Acute cervical spine trauma

Mechanism of injury is highly variable, ranging from seemingly innocuous falls to high-energy motor vehicle crashes.

Possible presentations include neck pain, limited range of motion, and/or neurological deficit.

A high index of suspicion and proper investigation is required to detect bone or ligament damage that can otherwise result in spinal cord injury.

If serious injury is suspected, immediate cervical spine stabilization is essential until this is excluded by neurological assessment and computed tomography scan or other imaging.

Maintenance of mean arterial blood pressure and consideration of the use of methylprednisolone are potentially important and time-sensitive therapeutic interventions. The use of methylprednisolone, while certainly time-sensitive, is an intervention whose efficacy is debated among professionals. Early consultation with a specialist is advisable to avoid delays that may affect patient outcome.

This topic concentrates on cervical spine trauma in adults. 

Acute cervical spine trauma encompasses a wide range of potential injuries to ligaments, muscles, bones, and 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 neurological deficit, quadriplegia, and even death.