Esophageal and Hypopharyngeal Injuries in Patients with Cervical Spine Trauma

1981 ◽  
Vol 90 (4) ◽  
pp. 323-327 ◽  
Author(s):  
Richard A. Pollock ◽  
David F. Apple ◽  
John M. Purvis ◽  
Herdon Murray
Keyword(s):  
Cervical Spine ◽  
Cervical Spine Injury ◽  
Fracture Dislocation ◽  
Spine Injury ◽  
Cervical Spine Fracture ◽  
Recent Experience ◽  
Spine Trauma ◽  
Radiographic Study ◽  
Cervical Fractures ◽  
Unexplained Fever

The authors review their recent experience with four patients referred to the Shepherd Spinal Center, Atlanta, with cervical spine fracture dislocation and quadriplegia. The patients were subsequently found to have tears of the hypopharynx or the esophagus as a complication of their injury. Unexplained fever, swelling of the neck, dysphagia or leukocytosis in the patient with acute cervical spine injury suggest, the authors urge, the possibility of esophageal or hypopharyngeal perforation. The authors review the kinematics and pathophysiology of cervical fractures and provide clues to early detection and management of perforation of the hypopharynx or esophagus, including the use of radiographic study and endoscopy.

An unusual presentation and resolution of syringomyelia after cervical spine injury

2005 ◽  
Vol 3 (6) ◽  
pp. 482-484 ◽  
Author(s):  
Joseph Cusick ◽  
Zvi Lidar
Keyword(s):  
Cervical Spine ◽  
Cervical Spine Injury ◽  
Spine Injury ◽  
Type I ◽  
Cervical Spine Trauma ◽  
Spine Trauma ◽  
Resonance Imaging ◽  
Chiari Malformation Type I ◽  
Content Type ◽  
Sequence Of Events

✓ The authors describe a case of noncommunicating syringomyelia associated with Chiari malformation Type I in a patient in whom acute symptomatic exacerbation occurred following cervical spine trauma. Surgical stabilization and realignment of the spine resulted in marked resolution of the neurological abnormalities, and subsequent magnetic resonance imaging demonstrated persistent collapse of the syrinx. The authors review the various factors in the pathogenesis of this unusual sequence of events.

scholarly journals Motorcycle helmets and cervical spine injuries: a 5-year experience at a Level 1 trauma center

2018 ◽  
Vol 28 (6) ◽  
pp. 607-611 ◽  
Author(s):  
Paul S. Page ◽  
Zhikui Wei ◽  
Nathaniel P. Brooks
Keyword(s):  
Cervical Spine ◽  
Trauma Center ◽  
Cervical Spine Injury ◽  
Spine Fracture ◽  
Spine Injury ◽  
Cervical Spine Fracture ◽  
Helmet Use ◽  
Level 1 ◽  
Motorcycle Helmets ◽  
Level 1 Trauma Center

OBJECTIVEMotorcycle helmets have been shown to decrease the incidence and severity of traumatic brain injury due to motorcycle crashes. Despite this proven efficacy, some previous reports and speculation suggest that helmet use is associated with a higher likelihood of cervical spine injury (CSI). In this study, the authors examine 1061 cases of motorcycle crash victims who were treated during a 5-year period at a Level 1 trauma center to investigate the association of helmet use with the incidence and severity of CSI. The authors hypothesized that wearing a motorcycle helmet during a motorcycle crash is not associated with an increased risk of CSI and may provide some protective advantage to the wearer.METHODSThe authors performed a retrospective review of all cases in which the patient had been involved in a motorcycle crash and was evaluated at a single Level 1 trauma center in Wisconsin between January 1, 2010, and January 1, 2015. Biometric, clinical, and imaging data were obtained from a trauma registry database. The patients were then divided into 2 distinct groups based on whether or not they were wearing helmets at the time of the accident. Baseline and functional characteristics were compared between the 2 groups. The Student t-test was used for continuous variables, and Pearson’s chi-square analysis was used for categorical variables.RESULTSIn total, 1061 patient charts were examined containing data on 738 unhelmeted (69.6%) and 323 helmeted (30.4%) motorcycle riders. On average, helmeted riders had a much lower Injury Severity Score (p < 0.001). Cervical spine injury occurred in 114 unhelmeted riders (15.4%) compared with only 24 helmeted riders (7.4%) (p < 0.001), with an adjusted odds ratio of 2.3 (95% CI 1.44–3.61, p = 0.0005). In the unhelmeted group, 10.8% of patients were found to have a cervical spine fracture compared with only 4.6% of patients in the helmeted group (p = 0.001). Additionally, ligamentous injury occurred more frequently in unhelmeted riders (1.9% vs 0.3%, p = 0.04). No difference was found in the occurrence of cervical strain, cord contusion, or nerve root injury (all p > 0.05).CONCLUSIONSThe results of this study demonstrate a statistically significant lower likelihood of suffering a CSI among helmeted motorcyclists. Unhelmeted riders sustained a statistically significant higher number of vertebral fractures and ligamentous injuries. The study findings reported here confirm the authors’ hypothesis that helmet use does not increase the risk of developing a cervical spine fracture and may provide some protective advantage.

scholarly journals LO027: Cervical spine injury in trauma patients 65 years and older immobilised in the prehospital setting

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S39-S39
Author(s):  
L. Lamy ◽  
J. Chauny ◽  
D. Ross
Keyword(s):  
Cervical Spine ◽  
Cervical Spine Injury ◽  
Fracture Dislocation ◽  
Spine Injury ◽  
Trauma Patients ◽  
Minor Trauma ◽  
Cervical Injury ◽  
Geriatric Population ◽  
Spinal Immobilisation ◽  
A Minor

Introduction: Following a protocol derived from the Canadian C-spine Rule (CCR), patients 65 years and older transported by ambulance after trauma require full spinal immobilisation. Immobilisation complicates the transport and the evaluation; potential side effects have been recognized. The aim of this study was to evaluate the effect of mechanism of trauma and age on the rate of cervical injury in a geriatric population. Methods: We conducted a retrospective observational study on patients 65 years and older transported by ambulance to a level-one trauma center from March 2008 to October 2013. The outcome was the rate of clinically important cervical spine injury (CICSI), defined as any fracture, dislocation or ligamentous injury needing treatment or specialised follow up. The rate was calculated in the geriatric population and in the subgroup of patients with minor trauma, defined as a fall from a standing height, a chair or a bed. We then looked at the rate of CICSI based on age to define a subgroup at lower risk of lesion. Results: We included 1221 patients with a mean age of 80 y.o. (SD = 8), 739 women (61%). CICSI was found in 53 patients (4.3%, 95% CI 3.2-5.4). This is similar to the rate found in patients 65 years and older in the NEXUS population (4.6%) and the CCR population (6.0%). The mechanism of injury was a minor trauma for 716 patients (59%). Of those, 24 patients (3.4%, 95% CI 2.1-4.7) had CICSI. The rate increased after 85 y.o in both the overall population (3.4% vs 6.4%) and the minor trauma subgroup (2.6% vs 4.4%). Conclusion: The subgroup of patients 65-84 y.o. with a minor trauma had the lower rate of cervical spine injury (2.6%). In a lot of prehospital systems, those patients are not systematically immobilised for transport. It will be interesting to review the files of all patients with CICSI to identify any possible case that would have been missed without the age criteria.

Fracture dislocation of the cervical spine with gross displacement

1975 ◽  
Vol 42 (2) ◽  
pp. 209-211 ◽  
Author(s):  
Ian C. Bailey
Keyword(s):  
Cervical Spine ◽  
Vertebral Body ◽  
Cervical Spine Injury ◽  
Fracture Dislocation ◽  
Spine Injury ◽  
Content Type ◽  
Fine Print

✓ A case of cervical spine injury is presented in which complete displacement of one vertebral body was accompanied by only mild quadriparesis.

scholarly journals Cervical vertebral injuries associated with the ossification of the posterior longitudinal ligament: Imaging features

2017 ◽  
Vol 6 (3) ◽  
pp. 205846011769585 ◽  
Author(s):  
Tetsuo Nakayama ◽  
Shigeru Ehara
Keyword(s):  
Cervical Spine ◽  
Posterior Longitudinal Ligament ◽  
Fracture Dislocation ◽  
Spine Injury ◽  
Spine Fractures ◽  
Minor Trauma ◽  
Imaging Features ◽  
Cervical Fractures ◽  
Different Types ◽  
Cervical Spine Fractures

Background Spinal injuries associated with ossification of the posterior longitudinal ligament (OPLL) have been characterized. However, the imaging features of traumatic cervical spine fractures in patients with OPLL have not been assessed adequately. Purpose To characterize the patterns of traumatic cervical spine fractures associated with different types of OPLL. Material and Methods We retrospectively analyzed the patterns of fractures resulting from cervical spine injury in patients with OPLL of different types and assessed the fracture patterns in patients with ankylosed segments. Results Twenty-six patients (23 men, 3 women; median age, 67.0 years; age range, 43–87 years) were included. Fall from a height <3 m was the most common trauma. Contiguous type OPLL was seen in 11 patients (42%), segmental type in 11 (42%), and mixed type in four (15%). Four of the contiguous OPLL and one of the mixed OPLL patients had ankylosed segments. The incidence of cervical fractures was 69% (16/26): seven (64%) in contiguous OPLL, five (46%) in segmental OPLL, and in all four patients with mixed OPLL. Unilateral interfacetal fracture-dislocation was most common (4/16); the others were bilateral interfacetal fracture-dislocation, fractures through the ankylosed segment, transdiscal fractures, isolated facet fractures, and compression fractures. Cervical fractures were exclusively observed in the C4 to C7, except in one case occurred at the C2 level. Conclusion Interfacetal fracture-dislocation in the lower cervical vertebrae constitutes the most common injury resulting from minor trauma.

Burning Hands Syndrome Revisited

Neurosurgery ◽  
1986 ◽  
Vol 19 (6) ◽  
pp. 1038-1040 ◽  
Author(s):  
James E. Wilberger ◽  
Adnan Abla ◽  
Joseph C. Maroon
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Cervical Spine ◽  
Cervical Spine Injury ◽  
Fracture Dislocation ◽  
Spine Injury ◽  
Cervical Fracture ◽  
Resonance Imaging ◽  
Cord Injury ◽  
Spine Abnormalities

Abstract The burning hands syndrome of spinal cord injury was first described in 1977. The syndrome is characterized by burning dysesthesias and paresthesias in the hands and may be associated with either cervical fracture/dislocation or no detectable cervical spine abnormalities. A case of burning hands syndrome without cervical spine injury is presented in which somatosensory evoked potentials and magnetic resonance imaging were used to delineate the pathophysiology of this syndrome.

Subaxial Cervical Spine Injury in the Elderly and Treatment-Related Mortality – Anterior or Posterior Approach

2020 ◽  
Author(s):  
Anna Kiskämper ◽  
Carolin Meyer ◽  
Lars Müller ◽  
Peer Eysel ◽  
Hildegard Christ ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Cervical Spine Injury ◽  
The Elderly ◽  
Spine Injury ◽  
Mortality Data ◽  
Posterior Fixation ◽  
Cervical Spine Trauma ◽  
Spine Trauma ◽  
Advantages And Disadvantages ◽  
Subaxial Cervical Spine

Abstract Background Subaxial cervical spine injury especially in the elderly can be associated to severe complications and disability. Until today there is no consensus concerning the best operative treatment. A potential superiority of anterior or posterior fixation is the subject of controversial discussions. Objectives The aim of this study was to compare the outcome of anterior and posterior fixation after subaxial cervical spine trauma in the elderly focussing on the postoperative mortality. Material and Methods A retrospective cohort analysis was performed to analyse the data of 43 patients. Especially mortality data were collected. Results A total of 43 patients was identified. Anterior fixation was performed in 21 patients, posterior fixation was performed in 22 patients. There were no significant differences between these groups. Although statistical significance was not reached, a slightly higher mortality was found among patients undergoing anterior fixation (52,4 vs. 31,8%). Furthermore the male sex, a higher age, translation injuries, long duration of operation and hospitalisation as well as postoperative complications were slightly associated to a higher mortality. Conclusions Subaxial cervical spine trauma is associated to a high mortality in the elderly. Although neither anterior nor posterior fixation could show a significant superiority, every surgical decision making should be performed individually for each patient balancing the advantages and disadvantages of each method.

33 Improving Mortality with An Integrated Model of Care for Cervical Spine Fracture in Patients Over 75 Years Old

2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i1-i8
Author(s):  
R Mahmood ◽  
C Negasan ◽  
A Manzoor ◽  
P Enwere ◽  
A Arnada-Martinez ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Integrated Care ◽  
Early Identification ◽  
Cervical Spine Injury ◽  
Care Pathway ◽  
Cervical Collar ◽  
Spine Injury ◽  
Cervical Spine Fracture ◽  
Number Of Patients ◽  
Integrated Care Pathway

Abstract Introduction Cervical spine injury is a potentially life threatening trauma. Given the increase in the number of patients presenting to the emergency department (ED) who are elderly and who have fallen and sustained trauma, it has become ever so challenging to manage this cohort of patients. In addition to diagnostic challenges in the elderly population, a robust, integrated care pathway and comprehensive geriatric assessment with involvement of a geriatrician is essential to provide effective care to these patients who require cervical collar after cervical spine injury to prevent morbidity and mortality. Intervention Data was gathered about the patient’s demographics, nature of cervical spine injury, care required from January 2013 till November 2016 (pre intervention) and from November 2016 till October 2017 (post intervention). Current practice was reviewed which showed significant variability in care provision to patients with cervical spine injury including collar care. An integrated care pathway was designed with involvement of multidisciplinary team (MDT) members to standardise the care of this cohort of patients in our hospital. This included early identification of patients with cervical spine injury, co locating all patients, developing nursing expertise for cervical collar care, sitting up early to prevent complications like aspiration, pressure area care, early nutritional support, training staff in post discharge collar care with developing interface with primary care team. Outcome measures in patients over 75 years including length of stay (LOS) inpatient mortality and at 6 and 12 months were recorded respectively. Results Total: 54 patients, average age: 86.6 years Conclusions Cervical spine injuries are common in older patients, who are at greater risk of falls and thus sustaining injuries. Early identification and management of these patients in a clinical area with multidisciplinary approach with appropriate expertise is key to reducing LOS and adverse outcome including mortality.

scholarly journals Association of injury mechanism with the risk of cervical spine fractures

CJEM ◽  
2009 ◽  
Vol 11 (01) ◽  
pp. 14-22 ◽  
Author(s):  
Wendy L. Thompson ◽  
Ian G. Stiell ◽  
Catherine M. Clement ◽  
Robert J. Brison ◽  
Keyword(s):  
Cervical Spine ◽  
Cervical Spine Injury ◽  
Injury Mechanism ◽  
Spine Fracture ◽  
Spine Injury ◽  
Cervical Spine Fracture ◽  
Mechanism Of Injury ◽  
Full Understanding ◽  
Vehicle Collisions ◽  
The Relationship

ABSTRACTObjective:A full understanding of an injury event and the mechanical forces involved should be important for predicting specific anatomical patterns of injury. Yet, information on the mechanism of injury is often overlooked as a predictor for specific anatomical injury in clinical decision-making. We measured the relationship between mechanism of injury and risk for cervical spine fracture.Methods:Our case-control study is a secondary analysis of data collected from the Canadian C-Spine Rule (CCR) study. Data were collected from 1996 to 2002 and included patients presenting to the emergency departments of 9 tertiary care centres after sustaining acute blunt trauma to the head or neck. Cases are defined as patients who were categorized in the CCR study with a clinically important cervical spine fracture. Controls had no radiologic evidence of cervical spine injury. Bivariate and multivariate unconditional logistic regression models were used. Results are presented as odds ratios (ORs) with 95% confidence intervals (CIs).Results:Among the 17 208 patients in the CCR study, 320 (2%) received a diagnosis of a cervical spine fracture. Axial loads, falls, diving incidents and nontraffic motorized vehicle collisions (e.g., collisions involving snowmobiles or all-terrain vehicles) were injury mechanisms that were significantly related to a higher risk of fracture. For motor vehicle collisions, the risk of cervical spine injury increased with the posted speed, being involved in a head-on collision or a rollover, or not wearing a seat belt (p&lt; 0.05). The occurrence of cervical spine fracture was negligible in simple rear-end collisions (1 in 3694 cases; OR 0.015, 95% CI 0.002–0.104]).Conclusion:Our study quantitatively demonstrates the relationship between specific mechanisms of injury and the risk of a cervical spine fracture. A full understanding of the injury mechanism would assist providers of emergency health care in assessing risk for injury in trauma patients.

Sign in / Sign up

Export Citation Format

Share Document