Cervical Spine Injuries from High-Velocity Forces

Abstract

The detailed analysis of the radiologic and pathoanatomic data from 10 human cadaver head-neck complexes defined the type and extent of expected cervical spine injuries after high-velocity flexion-compression loads to the cranium. All specimens demonstrated multiple injuries with both contiguous and noncontiguous patterns. Although all preparations showed evidence of axial compression, a multiplicity of other force vectors, including noncontiguous occurrences of flexion, extension, and shear, were documented. These findings indicate that the injury pattern is not a sequential process but a reaction to changes in the segmental interrelations of the various vertebral column components, including varying vector applications of injurious forces at the segmental level. The presence of moderate or severe spondylotic alterations restricted the distal transmission of injury forces with the principal injury patterns occurring at or proximal to the initial level of severe spondylotic involvement. These data emphasize the need for increased awareness of the presence of multiple cervical spine injuries, both contiguous and noncontiguous, and that separate levels of compromise may not share similar mechanisms of injury.