Your Health - Neck Fracture

Neck Fracture

(Broken Neck; Cervical Fracture)

Definition

A neck fracture is a break in one or more of the cervical bones (vertebrae in the neck). The vertebrae are the bones that make up the spine.

A neck fracture is very serious and can lead to paralysis or possibly death. A person with a neck injury should not be moved without competent medical care, which is needed immediately.

It is important to recognize the possibility of a neck fracture. Injuries severe enough to cause head injury or other trauma often also cause neck fracture.

Cervical Spine Fractures

Causes

A neck fracture is caused by severe trauma to the neck. Trauma includes:

Falls , such as from a horse or bike
Collisions, such as motorcycle or automobile
Diving into shallow water
Severe and sudden twist to the neck
Severe blows to the head or neck area

Risk Factors

A risk factor is something that increases your chance of getting a disease, condition, or injury. Risk factors for a neck fracture include:

Advancing age
Decreased muscle mass
Osteoporosis
Certain contact sports, such as football or soccer
Violence
Not wearing your seatbelt when driving in a car
Head injury or other traumatic injury such as severe chest trauma, pelvis or femur fractures

Symptoms

Symptoms include:

Pain, which may or may not be severe
Swelling and bruising
Tenderness
Decreased feeling in the arms or legs
Muscle weakness or paralysis of the arms or legs

Diagnosis

The doctor will ask about your symptoms, physical activity, and how the injury occurred, and will examine the injured area.

Tests may include:

X-rays —a test that uses radiation to take a picture of structures inside the body, especially bones. It is used to look for a break in the bone or a dislocation of the vertebra.
MRI scan —a test that uses a strong magnetic field and radio waves to make pictures of structures inside the neck and back. An MRI provides cross-sectional images that allow the doctor to see if there is damage to the spinal cord.
CT scan —a type of x-ray that uses computers to make pictures of structures inside the neck and back. It can be used to analyze bone injury and to see if the spinal cord is compressed by a collection of blood.

Treatment

Treatment depends on:

The severity of the fracture
If there is an associated dislocation or instability
Which cervical bones are broken
Whether there is spinal cord or nerve injury, with muscle weakness or paralysis

Treatment includes:

Immobilization

When there is a possibility of a broken neck, complete immobilization of the neck area is necessary. For athletes, it is recommended to keep the helmet and shoulder pads on while immobilizing the spine.

Brace or Collar

A less serious neck fracture can be treated with a cervical brace or collar. It will need to be worn until the neck completely heals, usually 8 to 12 weeks. The doctor may recommend medications to reduce pain and swelling.

Surgery

For a more severe fracture, you may need surgery to realign the bones. Your neck may be placed in traction prior to surgery. A metal plate with screws, or other methods of fixation, may be used to help hold the bones in place.

Exercises

When your doctor decides you are ready, start range-of-motion and strengthening exercises. A physical therapist should assist you with these exercises. Talk with your doctor before returning to any type of physical activity, and about lifting restrictions and other precautions.

Healing Time

You may need to wear a neck splint, spinal brace, or surgical collar for many months. The period of rehabilitation can last many months and even years.

Living With Paralysis

A neck fracture can sometimes result in spinal cord and nerve injury and paralysis. This may require major life changes, involving work, family, and social life. Extensive rehabilitation may be required, including physical and occupational therapy, and psychological support.

Prevention

To help prevent a neck fracture:

Do not put yourself at risk for trauma to the cervical bones.
Always wear a seatbelt when driving in a car.
Wear proper padding and safety equipment when participating in sports or activities.
Use proper tackling techniques in football. Do not spear with the helmet.
Never dive in the shallow end of a pool.
Never dive into water where you do not know the depth or what obstacles may be present.
Eat a diet rich in calcium and vitamin D .
Do weight-bearing exercises to build strong bones.
Build strong muscles to prevent falls and to stay active and agile.

RESOURCES:

American Academy of Orthopaedic Surgeons
http://www.aaos.org/

American Academy of Physical Medicine and Rehabilitation
http://www.aapmr.org/

CANADIAN RESOURCES:

Physical Therapy Canada
http://www.physicaltherapy.ca/

Department of Orthopaedics
The University of British Columbia
http://www.orthosurgery.ubc.ca/index.html/

References:

American Academy of Orthopaedic Surgeons website. Available at: http://www.aaos.org/ . Accessed October 13, 2005.

Bailes JE, Petschauer M, Guskiewicz KM, Marano G. J Athl Train . 2007;42:126-134.

National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/ . Accessed October 13, 2005.

Rathlev NK, Medzon R, Bracken ME. Evaluation and management of neck trauma. Emerg Med Clin North Am . 2007; 25:679-694.

Yanar H. Pedestrians injured by automobiles: risk factors for cervical spine injuries. J Am Coll Surg . 2007;205:794-799.

Last reviewed November 2009 by Robert E. Leach, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.