How are cervical spine fractures caused?
Cervical spine fractures can be caused by a variety of mechanisms. Common causes of cervical spine fractures are
-Road traffic accidents
-Fall from a height
-sports accidents, Gunshot wounds
The spinal cord may also be injured, depending on the severity of the fracture.
Why are cervical spine fractures serious injuries?
The cervical spine forms the rigid bony column which supports the head. The other important function is the protection of the spinal cord which supplies both the upper limbs and the lower limbs.
Spinal cord injuries are more common in the cervical spine as the spinal canal is almost completely occupied by the cord and even a small degree of movement of the fractured fragments can lead to damage of the cord.
Spinal cord injury can lead to paralysis of the limbs and loss of bowel and bladder function. Loss of neurological function make these injuries serious requiring treatment at specialised centres.
Because of the high-energy mechanism of injury, patients often have other life-threatening injuries as well.
What are the first aid measures in cervical spine fractures?
Never attempt to move a person with a spinal injury because movement can cause more damage. It is important that the patient be transported at the earliest to a center specialised in spinal injuries, preferably by trained personnel after securing the neck with a collar. The collar should not be removed till the extent of spinal injury is confirmed. Unprotected movement of the injured spine can cause fresh damage to the nerves and cord or worsen existing damage.
What are the symptoms of cervical spine fractures?
The primary symptom is neck pain that is made worse by movement.
When the spinal cord is also involved, numbness, tingling, weakness, or bowel/bladder dysfunction may occur.
What is to be done when the patient reaches the hospital?
Doctors in the emergency room or Casualty will take adequate precautions to protect the spine while they proceed with a detailed examination which includes an ample history both regarding the accident as well as previous medical history, other diseases and medication. A complete spine examination requires the patient to be undressed and thoroughly examined for both spine and other limb injuries.
A detailed examination of the spinal cord and spinal nerve functions will be done to check the nature and extent of the cord injury. This serves as a guideline to decide treatment as well as gives an idea regarding the prognosis of recovery of neurological function.
What investigations are generally done for thoracolumbar spine injuries?
X-ray examinations of the entire spine from multiple angles may be necessary to see bone alignment and check for damage to soft tissue. Computed tomography (CT) or magnetic resonance imaging (MRI) scans are required to help the doctor better visualize the extent of injury. The CT clarifies the bone picture while the MRI delineates the extent of spinal cord and nerve damage. This helps doctors classify the injury and then decide the line of management.
How are cervical spine fractures treated?
Treatment goals in cervical spine injuries include
-Protecting spinal cord function
-Restoring alignment and stability of the spine thus preventing further damage to the nerves and the spinal cord.
-Allowing the patient to return to pre-injury activity at the earliest.
The doctor will determine the best treatment method based upon the type of fracture and other factors. In certain fractures, early surgery may be the treatment of choice especially in fractures which are unstable or associated with spinal cord or nerve injury.
What will be done during surgery for spinal injuries?
Surgery realigns the spinal column and holds it together using metal plates and screws (internal fixation) and/or spinal fusion. This serves many purposes, chief among these being
-Relief of pressure on the nerves and the spinal cord making it conducive for early neurological recovery.
-Stability of the fractured spine to decrease pain on movement and allow the patient to sit and stand as early as possible.
Can spine fractures be treated without surgery?
Some low-energy cervical fractures especially can be treated with a short period of rest followed by mobilisation in a protective collar. Admission may still be required to tide over the acute pain.
What is the treatment for paralysis due to spinal cord injury?
Paralysis is one of the extremely disabling complications of cervical spine trauma. The cord injury may be complete or incomplete and surgery forms only the first part of the treatment. Further treatment includes specialised physiotherapy and nursing with adequate patient education by trained personnel. There are multiple complications associated with paralysis if the patient is inadequately monitored and treated. These include bedsores, urinary infection and lung infection. Patients with permanent paralysis also require rehabilitative support to get back to a near normal life.
Our hospital specialises in treating all types of cervical spine fractures and has scientifically proven protocols to decide whether surgery is required or not. Cervical spine injury surgery is complicated and surgery requires many specialised instruments and equipment. Experience in treating these injuries is of paramount importance as complications can lead to permanent spinal cord damage and paralysis. The latest equipment including intra-operative fluoroscopy and computer navigation available at our hospital makes cervical spinal trauma surgery safe, effective and efficient.
Our rehabilitation team also provides support and rehabilitation for the paralysed patients to make it back on the road to recovery.
This information is provided by Ganga hospital and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. For additional health information, please contact the hospital (0422-2485000) to book an appointment to see a doctor. This document was last reviewed on: 1/05/2008
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