Blunt neck trauma
Background
- Suspect vascular damage to cord if discrepancy between neuro deficit and level of spinal column injury
- Cord injury is more likely if anterior (vertebral bodies) AND posterior (spinal canal) columns are disrupted
Differential Diagnosis
Vertebral fractures and dislocations types
- Cervical fractures and dislocations
- Thoracic and lumbar fractures and dislocations
Spinal cord trauma
Vertebral and Carotid Artery Dissection
Workup
X-rays Necessary?
NEXUS Cervical Spine Rule
Radiography is not necessary if the patient satisfies ALL of the following low risk criteria:
- No midline cervical tenderness
- No focal neuro deficits
- Normal alertness
- No intoxication
- No painful distracting injury
C-spine imaging should be considered unless the patient meets all of the above low risk criteria[1] [2]
X-rays Positive
- If find injury consider CT C-spine, x-ray rest of spine
Management
- Prehospital
- Hospital
- See specific diagnosis
See Also
- Penetrating neck trauma
- Spinal Cord Compression (Non-Traumatic)
- Neurogenic Shock
- Unstable spine fractures
Source
- National Spinal Cord Injury Statistical Center (NSCISC). Spinal Cord Injury. Facts and Figures at a Glance. Birmingham, Ala: NSCISC; July 1996
- Ivy ME, Cohn SM. Addressing the myths of cervical spine injury management. Am J Emerg Med. Oct 1997;15(6):591-5
- Woodring JH, Lee C, Duncan V. Transverse process fractures of the cervical vertebrae: are they insignificant? J Trauma. June 1993; 34(6):797-802.
- Tintinalli's