Sprain of the Cervical Spine

A sprain is a condition that is caused due to a tear in the ligament tissue. A ligament is a kind of fibrous tissue that connects bones to other bones. Complex systems of ligaments are responsible for proper posture and act as a support system for head and neck. Due to sprain, a few ligament fibers may be completely or incompletely broken, depending upon the severity of collision or impact.

A cervical sprain occurs when the neck or spinal muscle is challenged to the extreme such as in a head-on car accident where the head is suddenly thrown forward while the body tends to stay in its original position due to inertia and is pushed backward. This uneven circumstance leads to hyperflexion of the muscles as the muscles are pushed beyond the normal range.

It can also occur when a gymnast or trapeze artist suffers a whiplash injury while performing dicey acrobatic stunts during sports. The extent of hyperextension of the Trapezius muscle (neck muscle) generally depends on the severity of the impact.

DIAGNOSIS
The patient experiences pain and stiffness, especially in the back area of the neck that worsens with movement. The patient may feel relief after a bit of rest.

The lower cervical nerve roots are interwoven to form the brachial plexus that is further responsible for the movement of the arm and hand. When these nerve roots are stretched beyond the normal posture, as in case of a cervical sprain, the pain may travel along the shoulder and then down to the arms and hands.  The patient may experience a warm or burning pain over the site muscle soreness. Stretching of the cervical sympathetic nerves and vertebral artery spasm can often lead to disorientation or discomfit of muscles of the posterior part of the shoulder or other areas.

X-Ray: In case of a normal sprain, general X-ray diagnosis does not give any decisive result as the pressure of already existing joint swelling (osteoarthritis) may be revealed by the X-Ray radiological treatment.

TREATMENT

(i) Rest, analgesic and local heat: Ample amount of rest, use of counter pain relievers and application of heat in the affected area are the basic treatment steps that are required to be followed in case of a simple sprain.

(ii) Exercise: Cervical spine exercise and gentle rub down are quite helpful.

(iii) Cervical collar: Cervical collar made of stockinette, cotton wool or plastic provides gentle immobilization and gives comfort to the cervical spine.

Traction: Alternating cervical hold is applied in cases where the pain persists and has spread out in the area of the upper limb.

RUPTURE OF THE CERVICAL

SPINE LIGAMENTS

MECHANISM OF INJURY

A severe collision or impact that produces sprain of the cervical spine can also cause tear of the ligaments.  Excessive bending or joint movements or hyperextension injuries can also cause this type of lesion.

NATURE OF INJURY

The ligaments involved in the injured area may be the anterior longitudinal ligaments, nuchal ligament, interspinal ligaments, ligaments within the vertebral canal and the ones involved in intervertebral joints. Serious rupture may proceed to partial dislocation
(subluxation) or in more serious cases even fracture.

DIAGNOSIS

Clinical examination: Clinical signs and symptoms are similar to a sprain of the cervical spine but the injury or lesion is of a sterner nature. Patients may even find it difficult to support the weight of their own head.

X-ray: There may be a fracture of the spinous process (bony projection of the vertebral back) or in the body of the vertebrae. Any kind of evidence of any dislocation of the cervical vertebra must be handled with utmost care. Degenerative changes of the cervical spine may be found from before and such patients are prone to ligament rupture even with a minor injury. To recover from spine problems some time surgery needed. For surgery of the spine, implants and instruments required which can be obtained from Spine Implants Exporters in India.

TREATMENT
Rest and analgesic: Enough bed rest and prescribed analgesics may be enough in mild types of lesion.

Cervical immobilization: Immobilization of the cervical spine is another form of the treatment which involves the use of cervical collar or plaster for a period of 6-12 weeks, depending upon the severity.

Physiotherapy: Physiotherapy is helpful in cases where the soft tissue has healed up completely

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