Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • concordant mechanism of injury
  • neck pain
  • sacral sparing
  • associated traumatic injury
  • posterior cervical tenderness

Other diagnostic factors

  • male gender
  • age 18 to 25 years
  • intoxication
  • numbness, tingling, or weakness of extremities
  • bowel or bladder dysfunction
  • motor weakness
  • sensory loss
  • reduced or painful cervical range of motion (ROM)
  • loss of anorectal tone and perianal sensation
  • spasticity
  • hyperreflexia
  • Babinski sign
  • Hoffman sign
  • neurogenic shock
  • spinal shock
  • respiratory change
  • cranial nerve deficit

Risk factors

  • male gender
  • female gender (whiplash injury)
  • lack of preparation or awareness of collision
  • head rotated at time of collision
  • previous cervical spine trauma or surgery
  • pre-existing spinal, cranial, or other abnormality

Diagnostic investigations

1st investigations to order

  • axial CT cervical spine with 3D reconstructions
Full details

Investigations to consider

  • cervical spine x-ray series
  • MRI cervical spine
  • flexion-extension (F/E) cervical spine x-rays
  • nerve conduction studies
  • electromyography
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Christopher S. Ahuja

Research Fellow

Division of Neurosurgery

Department of Surgery

University of Toronto

Ontario

Canada

Disclosures

CSA declares that he has no competing interests.

Michael G. Fehlings

Professor

Division of Neurosurgery

Director of Neuroscience Program

University of Toronto

Krembil Chair in Neural Repair and Regeneration

Medical Director

Krembil Neuroscience Center

Toronto Western Hospital

Ontario

Canada

Disclosures

MGF served as a consultant for Zimmer, In Vivo Therapeutics, and Pfizer. He receives institutional fellowship grant support from AOSpine, Medtronic, and Depuy-Synthes. MGF is an author of a reference cited in this monograph.

Dr Christopher S. Ahuja and Dr Michael G. Fehlings would like to gratefully acknowledge Dr Narihito Nagoshi, Dr Hiroaki Nakashima, Dr David W. Cadotte, and Dr Jefferson R. Wilson, previous contributors to this monograph. NN, HN, DWC, and JRW declare that they have no competing interests.

Peer reviewers VIEW ALL

Consultant Orthopaedic and Spinal Surgeon

BMI Werndale Hospital

Carmarthen

Carmarthenshire

UK

Disclosures

JM has been provided with educational support for attending conferences by Medtronic, Depuy Spine UK, and Nuvasive.

Assistant Professor

Orthopedic Surgery Operations

Department of Orthopedics

University of Utah

Salt Lake City

UT

Disclosures

AP is an author of a reference cited in this monograph.

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