Transcript Chapter 25: The Spine

Cervical Spine Injuries
• Vertebrae
– 7 cervical
– 12 thoracic
– 5 lumbar
– 5 sacral
– 4 coccyx
The Cervical Spine
Anatomy of Cervical Vertebrae
Odontoid Process
(Dens) of Axis
Superior Articular
Facet
Transverse
Foramen
Anterior Arch of Atlas
Transverse Process
C1-C2 Facet
Inferior Articular
Process
Lamina
Bifid Spinous
Process
Body of Axis
Posterior Arch of
Atlas
Dermatomes
Cervical Sprain
• Facet Joint Injury
– Mechanism of Injury
• Generally the same mechanism as a strain
• More violent
• Involves a snapping of the head and neck
• Ligaments injured
• Signs and Symptoms
• Similar signs and symptoms to a strain
• Tenderness facet joints and ligaments
• Pain will usually arise the day after the trauma
• Muscle spasms
Cervical (Sprain)
• Management
– Severe injuries
• Activate EMS
• Refer to MD
– RICE for first 48-72 hours
– Bed rest if severe
– Rehabilitation
• Strengthening
• Restore ROM
• Review tackling techniques for football
players
Brachial Plexus Injuries
(Burner/Stinger)
• Mechanism of Injury
– Lateral flexion
• Result of
– Stretching of the brachial plexus or
– Compression of the brachial plexus
– Disrupts peripheral nerve function
Brachial Plexus Injury (Burner/Stinger)
• Signs and Symptoms
• Burning sensation
• Numbness and tingling from the shoulder into the hand
• Pain extending from the shoulder into the hand
• Some loss of function of the arm and hand for several minutes
– Dead arm feeling by athlete
• Symptoms rarely persist for several days
• Repeated injury can result in permanent damage
Brachial Plexus Neurapraxia
(Burner/Stinger)
• Management
– Assessment by medical personnel
– Ice
– Rest
– Strengthening and stretching program
– Return to activity once signs and symptoms have returned to normal
– Padding to limit neck ROM during impact
Cervical Fractures
• Mechanism of Injury
– Usually axial load w/ some degree of cervical flexion
– Spearing
• Prevention
– Teach proper tackling technique
– (See what you hit)
Cervical Fractures
• Signs and Symptoms
• Management
– Neck point tenderness
– Activate EMS (911)
– Restricted motion
– Treat like an unconscious athlete
– Cervical muscle spasm
– Use extreme care
– Cervical pain
– X-ray and physician referral
– Pain in the chest and extremities
– Transport with extreme caution
– Numbness in the trunk and or limbs
– Weakness in the trunk and/or limbs
– Loss of bladder and bowel control
– Minimize movement of cervical spine
• Cervical extrication collar
• Spine Board
Cervical Dislocation
• Mechanism of Injury
– Usually violent flexion and rotation of the head
Cervical Dislocation
• Signs and Symptoms
– Considerable pain
– Numbness
– Weakness or paralysis
• Management
– Extreme care must be used
– Do not straighten athletes neck
– Activate EMS (911)
– More likely to cause spinal cord injury
than a fracture
Stabilize Head and Neck
Log Roll onto Spine Board
Lifting Spine Board
2b
1
5 Man Lift
5
Facemask Removal
2a
3
5
Log Roll onto Spine Board
Strap to Board
2b
4
5
Strengthening Exercises
• Initiated when near normal range has been achieved
• Should be performed pain free
• Exercise progression
• Isometric
• Isotonic exercises