Poranění horní krční páteře

RYBA, Luděk, Jan CIENCIALA, Richard CHALOUPKA, Martin REPKO and Robert VYSKOČIL. Poranění horní krční páteře (Injury of upper cervical spine). Česko-slovenská patologie a Soudní lékařství. Praha: Česká lékařská společnost J.E.Purkyně, 2016, vol. 61, No 2, p. 20-25. ISSN 1210-7875.

Basic information

• Original name: Poranění horní krční páteře
• Name (in English): Injury of upper cervical spine
• Authors: RYBA, Luděk (203 Czech Republic, guarantor, belonging to the institution), Jan CIENCIALA (203 Czech Republic), Richard CHALOUPKA (203 Czech Republic, belonging to the institution), Martin REPKO (203 Czech Republic, belonging to the institution) and Robert VYSKOČIL (203 Czech Republic).
• Edition: Česko-slovenská patologie a Soudní lékařství, Praha, Česká lékařská společnost J.E.Purkyně, 2016, 1210-7875.

Other information

• Original language: Czech
• Type of outcome: Article in a journal
• Field of Study: 30211 Orthopaedics
• Country of publisher: Czech Republic
• Confidentiality degree: is not subject to a state or trade secret
• RIV identification code: RIV/00216224:14110/16:00092286
• Organization unit: Faculty of Medicine
• Keywords (in Czech): trauma – traumatologie; krční páteř; tupé poranění; mechanizmus vzniku poranění; závažnost poranění
• Keywords in English: injury – traumatology; cervical spine; blunt injury; biomechanics of trauma; heaviness of injury
• Tags: EL OK
• Tags: Reviewed

Abstract

Poranění horní krční páteře představuje až 1/3 všech poranění krční páteře a až 40 % z nich končí smrti. K úrazu může dojít na každé úrovní páteře. U mladších pacientů převažují vysokoenergetické poranění, autonehody, motonehody, úrazy na kole a srážky chodců s autem, u starších pacientů jednoduché pády. Mechanismus úrazu je axiální násilí, hyperflexe, hyperextenze, lateroflexe, rotace a různé kombinace. Klinický nález je různorodý. Poranění jsou často kombinovaná.

Abstract (in English)

Injuries of the upper cervical spine represent 1/3 of all cervical spine injuries and approximately 40 % result by the death. Every level of the cervical spine can be injured – fractures of condyles of the occipital bone (CO), atlantooccipital dislocation (AOD), fractures of the Atlas (C1), atlantoaxial dislocation (AAD) and fractures of the axis (C2). Most of cases in younger patients are caused by high-energy trauma, while by elderly people, because of the osteoporosis, is needed much less energy and even simple falls can cause the injury of the cervical spine. That´s why the etiology of injuries can be different. In younger patients are caused mainly by car accidents, motorcycle and bicycle accidents and pedestrian crashes by car and in elderly populations are the main reason falls. The mechanism of the injury is axial force, hyperflexion, hyperextension, latero-flexion, rotation and combination of all. The basic diagnostic examination is X ray in AP, lateral and transoral projection. But in the most of cases is CT examination necessary and in the suspicion of the ligamentous injury and neurological deterioration must be MRI examination added. Every injury of the upper cervical spine has its own classification. Clinical symptoms can vary from the neck pain, restricted range of motion, antalgic position of the head, injury of the cranial nerves and different neurologic symptoms from the irritation of nerves to quadriplegia. A large percentage of deaths is at the time of the injury. Therapy is divided to conservative treatment, which is indicated in bone injuries with minimal dislocation. In more severe cases, with the dislocation and ligamentous injury, when is high chance of the instability, is indicated the surgical treatment. We can use anterior or posterior approach, make the osteosynthesis, stabilisation and fusion of the spine. Complex fractures and combination of different types of injuries are often present in this part of the spine. Correct and early diagnosis with the best treatment option is necessary for successful result of the cervical spine injuries.