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
Investigations to consider
- cervical spine x-ray series
- MRI cervical spine
- flexion-extension (F/E) cervical spine x-rays
- nerve conduction studies
- electromyography
Treatment algorithm
Contributors
Authors VIEW ALL
Research Fellow
Division of Neurosurgery
Department of Surgery
University of Toronto
Ontario
Canada
Disclosures
CSA declares that he has no competing interests.
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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