Abstract
Cervical spine immobilization in penetrating cervical trauma is associated with an increased risk of indirect central neurological injury
Highlights
Current recommendations for cervical spine immobilization (CSI) were developed for blunt trauma patients and empirically extended to include patients with penetrating injury [1,2,3,4]
The purpose of this study is to examine the relationship between penetrating cervical trauma and the development of central neurologic injury with prophylactic CSI
Demographics, mechanism of injury and neurologic deficits were similar between the two groups, but mortality and the incidence of CSI in the Charity group was significantly higher than the Hurley group
Summary
Current recommendations for CSI were developed for blunt trauma patients and empirically extended to include patients with penetrating injury [1,2,3,4]. CSI was designed to prevent progression of direct neurologic injury from cervical spine instability caused by CSFx and/or ligamentous injury. Cervical spine instability resulting from isolated ligamentous instability does not occur following penetrating cervical trauma making CSI unindicated in the absence of unstable CSFx. Unstable CSFx in association with neurologic salvageability has not been clearly shown to exist in the setting of penetrating cervical trauma. Unstable CSFx resulting from penetrating cervical trauma has been repeatedly associated with complete neurologic devastation in the surveyed literature. CSI has no demonstrated benefit in neurologically devastated patients [2]
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