Ideally the horizontal beam lateral projections for the cervical spine require a SID

Citation metadata

Document controls

Main content

Article Preview :

This article provides a comprehensive look at trauma to the upper cervical spine. It begins with an in-depth discussion of vertebral anatomy, then focuses on types of cervical trauma and examines the diagnostic techniques used to image cervical trauma.

This article is a Directed Reading. See the quiz at conclusion.

Recently there has been an increasing interest in the radiographic evaluation, treatment and prognosis of trauma to the cervical spine. This fascination may be due in part to the media attention generated following the spinal injuries sustained by actor Christopher Reeve. Known for his portrayal of Superman in a series of Hollywood movies, Reeve was paralyzed after falling from his horse at an equestrian event in 1995.

Reeve's first and second cervical vertebrae were fractured in the fall, resulting in damage to his spinal cord and leaving him a quadriplegic. Reeve has made remarkable progress in his recovery despite the severity of his injuries. Quick thinking by a bystander who administered artificial respiration to Reeve immediately after the accident and by the emergency medical team, which was familiar with recent advances in the treatment of cervical spine injuries, helped save the actor's life and minimize additional trauma.[1]

Trauma is a major health and social problem that primarily affects young people. The estimated cost for death, disability and lost productivity related to trauma exceeded $284 million per day according to data from 1988.[2,3] Acute spine and spinal cord injuries are among the most common causes of severe disability and death after trauma. Spinal column trauma occurs at a rate of approximately 5 per 100,000 population. Of the roughly 5000 new cases of spinal cord injury occurring in the United States each year, 10% (or about 500) will result in the genesis of a quadriplegic patient.[4] Unfortunately, the diagnosis of spinal injuries often is delayed and the treatment is frequently unstandardized or inadequate, exacerbating problems with rehabilitation.

Most cervical spine injuries occur in people between 15 and 30 years old, with injuries in men outnumbering those in women 3 to 1. Nearly 50% of cervical spine injuries are the result of automobile accidents. Of the remainder, diving injuries are more common in younger patients, whereas falls account for the majority of injuries sustained in older patients. Other trauma results from injuries incurred during water sports (surfing, water skiing), snow skiing, and penetrating injuries such as gunshot wounds.[2]

The onset and evolution of injury is contingent upon the physical integrity of the patient's cervical spine prior to injury, the mechanical processes of injury and the forces exerted to the head, neck and associated structures at the time of the accident. It often is difficult to distinguish the presence of minor injuries from more serious injuries in the emergency setting. Research indicates that as many as one-third of patients with subsequently proven spinal injuries had injuries that were missed on initial emergency evaluation. Therefore, patients with suspected cervical injury should be handled very carefully.[2]

Nearly 80% of cervical spine injuries occur when the accelerating...

Get Full Access

Gale offers a variety of resources for education, lifelong learning, and academic research. Log in through your library to get access to full content and features!

Access through your library

Copyright: COPYRIGHT 1997 American Society of Radiologic Technologists

Source Citation

Gale Document Number: GALE|A19128865