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Do you experience persistent neck pain? Have difficulty in moving your neck? Feel weakness in the arms? Involved in any kind of traumatic accident? If “yes” is the answer to all these questions, the possibility of cervical spine injuries cannot be overlooked.
Our cervical bone consists of seven bones stacked on one another with rubbery discs in between to provide flexible movement. The cervical spine is on the superior part of our vertebral column connecting the cranial bones and the thoracic spine.
The top two cervical vertebrae differ in size and function from the rest of the cervical spine. C1, known as the atlas, does not have a vertebral body and the center of it is like a ring. This helps the head in forward and backward range of motion. C2, known as the axis, has a protruding bony structure that fits into the atlas’s ring. The cervical vertebrae along with the ligaments, muscles, and tendons support the neck and give flexibility.
The injury to the cervical spine is more catastrophic as more damage can be caused to the central nervous system that may lead to paralysis/ quadriplegia. If you suspect any fracture in the neck after an accident, don’t move and get assistance.
Mechanism of Cervical Spine Injuries:
More males and old people, as well as youngsters of the 15 – 30 age group, suffer cervical injuries often. Trauma of any kind can be the prominent cause of cervical spine injuries. Motor accidents such as motorcycle accidents, car accidents, truck accidents, and slip and fall, and sports-related accidents can produce penetrative or blunt traumas to the neck. Other reasons may be degenerative like arthritis, osteoporosis, and disc herniation in the spinal cord.
According to the update in 2021 by the National Spinal Cord Injury Statistical Center (NSCISC), approximately 17,900 spinal cord injuries are recorded every year. Incomplete tetraplegia is the most common outcome of spinal cord injuries. The incomplete and complete paraplegia shares the same frequency. Vehicle crashes (37%) are the most leading cause of cervical spine injuries.
Motor Accidents and Cervical Spine Injuries:
Our neck is the most vulnerable part of our body in motor accidents. Auto accidents becomes a prominent reason for cervical spine injuries in America. Rear-end collision is the worst type of impact that affects the cervical spine. Sudden jerks can damage the ligaments, muscles, tendons, joints, or nerves in the cervical spine. Strong impacts can even end up in neck fractures. Some neck injuries may not produce symptoms for hours or days. Negligence can lead to catastrophic aftermaths in such situations.
Types of Cervical Spine Injuries:
The most common neck injuries caused by motor accidents can be seen below.
- Whiplash: when the neck jerks with force during the impact, the whiplash injury can occur. During the rear-end crashes, the neck undergoes a violent movement and can injure the ligament, muscle, tendon, or joints.
- Lacerations: the cuts and wounds made by the sharp metals, or objects can damage the ligaments, muscles, or tendons.
- Soft tissue injuries: the sprain or strain of the muscles or tendons can create spasms and pain. It also can reduce the range of motion.
- Facet joint injuries: motor accidents can damage the facet joints and result in inflammation and irritation of the facet joints.
- Disc herniations: violent impacts can slip the spinal discs from their position, and the herniated discs cause nerve compressions and impingement.
- Neck fractures: fracture is the most dangerous injury to our neck. With the uncontrollable pain, one can suspect the fracture. No kind of movement should be administered to prevent further damage.
Cervical Spine Injury Symptoms:
- Neck pain
- Radiating pain to the upper extremities
- Breathing difficulty
- Speech impairment
- Numbness or tingling
- Inability to control bladder or bowel
- Paralysis in the arms, torso, and legs (Tetraplegia or quadriplegia)
- Limited range of motion in the arms
- Decrease in diaphragm function
Methods To Diagnose Cervical Spine Injuries:
X-ray is the primary diagnostic study to find out any kind of cervical injuries. Sometimes, this traditional radiography could not provide a clear picture of craniocervical and cervicothoracic joints and may miss out on possible injuries. In such circumstances, CT scans prove to be effective in giving good visuals. To detect suspected cervical spine infections, delineating disc herniations, and deciphering bone erosions, CT scans play an indispensable role.
Electromyography is a diagnostic test, which records the electrical activity during the nerve stimulation in the muscle. EMG may create some discomfort as small needles are inserted into the muscle. Nerve Conduction Study, which is most often done along with the EMG, helps in measuring the electrical impulse of the nerve. It helps in identifying nerve damages in the cervical spine.
Magnetic Resonance Imaging (MRI) machines use magnetic and radio waves to record the clear images of the area scanned. It helps the physicians
- in evaluating the cervical spine anatomy,
- the problems in the soft tissues inside the spinal cord, nerves, and discs
- to detect tumors, and inflammations in the spine or tissues around the spine
- to decide the procedure for the surgery
- to monitor the post-surgery changes in the cervical spine.
Since the cervical spine MRI gives precise images to collect scrupulous details about cervical spine problems, it becomes a crucial method to find the injuries.
Effective Cervical Spine Injury Treatment:
Non-surgical therapies including physical therapies and chiropractic care are the first approach in treating non-traumatic neck pains. Even cervical spine disc herniation can be cured by effective and conservative treatments. Proper rest without involving in strenuous activities, muscle relaxants, and anti-inflammatories can do wonders and reduce the possibilities for surgery. Epidural steroid injections are advocated to give relief to a particular period of time.
Cervical Spine Surgery Types and Complications:
When the conservative therapies fail to produce results for cervical spinal cord injury, the next option is surgery. Let us take a look at the various cervical surgeries and the complications.
- Cervical Spinal Fusion:
To treat the instability of the neck, spinal stenosis, disc herniation, spinal cord misalignment, and arthritis, cervical spine fusion is advocated. This surgery is done in different methods. Bone taken from any other part of the body or the bone bank is used to join the weak vertebra with the adjacent one. This bone graft stimulates the growth of the new bone.
In some cases, metal braces are screwed into the bone to join two adjacent vertebrae. The damaged vertebra can be removed and the vertebrae above and below the affected one can be fused.
Complications: depending on your age and health conditions, different risks can be found. Pain in the area from where the bone graft is taken, spinal cord injury, bone graft rejection by the body, infection in the affected area or the donor site, breakage of the metal implants.
- Anterior Cervical Discectomy and Fusion (ACDF):
ACDF or anterior cervical decompression involves removing the affected disc to relieve the pressure on the spinal cord or nerve roots and mitigate the pain and weakness. This surgery has two parts: discectomy and fusion. In a discectomy, the surgery can be done from the anterior or front of the neck. The damaged disc compressing the nerves will be removed. To stabilize the cervical spine, fusion surgery will be done. To treat disc herniations and nerves compressions, ACDF is effective.
Complications: bleeding, infection, damage to the esophagus and trachea due to infection, damage to the nerves or vertebral artery during the surgery.
- Anterior Cervical Corpectomy and Fusion (ACCF):
When the degeneration of the cervical spine extends to more areas, discectomy cannot be advocated. The doctors had to mandate an extensive procedure like the corpectomy to treat the multi-level degeneration, removal of bone spurs (osteophytes), vertebrae, and discs. Like discectomy, corpectomy is also advocated to decompress the nerves or spinal cord. After the removal of the discs, fusion is done using bone grafts or metal plates to stabilize the cervical spine.
Complications: hemorrhage, infection, nerve root damage, damage to the esophagus and trachea, spinal cord damage, graft misalignment, prolonged pain.
- Laminoplasty and Laminectomy:
Laminoplasty is an alternative to laminectomy to treat cervical myelopathy. In a laminectomy, part of the lamina or bony roof is removed to decompress the nerves, whereas laminoplasty decompresses the spinal cord by reshaping the vertebral lamina. Laminectomy may cause instability while removing the laminae completely. The cervical spine may tilt forward to cause issues in the future. In laminoplasty, a hinge is created on one part of the lamina, and on the other side, a part of the lamina is wedged and connected to the hinge. The cervical brace is given for support.
For patients with cervical stenosis, cervical spondylotic myelopathy, and ossification of the posterior longitudinal ligament, laminoplasty is effective.
Complications: cerebrospinal fluid leak, vertebral infection, laminoplasty closure, nerve damage.
- Artificial Disk Replacement (ADR):
Disc replacement is a new step forward in cervical spine surgery and also the safest procedure compared to the others. In an ADR, the damaged disc will be replaced with an artificial or prosthetic disc. The success rates are more, and the fastest recovery can be assured. For people with disc herniations and degenerative issues, ADR cannot be administered.
Complications: allergic to the implant, breakage to the implant, infection, nerve or spinal cord injury, damage to the vocal cord, spinal fluid leak.
- Posterior cervical Laminoforaminotomy:
This is a minimally invasive surgery, where the incision is made from the back of the neck. A tubular retractor is inserted, and a part of the bone is removed to have clear and easy access to the affected area. With the help of an endoscope, the protruding disc or the disc material compressing the spinal nerves will be removed. The compressed spinal nerves are relieved by minimal bone removal.
Complications: infection, dysphagia (difficulty in swallowing), nerve root injury, hemorrhage, dural tear, revision surgery.
Ramifications of Cervical Spine Injury:
Spinal cord injuries can rewrite your future. Cervical spine injuries are the most pernicious of all spinal cord injuries. Since the spinal cord is connected to the brain, the injury to the cervical spine can affect the central nervous system and result in autonomic dysfunction. Autonomic dysfunction includes problems related to respiratory, cardiovascular, gastrointestinal, urinary, and sexual activities.
More severe cervical injuries can cause weakness in all four limbs resulting in quadriplegia. Maintaining the health of a paralyzed patient needs arduous efforts and is not easy. Sores, spasms, chronic pain, and urinary tract infections cannot be avoided. Long-term medical assistance is indispensable.
Even after surgery, aggressive physical therapies are needed to recover from the injury. Most of the injuries improve within a year. The symptoms, which continue beyond that will be permanent.
Most of the patients return to their integration with society and be productive. Due to the limitations, some may end up in divorce and depression. The expensive cervical spine surgeries and extensive medical care needed in the future may create financial burdens.
Cervical Spine Injuries and Claims:
If you plan to proceed with your claims to meet the extensive medical expenses, contact an experienced personal injury lawyer. He will guide you in every step to build your claim effectively. He collects all the essential evidence, medical records, statements of witnesses, police report, expert accident analyses, etc., to help you claim the deserved recompense.
You can claim for your economic as well as emotional damages under personal injury claims. The economic damages include
- present medical expenses
- loss of wages
- future loss of earning capacity
- property damage
- expense for future medical care
The non-economic damages include
- pain and suffering
- mental agony
- loss of enjoyment
- loss of consortium
- disability or paralysis
The economic damages can be evaluated based on your medical bills and other medical records. However, assessing your emotional damages need expertise. Only your well-qualified lawyer can understand and analyze your case and estimate your damages effortlessly.
Depending on the severity of your cervical spine injuries and the ongoing treatment needed for that, your compensation will also vary. Even a few million can be availed for catastrophic cervical injuries.
Neck pain after an accident should not be taken light-heartedly. Mild cervical spine injuries can be cured with proper conservative care. The delay in acquiring medical care can intensify your injuries and end in drastic irreparable damages. The more acute the injuries, the more arduous to cure them. The delay in getting treatment and the delay in filing your claim can make your litigation more complicated. Therefore, treat on time and claim on time. Conservative care, cervical surgeries, a compassionate approach from the family, and compensation can aid you in recuperating.
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