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.

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.

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), neurological 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.

The use of methylprednisolone, which is 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.

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. This topic concentrates on cervical spine trauma in adults.