- Discussion:
- occurs most often in
pediatric population;
- accounts for up to 2/3 of severe cervical injuries in children < 8 years of age;
- inherent elasticity in pediatric cervical spine can allow severe spinal cord injury to occur in absence of x-ray findings;
-
causes
-
transverse atlantal ligament injury
- fracture through the cartilaginous end plates (which are not visualized by x-rays), may be among the causes of this injury;
- unrecognized interspinous
ligamentous injury:
- in above 2 situations,
flexion & extension views taken with pt awake and physician in attendance will demonstrate injury;
- adult with acute traumatic
disc prolapse
-
cervical spondylosis
- C-spine trauma occurs w/
hyperextension injury to spine w/ vertebral canal whose diameter is already comprimised by
spondylosis;
- excessive anterior buckling of ligamentum flavum into canal already compromised by posterior vertebral body osteophytes
probably is cause of
central cord syndrome:
- motor loss in arms > than in legs, & variable sensory loss;
- typically, pts are managed nonsurgically w/ orthosis, & their neurologic status is carefully monitored;
- Radiographs:
- diagnosis of exclusion:
- MRI may give a more anatomic diagnosis by showing hemorrhage or edema of the spinal cord;
- pseudosubluxation: anterior displacement may be up to 4 mm;
- Treatment: spine is immobilized for one to three weeks;
Spinal cord injury without radiographic abnormality in children--the SCIWORA syndrome.
Spinal cord injury without radiographic abnormality in children.
Spinal Injury with out osseous spine fracture.
DA Yngve et al. JPO. Vol 8. 1988. p 153-159.
