Within the neck are vertebral bones known as the cervical vertebrae. These are interconnected to each other through a series of ligaments and discs that allow for smooth, fluid movements and twisting actions. In certain circumstances, trauma to the cervical vertebrae can result in a fracture. In this article, we briefly review fractures of the neck and talk about how it can be managed.
Typically, fracture of the cervical vertebrae results from sudden high-impact trauma. It is primarily seen in individuals who have fallen off a rooftop and landed on their head, ice hockey players, gymnasts and divers.
The primary concern with fracture of the neck is that the crushed vertebral bones can compress upon the spinal cord, which lies within the vertebrae. Any impact on the spinal cord can result in serious damage to the nerve fibers, which in turn can cause paralysis of some of the major muscle groups. Depending upon the level at which the fracture occurs, different deficits may be noticed in a patient’s nerve function. For example, the fracture of the neck may cause paralysis of the breathing muscles and can be fatal.
Sometimes, patients who have suffered fracture of the neck may not necessarily have symptoms. Loss of consciousness may occur, especially if the trauma is significant. Depending upon the nerve that has been affected due to the fracture, different neurological signs and symptoms may be experienced. Depending upon the extent of the fracture, patients may either have temporary or permanent nerve damage and paralysis.
The diagnosis can be made through clinical history and examination to an extent. However, in some patients, additional investigations such as a CT scan of the neck or an MRI scan may be warranted. This will provide a clear view of the cervical vertebrae and the underlying spinal cord and can help determine the extent of damage and the degree to which the nerves have been involved.
Treatment of fractures of the neck can be a rather tricky situation, as it primarily depends upon which cervical vertebra has been affected. In case of multiple cervical vertebral fractures, the extent of neurological damage may be so significant that it causes severe paralysis. Minor fractures do not require specialist treatment and can be managed with the use of a cervical collar.
Patients are requested not to perform any sudden neck movements, as this can worsen the fracture and can compress any nerve fibers.
The duration of treatment varies depending upon the extent of injury. In the event of total paralysis, patients may be bedbound for the rest of their lives. Minor cervical fractures instead can heal within 1 to 2 months, though they require the patient to rest and take extra care during that time.