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Cervical Spine Injury

Pathophysiology

Mechanism of Injury: Hyperflexion

Mechanism of Injury: Flexion and Rotation

Mechanism of Injury: Hyperextension

Mechanism of Injury: Rotation

Differences Between Adults and Children

Clinical Assessment and Risk Stratification

Clinical Assessment: Adults

Clinical Assessment: Children

Prognosis of neck sprains

Pearls and Pitfalls

Assessing and Clearing the Cervical Spine – Post Test

Assessing and Clearing the Cervical Spine – Post Test

Cervical Spine Injury
Assessing and Clearing the Cervical Spine – Post Test

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Question 1 of 10

1. Question

What is the approximate incidence of cervical spine injuries amongst conscious cooperative trauma patients who attend emergency departments?

0-2%
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2-4%
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4-8%
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8-12%
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>12%
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Question 2 of 10

2. Question

Which has the highest sensitivity for excluding cervical spine injury:

Normal lateral film
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Normal 3 film series
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Senior Physician judgement
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Canadian C-spine rule
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NEXUS rule
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Question 3 of 10

3. Question

In the unconscious trauma patient what imaging of the cervical spine is recommended by NICE guidelines?

3 series plain radiographs of the cervical spine
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Lateral c-spine view followed by CT of C-spine
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MRI of the C-spine
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CT of the C-spine
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CT followed by MRI of the C-spine
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Question 4 of 10

4. Question

Which one of the following is NOT part of the Nexus Criteria?

Age over 16
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Midline c-spine tenderness
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Presence of a distracting injury
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Under influence of alcohol or drugs
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Presence of neurology
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Question 5 of 10

5. Question

In the Canadian Cervical Spine Rules which one of the following would mandate radiology?

Rear end shunt
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Age >60
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Cervical spine tenderness
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Delayed onset of neck pain
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Roll-over road traffic collision
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Question 6 of 10

6. Question

Which one of the following is NOT associated with wearing a cervical collar and supine immobilisation?

Pressure sores over occiput
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Reduction in intracranial pressure
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Reduction in respiratory function (FVC and FEV1)
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Reduction in mouth opening
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Pressure sores over the sacral area
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Question 7 of 10

7. Question

Regarding the cervical spine in children, which one of the following is true?

Cervical spine injuries in younger children (<10 years old) are more common in the lower cervical spine (C1-C4) than in older children
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The facet joints are more vertical in orientation than in adults
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Younger children (<10 years old) are more prone to spinal cord injury than older children
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Pseudosubluxation is commonest at the C3/4 level in the cervical spine of young children.
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The ligaments and joint capsules are more lax than in adults
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Question 8 of 10

8. Question

With regard to mechanism of injury, which one of the following statements is FALSE?

Hyperextension injury is associated with damage to the anterior column
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Facet joint dislocation may be associated with rotational injury
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The “Jefferson” fracture is associated with an axial loading mechanism
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Crush fracture of the posterior aspect of the vertebral body is associated with hyperextension injury.
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Tear drop” fractures are associated with hyperextension injury
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Question 9 of 10

9. Question

With regard to prognosis following neck sprain injury, which one of the following is associated with a better outcome?

Female gender
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Instruction of a solicitor for the purposes of personal injury litigation
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Younger age
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Early use of a cervical collar
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The presence of neck pain and headache following injury
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Question 10 of 10

10. Question

Which one of the following statements about imaging modalities of the cervical spine is FALSE?

MRI scanning is indicated when there is still significant clinical suspicion of injury despite normal plain x-rays
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MRI scanning is more sensitive for visualising soft tissue injury than CT scanning
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CT scanning is the primary imaging modality for unconscious patients
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Flexion / extension views should not be performed on unconscious patients.
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Plain radiographs are not adequate to exclude significant spinal injury in unconscious patients.
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4 Comments

Dr Fady Issa Hussain Dahalan September 9, 2023 at 4:28 pm

Informative module

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Dr Emad Eltayeb Abdallatif Eltoum August 7, 2024 at 2:39 pm

nice informative well organized

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Mr. Ahmed Kamal September 2, 2024 at 4:36 pm

Good module

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Dr Lucky Osakue Idemudia March 26, 2026 at 4:42 am

Nice revision

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