Acute cervical spine trauma

Acute cervical spine trauma requires a high index of suspicion and thorough investigation to detect bone or ligament damage that can otherwise result in spinal cord injury.

All patients with suspected trauma should be assessed and stabilized using the Advanced Trauma Life Support protocol, starting with a primary survey using an xABCDE approach.

Assessment for spinal injury should be done immediately after the patient's cervical spine has been protected with manual inline spinal motion restriction.

Patients with acutely altered level of consciousness (Glasgow Coma Scale [GCS] <15), neurologic deficit, high-risk injury mechanism, distracting injuries, neck pain or tenderness, or decreased range of motion of the cervical spine require a cervical collar, spinal precautions, and urgent cervical spine imaging.

Acute cervical spine trauma encompasses a wide range of potential injuries to ligaments, muscles, bones, and the spinal cord that follow acute incidents ranging from a seemingly innocuous fall to a high-energy motor vehicle accident. Patients may present immediately after a traumatic incident or days to weeks later. In all cases, careful investigation is required to ensure that the stability of the cervical spine has not been compromised, because, in extreme cases, cervical spine instability can lead to progressive neurologic deficit, quadriplegia, and even death. This topic concentrates on acute cervical spine trauma in adults.