Injuries of the cervical spine

There has been a world-wide increase in serious neck injuries. Better understanding of the altered physiology of spinal man, and the employment of the appropriate supportive measures, has led to a lessening in morbidity. Road traffic and domestic accidents account for most of these injuries. Regretfully we are seeing an increasing number of recreational tragedies, notably from the tram-poline, from rugby football and from diving into shallow water. Complete or almost complete cervical cord injuries are accompanied by varying degrees of dysfunction of the automatic nervous system. The bradycardia of vagal pre-ponderance and the upper respiratory and conjunctival congestion are familiar signs of the acute injury.

• 1
  The discovery of any voluntary muscle action below the accepted level of injury is an indication that the lesion is incomplete, with a correspondingly favourable prognosis.
• 2
  Fractures of the odontoid are seldom accompanied by serious neurological signs and when present these are usually bizzare. Fractures at the tip are of little consequence and those below the level of the atlanto-axial joints usually unite without difficulty.
• 3
  The recovery of cord function is more directly related to the pattern of neurological impairment on admission and its early progress than to the type of bony injury.