Type your tag names separated by a space and hit enter

Cervical Hyperextension Injuries

Cervical Hyperextension Injuries is a topic covered in the 5-Minute Clinical Consult.

To view the entire topic, please or purchase a subscription.

Medicine Central™ is a quick-consult mobile and web resource that includes diagnosis, treatment, medications, and follow-up information on over 700 diseases and disorders, providing fast answers—anytime, anywhere. Explore these free sample topics:

Medicine Central

-- The first section of this topic is shown below --

Basics

Description

  • Class of neck injuries typically seen in rapid, forceful extension of the cervical spine
  • Usually from motor vehicle accidents (MVA—whiplash), falls, violence, or sports-related injuries (1)
  • May involve:
    • Injury to vertebral and paravertebral structures: fractures, dislocations, ligamentous tears, and disc disruption/subluxation
    • Spinal cord injury (SCI): traumatic central cord syndrome (CCS) secondary to cord compression or vascular insult, SCI without radiologic abnormality (SCIWORA) (see “SCIWORA”)
    • Blunt cerebrovascular injury (BCVI): vertebral artery or carotid artery dissection
    • Soft tissue injury: cervical strain/sprain (i.e., whiplash), cervical stingers (see “Brachial Plexopathy”)

Epidemiology

  • Predominant age: CCS mostly seen in older population (average age is 53 years). Trauma and sports injuries are more common in young adults (average age 29 years).
  • Predominant sex: male > female (1)

Incidence

In the United States

  • Cervical fractures: 2 to 5/100 blunt trauma patients
  • CCS: 4/100,000 people/year
  • BCVI: estimated 1/1,000 of hospitalized trauma patients; incidence increased with cervical spine or thoracic injury
  • Cervical strain: 3 to 4/1,000 people/year
  • Whiplash is the most common injury in MVAs and accounts for 28% of all ED visits for MVAs.
  • Incidence of whiplash is 70 to 328/100,000 with rates highest in 20- to 24-year-old females.
  • 5% of trauma patients have spinal fractures, and 20% of those have SCI.
  • The incidence of traumatic SCI ranges from 2.3 to 83 cases per million population per year.

Etiology and Pathophysiology

Blunt trauma due to MVAs, sports injuries, falls, and assaults

Risk Factors

  • Whiplash, initial injury: no seat belt use, female gender
  • Chronic pain and/or disability: litigation, previous neck pain or injury, female gender, report of headache/low back pain at inception, low education level (2)[C]
  • Fractures: osteoporosis, conditions predisposing to spinal rigidity, such as ankylosing spondylitis or other spondyloarthropathies
  • CCS: preexisting spinal stenosis present in >50%
    • Acquired: prior trauma, spondylosis
    • Congenital: Klippel-Feil syndrome (congenital fusion of any two cervical vertebrae)

General Prevention

Seat belts, use of proper safety equipment, rule changes for sports activities, and proper technique in sports activities can prevent or minimize injury.

Commonly Associated Conditions

Closed head injuries, whiplash-associated disorders (WAD), SCI, soft tissue trauma

-- To view the remaining sections of this topic, please or purchase a subscription --

Citation

Stephens, Mark B., et al., editors. "Cervical Hyperextension Injuries." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816615/all/Cervical_Hyperextension_Injuries.
Cervical Hyperextension Injuries. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816615/all/Cervical_Hyperextension_Injuries. Accessed April 21, 2019.
Cervical Hyperextension Injuries. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816615/all/Cervical_Hyperextension_Injuries
Cervical Hyperextension Injuries [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 April 21]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816615/all/Cervical_Hyperextension_Injuries.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Cervical Hyperextension Injuries ID - 816615 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816615/all/Cervical_Hyperextension_Injuries PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -