Risk Factors for Neck and Spine Injuries

Risk Factors for Cervical Spine (Neck) Injuries

In a study by Chang, Tominaga, Wong, Weldon, and Kaan (2006), the authors examined spinal cord injury without radiologic evidence of trauma (SCIWORET) in relation to water-sports related injuries. Hyperflexion and hyperextension injuries (whiplash type movements) occur in motor vehicle accidents in a similar fashion. Spinal cord injury can occur with or without radiologic evidence of trauma, so we have to also rely on a complete physical examination. The authors stated, “Fractures or dislocations of the cervical spine only require 500 to 750 pounds of force…”(Chang et al., 2006, p. 1044), so they are fairly common. However, neurological deficits can be present in patients that do not exhibit evidence of fractures. A frequent cause of cervical spinal cord injury is hyperflexion or hyperextension, which can occur in ways such as motor vehicle accidents, shallow water dives and wave related accidents.

The study states that pre-existing conditions can predispose certain individuals to increased injury when faced with a similar mechanism of injury as a “normal” individual. Such risk factors include cervical spondylosis (spinal arthritis), ossification of the posterior longitudinal ligament in the cervical region, cervical stenosis, increased age, and increased body mass. This means that if a person presents with any of these risk factors, he or she may be more likely to sustain spinal cord injury with a level of trauma that may not implicate the spinal cord in an otherwise healthy individual. In conclusion, the authors state, “Because hyperflexion and hyperextension are common mechanisms of injury…patients with pre-existing cervical spine abnormities - in particular, spinal stenosis, degenerative spondylosis, and the presence of OPLL [ossification of the posterior longitudinal ligament] - may be at a higher risk of a SCIWORET type injury” (Chang et al., 2006, p. 1045).

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Reference:

Chang, S., Tominaga, G. T., Wong, J. H., Weldon, E. J., & Kaan, K. T. (2006). Risk factors for water sports-related cervical spine injuries. The Journal of Trauma Injury, Infection, and Critical Care, 60(5), 1041-1046.