The doctor understands a cervical spine fracture or a cervical spine fracture to be a complete or partial vertebral fracture of the cervical spine . Colloquially, a cervical vertebra fracture is often referred to as a broken neck. This injury carries the risk of paraplegia if the spinal cord of the cervical spine is also affected. Treatment depends on the severity and type of fracture.
What is a cervical spine fracture?
The seven vertebrae of humans and mammals that lie between the head and the thoracic spine are defined as the cervical spine, or cervical spine for short. Injuries and fractures of the cervical spine occur more frequently in children and the elderly.
All nerve pathways that connect the body and brain run through the cervical spine, so that a fracture in this area can have numerous consequences and symptoms. The typical symptoms of a cervical spine fracture are pain in the affected area, both at rest and when moving, a bad posture of the head and the subjective feeling of the affected person that they can no longer hold their head up.
If nerve tracts were damaged by the vertebral fracture, loss of sensation and symptoms of paralysis also occur, for example respiratory or circulatory arrest or paraplegia.
The possible causes of the cervical spine fracture must be differentiated according to whether the person concerned belongs to a special risk group. In older people, even minor acts of violence, such as falls, can lead to a fracture of the cervical spine.
In small children and infants, the neck muscles are too weak to keep the large head stable, so that even minor trauma can lead to fractures of the cervical spine. Serious traffic accidents with frontal or rear collisions also lead to cervical spine injuries more frequently in older people and children.
If the affected person does not belong to a risk group, the causes of a cervical spine fracture are overstretching or hyperextension of the cervical spine, as can occur with direct or indirect violence. Frequently, bicycle and motorcycle accidents, accidents in contact sports and equestrian sports and careless diving into unfamiliar waters or from too great heights are the causes of a cervical spine fracture.
Symptoms, Ailments & Signs
A fractured cervical spine is a dangerous injury that can sometimes be fatal. Headaches and neck pain are observed as typical symptoms. In addition, turning the head is difficult. This leads to unbearable pain and dizziness.
Paralysis is also possible in both arms or just in one arm. Often the head can no longer be held upright, so that some patients even try to support it with their hands. Under certain circumstances, the cervical vertebrae can shift against each other. This is particularly common in unstable fractures. In addition, if bone fragments enter the spinal canal, further damage to vertebral bodies can occur.
In addition, bleeding into the spinal canal or the spinal cord is often observed. A cervical spine fracture is often accompanied by swallowing difficulties and bruising. Respiratory function is also sometimes impaired. This is especially true when the fourth cervical vertebra is affected. One of the worst consequences of a cervical spine fracture is paraplegia.
Respiratory and circulatory arrest, which leads to death, is also possible. A cervical spine fracture can also occur with whiplash. In addition to headaches and neck pain, it is often characterized by abnormal sensations in the extremities, weakened reflexes, dizziness and hearing disorders. Left untreated, a cervical spine fracture often leads to severe disability or even death. Depending on the type of injury, timely treatment can result in complete healing.
Diagnosis & History
If there is a suspicion of a cervical spine fracture after a violent impact on the cervical spine, the doctor first carries out a physical examination. As part of this careful diagnosis of mobility and pain in the cervical vertebrae, the nerve function is also checked.
The examination is carried out while avoiding greater stress on the cervical spine. Since a manual examination can only substantiate the suspicion of a cervical spine fracture, not confirm or rule it out, radiological diagnostics must be carried out afterwards. As a rule, the X-ray examination from the front and from the side is sufficient for this. The X-ray image is meaningful and can be created quickly, making X-ray the diagnostic method of choice.
In order to dispel doubts about the diagnosis or to clarify further questions, such as the exact course of the fracture or injuries to the nerve tracts, additional images can be taken using computer tomography ( CT ) or magnetic resonance imaging ( MRI ). The prognosis and course of a cervical spine fracture must be assessed individually based on the exact type of injury and the nerve tracts that are affected.
The symptoms of a cervical spine fracture usually depend on the severity of the fracture. In the worst case, the affected person suffers a so-called paraplegia and is extremely restricted in his everyday life. This leads to significant limitations in movement, so that the patient may be dependent on a wheelchair and on other people in their everyday life.
The quality of life is extremely reduced by the cervical spine fracture. Various paralysis of the body and pain in the affected regions also occur. Sudden paralysis and pain often lead to psychological problems or depression. The patients also suffer from insomnia, which makes it difficult for them to absorb liquids and food.
As a rule, severe pain also makes everyday life more difficult, which can also lead to sleeping problems at night in the form of rest pain. Thoughts of suicide are not uncommon. Whether treatment is possible for a cervical spine fracture depends heavily on the severity of the fracture.
However, a positive course of the disease cannot be guaranteed. In some cases, those affected are dependent on a wheelchair and other everyday aids for the rest of their lives. However, life expectancy is not affected by a cervical spine fracture.
When should you go to the doctor?
Since a fracture in the cervical spine can, in the worst case, lead to paraplegia, which can no longer be treated, a doctor should always be consulted. Since the cervical spine fracture usually occurs as a result of an accident, the person concerned is taken to a hospital. Otherwise, the patient should see a doctor if there is severe pain in the cervical vertebrae or spine.
Significant movement restrictions also occur. Furthermore, a bruise indicates a cervical spine fracture, which is accompanied by swallowing disorders. Normal intake of food and liquids is no longer possible for the patient. A doctor should also be consulted if the cervical spine fracture causes paralysis or numbness. The earlier these are diagnosed, the higher the chances of a positive course of the disease.
A fracture of the cervical spine should usually always be treated in a hospital or by an emergency doctor. After the fracture is treated, patients often require a variety of exercises and therapies to reduce paralysis and restore mobility.
Treatment & Therapy
It is important to move the patient as little as possible. The head must be subjected to even traction so that it is held in a slight backward bend. The injured person should be transported in a supine position and wearing a neck brace (cervical support).
The treatment of a cervical spine fracture also depends on the exact type of injury and consists primarily of protecting and immobilizing the affected vertebral area. In addition to immobilization with a cast, there are various types of cervical braces available that must be worn for eight to twelve weeks. Conservative therapy may only be initiated if the intervertebral disc between the 2nd and 3rd cervical vertebrae is undamaged. Then the doctor speaks of a stable injury.
An unstable fracture, in which the second and third vertebrae are displaced from one another due to the disc injury, must be treated surgically. Similarly, if the spinal cord is injured, no conservative therapy is allowed. Good results were achieved with the osteosynthesis, the fixation of the fragments with metal implants.
Outlook & Forecast
The prognosis of a cervical spine fracture depends on the fracture and the severity of the damage. With a stable fracture of the atlas vertebrae, the patient will experience healing within six to eight weeks. The patient should take it easy and keep calm so that no complications arise. The cervical vertebrae can then gradually be loaded again. Complete freedom from symptoms is usually achieved after several months.
With an unstable fracture, the prognosis worsens. The healing path is prolonged and usually lasts three months. The affected region must be spared and sufficiently stabilized during the recovery process. In rare cases, surgery is required to correct it. If the damage can be corrected during an operation, the patient also has good prospects of recovery.
It takes two to three months for an axis fracture to heal before recovery. If the patient suffers a dens fracture, a healing time of between two weeks and four months must be expected. An atlanto-occipital fracture has an unfavorable prognosis. This cervical spine fracture is fatal and irreparable. In most cases, trauma occurs in addition to the fracture. This heals completely and leaves no consequential damage. However, sudden movements should be avoided during the recovery period.
It is not possible to completely prevent a cervical spine fracture. Risk groups and their relatives in particular should be aware of the risk of injury and act with appropriate caution. Timely treatment can prevent serious complications.
After a treated fracture of the cervical spine, follow-up care and the associated physiotherapy and ergotherapy are started as early as possible. This often happens on the first day after the operation. Due to the only small skin incisions, special care of the wound is usually not necessary.
Slow movements and targeted exercises allow spinal mobility to be restored relatively quickly. However, the success of physiotherapy largely depends on whether the spinal cord is injured and how the associated limitations affect it. The aim of physiotherapy and occupational therapy is for the patient to be able to master the daily challenges themselves again.
In the second step of rehabilitation, the person concerned should be quickly reintegrated into working life. It must always be weighed up whether it is still possible to continue in the old profession. Heavy physical stress in everyday work can make reintegration impossible. This finding can be psychologically distressing and should be psychologically monitored.
This is especially the case when the surgery did not bring the desired effect and the patient retains permanent spinal cord injuries. In the case of signs of paralysis, aftercare is about being able to live with the new conditions. The focus of aftercare is on restoring independence. The challenges of a wheelchair usually require lifelong care.
You can do that yourself
A fracture in the cervical spine requires medical treatment, which in many cases can be positively supported by the active cooperation of the patient. This already begins in the acute phase, in which the behavioral measures recommended by the treating physicians, such as rest, must be followed. This includes in particular the consistent wearing of a neck brace for the period of time specified by the doctors.
In the regeneration phase, too, there are remedies that the affected person can use to positively influence the healing process, preferably in consultation with a doctor or physiotherapist. By participating in a special back school, you can learn which movements are unfavorable for the cervical spine and how to avoid them. Even at night, the patient can support the healing process by ensuring that the cervical spine is positioned as recommended by a doctor by choosing a suitable pillow and mattress.
When the bony structures are stabilized again after a cervical spine fracture, a well-trained muscle corset provides additional support. The appropriate exercises are shown to the patient by the physiotherapist. He can then carry out this targeted training program for a stable neck and neck region at home. Motor training is also recommended for areas of the body that have lost function due to nerve damage.