Cervical spine injury
Updates to Article Attributes
Cervical spine injuries can involve the cervical vertebral column, intervertebral discs and cervical spine ligaments, and/or cervical spinal cord. The cervical spine accounts for ~50% of all spinal injuries.
Epidemiology
5-10% of patients with blunt trauma have a cervical spine injury 1.
Pathology
Patients can have a combination of injuries including:
- atlanto-occipital dissociation
- occipital condyle fracture
- cervical spine fractures
- discoligamentous injury
- facet joint dislocation
- spinal epidural haematoma
- spinal cord injury
- vertebral artery dissection
Aetiology
- blunt trauma: motor vehicle accident (40%), falls, sports injuries
- penetrating trauma: gun shot injuries, stabbing
Associations
- closed head injury: patients with GCS <8 at highest risk 3
Radiographic features
CT and MRI both have roles to play. CT is used to assess patients who are obtunded, at high-risk, or those unable to be cleared by clinical criteria (e.g. NEXUS, Canadian C-spine rule).
MRI is used to assess for discoligamentous injury but has a controversial role in patients who are obtunded and a normal CT with some advocating it as unnecessary due to the CT's high negative predictive value for unstable cervical spine injuries 1.
Please see individual articles listed above for further details in imaging findings.
Classification
There are two classification systems incorporating CT findings 1:
-<li><a title="Atlanto-occipital dissociation (AOD)" href="/articles/atlanto-occipital-dissociation-injuries">atlanto-occipital dissociation</a></li>-<li><a title="Occipital condyle fracture" href="/articles/occipital-condyle-fracture">occipital condyle fracture</a></li>-<li><a title="Cervical spine fractures" href="/articles/cervical-spine-fractures">cervical spine fractures</a></li>- +<li><a href="/articles/atlanto-occipital-dissociation-injuries">atlanto-occipital dissociation</a></li>
- +<li><a href="/articles/occipital-condyle-fracture">occipital condyle fracture</a></li>
- +<li><a href="/articles/cervical-spine-fractures">cervical spine fractures</a></li>
-<li><a title="Facet joint dislocation" href="/articles/facet-dislocation">facet joint dislocation</a></li>-<li><a title="Spinal epidural haematoma" href="/articles/spinal-epidural-haematoma">spinal epidural haematoma</a></li>-<li><a title="Spinal cord injury" href="/articles/spinal-cord-injury">spinal cord injury</a></li>-<li><a title="Vertebral artery dissection" href="/articles/vertebral-artery-dissection">vertebral artery dissection</a></li>- +<li><a href="/articles/facet-dislocation">facet joint dislocation</a></li>
- +<li><a href="/articles/spinal-epidural-haematoma">spinal epidural haematoma</a></li>
- +<li><a href="/articles/spinal-cord-injury">spinal cord injury</a></li>
- +<li><a href="/articles/vertebral-artery-dissection">vertebral artery dissection</a></li>
-<li>penetrating trauma: <a title="Imaging of gun shot injuries" href="/articles/imaging-of-gun-shot-injuries">gun shot injuries</a>, stabbing</li>- +<li>penetrating trauma: <a href="/articles/imaging-of-gun-shot-injuries">gun shot injuries</a>, stabbing</li>
-<a title="Traumatic brain injury" href="/articles/traumatic-brain-injury">closed head injury</a>: patients with <a title="Glasgow coma scale (GCS)" href="/articles/glasgow-coma-scale">GCS</a> <8 at highest risk <sup>3</sup>- +<a href="/articles/traumatic-brain-injury">closed head injury</a>: patients with <a href="/articles/glasgow-coma-scale">GCS</a> <8 at highest risk <sup>3</sup>
-<li><a title="Subaxial Injury Classification and Scoring (SLIC) system" href="/articles/subaxial-injury-classification-and-scoring-slic-system">subaxial injury classification and scoring (SLIC) system</a></li>-<li><a title="cervical spine injury severity score" href="/articles/cervical-spine-injury-severity-score">cervical spine injury severity score</a></li>- +<li>
- +<a href="/articles/subaxial-injury-classification-and-scoring-slic-system">subaxial cervical spine injury classification </a><a href="/articles/subaxial-injury-classification-and-scoring-slic-system">system</a><a href="/articles/subaxial-injury-classification-and-scoring-slic-system"> (SLICS) </a>
- +</li>
- +<li><a href="/articles/cervical-spine-injury-severity-score">cervical spine injury severity score</a></li>
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