, C, Cameron, P. Routine application of cervical collars – what is the evidence? Injury. 2011;42(9):841–42.Google Scholar
Bandiera, G, Stiell, IG, Wells, GA, et al. The Canadian C-spine rule performs better than unstructured physician judgment. Ann Emerg Med. 2003;42(3):395–402.Google Scholar
Healey, CD, Spilman, SK, King, BD, Sherrill, JE 2nd, Pelaez, CA. Asymptomatic cervical spine fractures: current guidelines can fail older patients. J Trauma Acute Care Surg. 2017;83(1):119–25.Google Scholar
Holmes, JF, Akkinepalli, R. Computed tomography versus plain radiography to screen for cervical spine injury: A meta-analysis. J Trauma. 2005;58(5):902–5.Google Scholar
Mathen, R, Inaba, K, Munera, F, et al. Prospective evaluation of multislice computed tomography versus plain radiographic cervical spine clearance in trauma patients. J Trauma. 2007;62(6):1427–31.Google ScholarPubMed
Miller, CP, Brubacher, JW, Biswas, D, et al. The incidence of noncontiguous spinal fractures and other traumatic injuries associated with cervical spine fractures: a 10-year experience at an academic medical center. Spine. 2011;36(19):1532–40.CrossRefGoogle ScholarPubMed
Crim, JR, Moore, K, Brodke, D. Clearance of the cervical spine in multitrauma patients: the role of advanced imaging. Semin Ultrasound CT MR. 2001;22(4):283–305.CrossRefGoogle Scholar
Pollack, CV Jr, Hendey, GW, Martin, DR, Hoffman, JR, Mower, WR; NEXUS Group. Use of flexion-extension radiographs of the cervical spine in blunt trauma. Ann Emerg Med. 2001;38(1):8–11.Google Scholar
Oh, JJ, Asha, SE, Curtis, K. Diagnostic accuracy of flexion-extension radiography for the detection of ligamentous cervical spine injury following a normal cervical spine computed tomography. Emerg Med Australas. 2016;28(4):450–55.Google Scholar
Biffl, WL, Moore, EE, Offner, PJ, Burch, JM. Blunt carotid and vertebral arterial injuries. World J Surg. 2001;25(8):1036–43.CrossRefGoogle ScholarPubMed
Miller, PR, Fabian, TC, Croce, MA, et al. Prospective screening for blunt cerebrovascular injuries: analysis of diagnostic modalities and outcomes. Ann Surg. 2002; 236(3):386–93.Google Scholar
Kopelman, TR, Leeds, S, Beradordoni, NE, et al. Incidence of blunt cerebrovascular injury in low-risk cervical spine fractures. Am J Surg. 2011;202(6):684–88.Google Scholar
Allen, BL, Ferguson, RL, Lehmann, TR, O’Brien, RP. A mechanistic classification of closed, indirect fractures and dislocations of the lower cervical spine. Spine. 1982;7(1):1–27.Google Scholar
Vaccaro, AR, Hurlbert, RJ, Fisher, CG, et al. The sub-axial cervical spine injury classification system (SLIC): a novel approach to recognize the importance of morphology, neurology and integrity of the disco-ligamentous complex. Spine. 2007;32(21):2365–74.Google Scholar
Vaccaro, AR, Koerner, JD, Radcliff, KE, et al. AOSpine subaxial cervical spine injury classification system. Eur Spine J. 2016;25(7):2173–84.Google Scholar
Tescher, AN, Rindflesch, AB, Youdas, JW, et al. Comparison of cervical range-of-motion restriction and craniofacial tissue-interface pressure with 2 adjustable and 2 standard cervical collars. Spine. 2016;41(6):E304–12.CrossRefGoogle ScholarPubMed
Crosby, ET. Airway management in adults after cervical spine trauma. Anesthesiology. 2006;104(6):1293–318.Google Scholar
Hurlbert, RJ, Hadley, MN, Walters, BC, et al. Pharmacological therapy for acute spinal cord injury. Neurosurgery. 2015;76(Suppl 1):S71–83.Google Scholar
Eckert, MJ, Martin, MJ. Trauma: Spinal cord injury. Surg Clin North Am. 2017;97(5):1031–45.Google Scholar
Stein, DM, Knight, WA 4th. Emergency neurological life support: traumatic spine injury. Neurocrit Care. 2017;27(Suppl 1):170–80.Google Scholar
Boese, CK, Lechler, P. Spinal cord injury without radiologic abnormalities in adults: a systematic review. J Trauma Acute Care Surg. 2013;75(2):320–30.Google Scholar
Licinia, P, Nowitzke, AM. Approach and considerations regarding the patient with spinal injury. Injury. 2005;36(Suppl 2):B2–12.Google Scholar
Duane, TM, Young, AJ, Vanguri, P, et al. Defining the cervical spine clearance algorithm: a single-institution prospective study of more than 9,000 patients. J Trauma Acute Care Surg. 2016;81(3):541–47.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×