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Neck Injury : Fracture
Neck, or cervical, fractures refer to breaks in the bony structure of vertebrae. There are 7 cervical vertebrae which comprise the neck. They are stabilized by fibrous structures known as ligaments. Vertebrae provide a safe shelter for the relatively delicate spinal cord. Cervical fractures are more commonly seen in injuries involving a rapid and strong force to the neck (e.g. whiplash, or a force applied along the long axis of the spinal column as seen in diving accidents). These fractures are
categorized as stable or unstable. Instability can lead to a "shift" in the normal position of the cervical spine, putting stress on the spinal cord, resulting in neurologic injury. Unstable cervical fractures must be rigidly immobilized, preventing the patient from any further neurologic damage. ALLneck injuries are considered UNSTABLE until proven otherwise. Great care is taken in the field by ambulance personnel in dealing with potential neck injuries. Spine x-rays can help the physician in determining whether a neck fracture has occurred. Additional studies, such as cervical CT-scanning and magnetic resonance scanning, have revolutionized the care of these patients. These special tests allow the physician not only to "see" the bones, but also the spinal cord and the nerve roots. More subtle fractures can now be detected through the use of this technology. Treatment will be based on the type of fracture and the stability of the fracture site [stable fractures are less serious]. Surgery will frequently be necessary for unstable fractures. Rehabilitation is important since healing time is prolonged. Cervical fractures are expertly managed by trained Emergency Physicians; however, their case management will also require the expertise of a Neurosurgeon.
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