Vertebral Artery Injury in Cervical Spine Fracture Dislocation: An Observational Study in a Tertiary Care Center

Cureus, 2024 · DOI: 10.7759/cureus.57774 · Published: April 7, 2024

Simple Explanation

This study investigates vertebral artery injuries (VAI) in patients with cervical spine fractures, aiming to determine the incidence of VAI using MRI and its association with injury characteristics. The vertebral artery can be injured in cervical spine traumas, especially with facet joint subluxation or foramen transversarium fractures, potentially leading to neurological deficits or death. MRI is used to detect VAI by identifying specific signal changes in the vertebral artery, such as the absence of normal blood flow voids.

Study Duration

January 2013 to April 2023

Participants

96 patients who suffered cervical spine fracture dislocation

Evidence Level

Not specified

Key Findings

1
The study found that 18.75% of patients with cervical spine fracture dislocation had VAI based on MRI findings.
2
VAI was significantly more common in patients with severe spinal cord injuries (ASIA A and B) and was associated with flexion-distraction injuries.
3
The C5-C6 level was the most commonly involved cervical spine injury level associated with VAI.

Research Summary

This retrospective study evaluated the incidence of vertebral artery injury (VAI) in 96 patients with cervical spine fracture dislocation using MRI. The results showed that 18.75% of patients had VAI, with a higher incidence in those with severe spinal cord injuries and flexion-distraction mechanisms. The study concludes that careful screening for VAI is necessary in patients with cervical spine injuries to prevent complications, and MRI is a useful screening tool.

Practical Implications

Screening for VAI

MRI can be used as a screening tool for VAI in patients with cervical spine fracture dislocations.

Association with Injury Type

Flexion-distraction injuries are more likely to be associated with VAI.

Clinical Management

Pre-operative evaluation of vascular injury in cervical spine fracture dislocation is very important for patient counselling, patient management, and surgical planning.

Study Limitations

1
Retrospective review limits direct patient contact and follow-up.
2
Lack of confirmation of VAI cases by digital subtraction angiography (DSA) or CT angiography.
3
No treatment relationship for VAI patients could be established.

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