Neck injury

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In medicine, neck injuries are "general or unspecified injuries to the neck. It includes injuries to the skin, muscles, and other soft tissues of the neck.'[1]

Diagnosis

X-ray of the cervical spine should be considered, especially if the patient fulfills any criteria from the Canadian C-Spine Rule clinical prediction rule: [2][3]

  • Age 65 years or more
  • Paresthesias in extremities
  • Dangerous fall ("elevation >=3 ft or 5 stairs; an axial load to the head (e.g., diving); a motor vehicle collision at high speed (>100 km/hr) or with rollover or ejection; a collision involving a motorized recreational vehicle; or a bicycle collision")
  • Inability to rotate the neck 45° to the right and left
    • Only test if "simple rear-end motor vehicle collision, sitting position in ED, ambulatory at any time since injury, delayed onset of neck pain, or absence of midline C-spine tenderness"[4]
  • Glasgow Coma Scale less than 15 (the Canadian C-Spine Rule was only designed for alert patients)

References

  1. Anonymous (2024), Neck injury (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. Stiell IG, Clement CM, McKnight RD, et al (December 2003). "The Canadian C-spine rule versus the NEXUS low-risk criteria in patients with trauma". N. Engl. J. Med. 349 (26): 2510–8. DOI:10.1056/NEJMoa031375. PMID 14695411. Research Blogging.
  3. Stiell, Ian G; Catherine M Clement, Jeremy Grimshaw, Robert J Brison, Brian H Rowe, Michael J Schull, Jacques S Lee, Jamie Brehaut, R Douglas McKnight, Mary A Eisenhauer, Jonathan Dreyer, Eric Letovsky, Tim Rutledge, Iain MacPhail, Scott Ross, Amit Shah, Jeffrey J Perry, Brian R Holroyd, Urbain Ip, Howard Lesiuk, George A Wells (2009-10-29). "Implementation of the Canadian C-Spine Rule: prospective 12 centre cluster randomised trial". BMJ 339 (oct29_4): b4146. DOI:10.1136/bmj.b4146. Retrieved on 2009-11-05. Research Blogging.
  4. Stiell IG, Wells GA, Vandemheen KL, et al (October 2001). "The Canadian C-spine rule for radiography in alert and stable trauma patients". JAMA 286 (15): 1841–8. PMID 11597285[e]