Cervical Spine Injuries

The Cervical Spine Vertebrae –7 cervical –12 thoracic –5 lumbar –5 sacral –4 coccyx

Anatomy of Cervical Vertebrae Body of Axis Odontoid Process (Dens) of Axis Anterior Arch of Atlas Posterior Arch of Atlas C1-C2 Facet Lamina Bifid Spinous Process Transverse Process Transverse Foramen Inferior Articular Process Superior Articular Facet

Dermatomes

Facet Joint Injury –Mechanism of Injury Generally the same mechanism as a strain More violent Involves a snapping of the head and neck Ligaments injured Signs and Symptoms Similar signs and symptoms to a strain Tenderness facet joints and ligaments Pain will usually arise the day after the trauma Muscle spasms Cervical Sprain

Management –Severe injuries Activate EMS Refer to MD –RICE for first hours –Bed rest if severe –Rehabilitation Strengthening Restore ROM Review tackling techniques for football players Cervical (Sprain)

Brachial Plexus Injuries (Burner/Stinger) Mechanism of InjuryMechanism of Injury –Lateral flexion Result ofResult of –Stretching of the brachial plexus or –Compression of the brachial plexus –Disrupts peripheral nerve function

Brachial Plexus Injury (Burner/Stinger) Signs and SymptomsSigns and Symptoms Burning sensationBurning sensation Numbness and tingling from the shoulder into the handNumbness and tingling from the shoulder into the hand Pain extending from the shoulder into the handPain extending from the shoulder into the hand Some loss of function of the arm and hand for several minutesSome loss of function of the arm and hand for several minutes –Dead arm feeling by athlete Symptoms rarely persist for several daysSymptoms rarely persist for several days Repeated injury can result in permanent damageRepeated injury can result in permanent damage

Brachial Plexus Neurapraxia (Burner/Stinger) ManagementManagement –Assessment by medical personnel –Ice –Rest –Strengthening and stretching program –Return to activity once signs and symptoms have returned to normal –Padding to limit neck ROM during impact

Cervical Fractures Mechanism of Injury –Usually axial load w/ some degree of cervical flexion –Spearing Prevention –Teach proper tackling technique –(See what you hit)

Cervical Fractures Signs and Symptoms –Neck point tenderness –Restricted motion –Cervical muscle spasm –Cervical pain –Pain in the chest and extremities –Numbness in the trunk and or limbs –Weakness in the trunk and/or limbs –Loss of bladder and bowel control ManagementManagement –Activate EMS (911) –Treat like an unconscious athlete –Use extreme care –X-ray and physician referral –Transport with extreme caution –Minimize movement of cervical spine Cervical extrication collarCervical extrication collar Spine BoardSpine Board

Mechanism of Injury –Usually violent flexion and rotation of the head Cervical Dislocation

Signs and Symptoms –Considerable pain –Numbness –Weakness or paralysis Management –Extreme care must be used –Do not straighten athletes neck –Activate EMS (911) –More likely to cause spinal cord injury than a fracture Cervical Dislocation

Stabilize Head and Neck 5 Man Lift Log Roll onto Spine Board Facemask Removal Strap to Board Log Roll onto Spine Board Lifting Spine Board 1 2a 2b

Strengthening Exercises Initiated when near normal range has been achievedInitiated when near normal range has been achieved Should be performed pain freeShould be performed pain free Exercise progressionExercise progression IsometricIsometric Isotonic exercisesIsotonic exercises