CERVICAL FRACTURE (Broken Neck)
The seven bones in the neck are the cervical vertebrae. They support the head and connect it to the shoulders and body. A fracture, or break, in one of the cervical vertebrae is commonly called a broken neck.
Cervical fractures usually result from high-energy trauma, such as automobile crashes or falls. Athletes are also at risk. A cervical fracture can occur if:
- A football player “spears” an opponent with his head.
- An ice hockey player is struck from behind and rams into the boards.
- A gymnast misses the high bar during a release move and falls.
- A diver strikes the bottom of a shallow pool.
Any injury to the vertebrae can have serious consequences because the spinal cord, the central nervous system’s connection between the brain and the body, runs through the center of the vertebrae. Damage to the spinal cord can result in paralysis or death. Injury to the spinal cord at the level of the cervical spine can lead to temporary or permanent paralysis of the entire body from the neck down.
In a trauma situation, it may be difficult to assess at first evaluation the extent of injuries to the cervical spine. The neck should be immobilized until x-rays are taken and reviewed by a physician. Emergency medical personnel will assume that an unconscious individual has a neck injury and respond accordingly. The victim may experience shock and either temporary or permanent paralysis.
At the accident scene, first check vital signs, including the patient’s consciousness, ability to breathe, and heart rate. After these are stabilized, workers will assess obvious bleeding and limb-deforming injuries. Once the trauma team has stabilized all other life-threatening injuries, the doctor can evaluate the injury.
Conscious patients with an acute neck injury may or may not have severe neck pain. They may also have pain spreading from the neck to the shoulders or arms, resulting from the vertebra compressing a nerve. There may be some bruising and swelling at the back of the neck. The physician will perform a complete neurological examination to assess nerve function and may request additional radiographic studies, such as MRI or computed tomography (CT), to determine the extent of the injuries.
Treatment will depend on which of the seven cervical vertebrae are damaged and the kind of fracture sustained. Usually the “mechanism” of the fracture helps to indicate the type of fracture itself; for example, the most common mechanism, hyperflexion, can cause: dislocation, subluxation, flexion teardrop fractures and what’s called the clay-shoveler fracture.
A minor compression fracture can be treated with a cervical brace worn for 6 to 8 weeks until the bone heals. A more complex or extensive fracture may require traction, surgery, 2 to 3 months in a rigid cast, or a combination of these treatments. Following the healing process, physical therapy will usually be recommended based on the injury to the bones and surrounding muscles.
Improvements in athletic equipment and rule changes have reduced the number of sports-related cervical fractures over the past 20 years. You can help protect yourself and your family if you:
- Always wear a seat belt when you are driving or a passenger in a car.
- Never dive in a shallow pool area, and be sure that young people are properly supervised when swimming and diving.
- Wear the proper protective equipment for your sport and follow all safety regulations, such as having a spotter and appropriate cushioning mats.