Cervical fractures and dislocations
This page is for adult patients. For pediatric patients, see: cervical injury (peds)
Background
Vertebral fractures and dislocations types
- Cervical fractures and dislocations
- Thoracic and lumbar fractures and dislocations
Clinical Features
C-spine injuries may present with
- Rarely neurogenic shock (bradycardia, hypotension)
- Posterior neck pain
- Pain on palpation of spinous processes
- Limited neck ROM with pain
- Weakness, numbness, or paresthesias
Differential Diagnosis
Neck Trauma
- Penetrating neck trauma
- Blunt neck trauma
- Cervical injury
- Neurogenic shock
- Spinal cord injury
Neck pain
- Musculoskeletal
- Torticollis
- Dystonic reaction
- Cervical spondylosis
- Cervical stenosis
- Cancer
- Epidural abscess
- Vertebral osteomyelitis
- Transverse myelitis
- Temporal arteritis
- Epidural hematoma (anticoagulation, hemophilia)
- Cervical disk herniation
- Blunt neck trauma
- Anterior horn disease
- Cervical fractures and dislocations
- Cervical radiculopathy
Evaluation
- See blunt neck trauma for general workup
Management
- Prehospital
- Hospital
- See page for specific fracture
- Cervical spine clearance
Disposition
See Also
- Blunt neck trauma
- Cervical spine clearance
- C-Spine (EAST)
- Penetrating neck trauma
- Spinal Cord Trauma
- Spinal Cord Compression (Non-Traumatic)
- Neurogenic Shock
- Unstable spine fractures
- Vertebral fractures
- Cervical injury (peds)
References
📊 NEXUS Criteria Calculator [show]
NEXUS Criteria
| Criteria (ALL must be absent to clear) | Absent | Present |
|---|---|---|
| Posterior midline cervical tenderness | 1 | |
| Focal neurologic deficit | 1 | |
| Altered level of alertness | 1 | |
| Intoxication | 1 | |
| Distracting painful injury | 1 | |
| Criteria Present | / 5 | |
| Interpretation | |
|---|---|
| 0 | C-spine can be cleared clinically — All 5 criteria absent. No imaging needed. Sensitivity 99.6% for clinically significant injury. |
| ≥1 | Cannot clear clinically — C-spine imaging indicated. |
| References |
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