Highlights & Basics
- 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 a 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.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
CT reconstruction demonstrating undisplaced odontoid fracture
Common fracture patterns with severe cervical spine trauma. Top row: cervical burst fracture at C5 level; left: axial CT image showing a fracture of C5 vertebral body; right: mid-sagittal T2-weighted MRI showing retropulsion of the body of C5 with spinal cord compression, T2-weighted signal changes within the spinal cord and T2-weighted signal changes within the posterior ligamentous complex indicating disruption of these ligaments. Bottom row: fracture dislocation C6-C7 level. From left to right: lateral x-ray, axial CT through C6/C7 facet level, and T2-weighted mid-sagittal MRI demonstrating spinal cord compression and T2-weighted signal change within the spinal cord
Normal cervical spine: lateral, AP, and open-mouth odontoid view
Citations
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American College of Radiology. ACR appropriateness criteria: acute spinal trauma. 2024 [internet publication].[Full Text]
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