Neck Injuries

Definition

A neck fracture is a break in one or more of the 7 cervical bones. The vertebrae are the bones that make up the spine. The cervical vertebrae in the neck are labeled C1-C7. They protect the spinal cord, support the neck, and allow for movement.

C1-C7 Fracture Sites

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Causes

A neck fracture is caused by severe trauma to the neck, which is strong enough to break the vertebrae. Trauma may be caused by:

• Falls
• Car, motorcycle, or pedestrian collisions
• Diving into shallow water
• Severe and sudden twist to the neck
• Severe blows to the head or neck area

Risk Factors

Factors that may increase the risk of neck fracture include:

• Falls from heights, such as a ladder, bike, or horse
• Increased age
• Osteoporosis
• Certain diseases or conditions that result in bone or mineral loss, such as abnormal or absent menstrual cycles or post- menopause
• Certain diseases and conditions that weaken bones, such as tumors or cysts
• Decreased muscle mass
• Playing certain sports that may result in neck fracture, such as football, rugby, or ice hockey
• Not wearing a seatbelt or protective sports equipment
• Head or other traumatic injury, such as severe chest trauma, pelvic or femur fractures
• Violence

Symptoms

A person with a neck injury should not be moved without competent medical care, which is needed right away.

Neck fracture may cause:

• Severe pain
• Swelling and possible bruising
• Tenderness
• Decreased feeling in the arms or legs
• Muscle weakness or paralysis of the arms or legs

Diagnosis

You will most likely be taken to a hospital. You will be asked about your symptoms, physical activity, and how the injury occurred. Your neck will be examined and a complete neurological exam will be done.

Imaging tests evaluate the spine and surrounding structures. These may include:

• X-rays
• MRI scan
• CT scan

Treatment

Neck fractures are serious injuries that can lead to paralysis or death. Call for emergency medical services right away.

Immobilize and Stabilize the Injury

When there is a possibility of a neck fracture, immediate and complete immobilization of the head and neck area is necessary. Excessive movement will need to be avoided to prevent or minimize spinal cord injury. For athletes, it is recommended to keep the helmet and shoulder pads on while immobilizing the spine.

Other problems, such as secondary injuries, shock, or airway obstruction, will also be assessed. Stabilizing the injury may include:

• A breathing tube for a blocked airway
• IV fluids
• Admission to the hospital for monitoring

Initial Care

Treatment will depend on:

• The severity of the fracture
• Which of the cervical bones are broken
• Which part of the cervical bones are broken
• Whether there is temporary or permanent spinal cord or nerve injury

Treatment options for neck fracture include:

• Neck brace or collar—Minor fractures can be treated with a neck brace or collar for up to 8 weeks. These devices will keep the neck in line while it heals.
• Traction—Rigid braces or a halo vest worn for up to 12 weeks can be used to treat more severe or unstable fractures. Traction allows for minimal movement beyond what is necessary.
• Surgery—Plates, screws, or wires may be needed to reconnect bone pieces and hold them in place. Surgery may also be needed to repair vertebrae, relieve pressure on the spinal cord, or remove any damaged vertebral discs.

Overall recovery time depends on whether or not there are permanent injuries. Physical therapy and rehabilitation can last for months or years.

Hospitalization

People with neck fractures usually need to stay in the hospital. Serious injuries may need to be watched in an intensive care unit. Some people with neck fractures need to have help breathing. A tube is inserted and mechanical ventilation is used to protect and assist breathing.

Medications

Prescription or over-the-counter medications may be needed to relieve pain. Antibiotics may also be needed if an infection is present or possible.

Rest and Recovery

Healing time varies by age and overall health. Children and people in better overall health heal faster. In general, it may take several weeks to several months for a neck fracture to heal.

Physical therapy will be needed to keep your muscles strong. There may be permanent damage or paralysis even if the neck heals. If this is the case, long-term rehabilitation will be needed.

Long-term Rehabilitation

A neck fracture can sometimes result in spinal cord and nerve injury and paralysis. This may require major life changes, involving work, family, and social life. Extensive rehabilitation may be required, including occupational therapy, psychotherapy, or support groups.

Prevention

To help reduce your chance of getting a neck fracture:

• Avoid situations that put you at risk of physical harm.
• Always wear a seatbelt when driving or riding in a car.
• Do not drive under the influence of alcohol or drugs.
• Wear proper padding and safety equipment when participating in sports or activities.
• Use proper tackling techniques in football. Do not spear with your helmet.
• Never dive in the shallow end of a pool.
• Never dive into water where you do not know the depth or what obstacles may be present.
• Do weight-bearing exercises to build strong muscles and bones.

To help reduce falling hazards at work and home:

• Clean spills and slippery areas right away.
• Remove tripping hazards such as loose cords, rugs, and clutter.
• Use non-slip mats in the bathtub and shower.
• Install grab bars next to the toilet and in the shower or tub.
• Put in handrails on both sides of stairways.
• Walk only in well-lit rooms, stairs, and halls.
• Keep flashlights on hand in case of a power outage.