A detailed history, from either the emergency crew or the conscious patient, is of paramount importance and should be solicited whenever possible prior to clinical examination. On presentation to the emergency department, any suspected C-spine fracture patient should be assumed to have a C-spine injury until proven otherwise. Patients with suspected C-spine fracture are invariably managed in the pre-hospital setting with the application of a rigid brace to the C-spine (hard collar) in a neutral position to achieve cephalic immobilisation and keep the spinal column ‘in-line’ in order to prevent undue movement. Initial assessment of suspected C-spine fracture If not managed accordingly, C-spine injuries can eventually lead to significant morbidity and mortality with numerous functional and psychosocial ramifications.
#Cervical spine full
As the full extent of the injury may not be apparent initially, all patients with suspected C-spine trauma should be assessed systematically using a standardised approach to improve patient outcomes. showed that motor vehicle accidents were the most prevalent cause in the United States, responsible for 29.3% of C-spine fractures and most frequently occurring at the C2 (32.0%) and C7 (20.9%) levels. Ĭ-spine injuries are sustained following low-energy incidents such as a simple innocuous fall to higher energy traumas, such as in motor vehicle accidents. Varying underlying mechanisms such as hyperflexion, hyperextension, axial loading, rotational and distraction forces predispose the C-spine to injuries. Specialised ligamentous and osseous anatomy provides the C-spine with great range of motion but also makes it more susceptible to injury. C-spine injuries account for half of all spinal injuries, with approximately 500-600 people enduring acute traumatic SCIs every year in the United Kingdom. In this review, we also propose an algorithm to aid the initial management of a patient with suspected cervical spine injury in the emergency department.Ĭervical spine (C-spine) trauma constitutes a variety of injuries ranging from relatively mild ligamentous and muscular strains to fractures and dislocations of the bony vertebrae, which can result in significant spinal cord injuries (SCIs). The level of cervical spine instability and knowledge of their unique classification systems is of paramount importance and assists in the decision-making process to guide definitive management. Clinical decision rules such as the Canadian C-Spine Rule are frequently used to risk-stratify patients needing radiography. Although the presence of cervical spine injury is very often overt, reliance on clinical examination alone is sometimes not sufficient and potentially requires further imaging. Initial assessment and management should follow the Advanced Trauma Life Support (ATLS) protocols with adequate protection of the cervical spine through triple immobilisation to prevent any unnecessary movement, which can make the patient susceptible to further neurological injuries.
Trauma to the cervical spine encompasses a wide range of injuries from minor muscular strains to life-threatening fracture-dislocations associated with spinal cord lesions. Her father Yoshiaki won a team bronze for Japan at Barcelona 1992 and her younger sister, Chiaki, is also a competitive gymnast.The unique anatomy and flexibility of the cervical spine predispose it to a risk of injury. Hatakeda, tipped to lead the Japanese women towards Paris 2024 with Murakami Mai nearing the end of her career, made her Games debut at Tokyo 2020 in 2021, helping Japan to fifth place in the team event. She was taken to hospital in an ambulance on a spineboard. Hatakeda will undergo further tests on Thursday.Īccording to those who have seen the fall, Hatakeda fell face first while attempting a Komova (a transition element from low bar to high bar on the uneven bars), slamming her chin hard on the floor. The 21-year-old is in pain but conscious and in stable condition with her mother and coach, Yukiko, at bedside. Hatakeda, who had qualified for Thursday's final fourth in Kitakyushu, was diagnosed with damage to her central spinal cord and bruising of the cervical spine following an MRI, according to the Japan Gymnastics Association. Tokyo 2020 Olympian Hatakeda Hitomi was forced to pull out of the women's all-around final at the 2021 World Artistic Gymnastics Championships after suffering a gruesome training fall on the uneven bars on Wednesday (20 October).