NECK (CERVICAL SPINE) DISLOCATION |
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General Information
DEFINITION--A displacement of spinal vertebrae in the neck so that adjoining bones no longer touch each other. SUBLUXATION is a minor dislocation. Joint surfaces still touch, but not in normal relation to each other. Neck subluxation followed by spontaneous reposition occurs frequently in athletes. A neck dislocation is a serious injury that can lead to spinal-cord damage and paralysis of all four extremities, and sometimes leads to death.
BODY PARTS INVOLVED
Vertebrae of the spine in the cervical (neck) region.
Ligaments that hold the vertebrae in proper alignment.
Cartilage between the vertebrae that cushions the bones.
Spinal-cord and nerve roots (sometimes).
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SIGNS & SYMPTOMS
Excruciating pain at the time of injury.
Loss of function in the neck and severe pain when attempting to move it.
Visible deformity if the dislocated bones have locked in the dislocated position. Bones may spontaneously reposition themselves and leave no deformity, but damage is the same.
Tenderness over the dislocation.
Swelling and bruising in the neck.
Numbness or paralysis below the neck dislocation site from pressure, pinching or cutting of blood vessels or nerves.
CAUSES
Forceful flexing, extension or rotation of the neck.
Direct blow or violent force on the neck or head.
End result of a severe neck sprain.
RISK INCREASES WITH
Contact and collision sports such as football, hockey or basketball.
Gymnastics or diving.
Previous neck dislocation or sprain.
Repeated neck injury of any sort.
Arthritis of any type (rheumatoid, gout).
Poor muscle conditioning.
HOW TO PREVENT
Build your overall muscle tone with a conditioning program appropriate for your sport.
Warm up adequately before physical activity.
After healing, wear protective devices (such as a soft or rigid neck collar) to decrease the likelihood of reinjury during participation in any sports. Avoid all contact or collision sports.
WHAT TO EXPECT
APPROPRIATE HEALTH CARE
Doctor's treatment.
Surgery (sometimes) to restore the cervical vertebrae and torn ligaments to normal position and repair torn ligaments and tendons.
Self-care during rehabilitation.
DIAGNOSTIC MEASURES
Your own observation of symptoms.
Medical history and exam by a doctor.
X-rays of the neck and skull.
POSSIBLE COMPLICATIONS
AT TIME OF INJURY:
Shock.
Serious injury to neck cartilage, the spinal cord and roots of spinal nerves as they emerge from between vertebrae to serve other parts of the body. Neck dislocation can lead to paralysis from the neck down.
Pressure on or damage to other nearby smaller nerves, tendons, muscles, blood vessels and connective tissue.
AFTER TREATMENT OR SURGERY:
Excessive internal bleeding in the neck area.
Impaired blood supply to the dislocated area.
Death of bone cells due to interruption of the blood supply.
Infection introduced during surgical treatment.
Prolonged healing if activity is resumed too soon.
Unstable or arthritic neck joint following repeated injury.
PROBABLE OUTCOMEAfter the dislocation has been corrected, the neck may require immobilization with a soft or rigid collar for 8 weeks or more. Complete healing of injured ligaments requires a minimum of 6 weeks.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
FIRST AID
DON'T MOVE ANYONE WITH A NECK INJURY except on sturdy boards and with the neck immobilized. Don't remove the victim's headgear.
Transport the victim immediately to an emergency facility.
Ice helps stop internal bleeding. Prepare an ice pack of ice cubes or chips wrapped in plastic or a container. Place a towel over the injured area to prevent skin damage. Apply ice for 20 minutes, then rest 10 minutes until medical help is available. Compress the area with a loose-fitting elastic wrap to hold ice in place. Don't wrap too tightly. This can cause further damage.
The doctor will manipulate the dislocated bones or apply traction for 12 to 24 hours to return bones to their normal position. Manipulation should be done as soon as possible after injury. Six or more hours after dislocation, bleeding and displacement of body fluids may lead to compression of the spinal cord--a surgical emergency. Also, many tissues lose their elasticity and become difficult to return to a normal functional position.
CONTINUING CAREAt home:
Apply heat frequently. Use heat lamps, hot soaks, hot showers or heating pads.
Take whirlpool treatments, if available.
Massage gently and often to provide comfort and decrease swelling.
MEDICATIONYour doctor may prescribe:
General anesthesia or muscle relaxants prior to joint manipulation or application of traction.
Acetaminophen, aspirin or non-steroidal anti-inflammatory drugs for mild pain.
Narcotic pain relievers for severe pain.
Stool softeners to prevent constipation due to decreased activity.
Antibiotics to fight infection, if surgery is necessary.
ACTIVITY
Begin reconditioning the neck after clearance from your doctor.
If surgery is necessary, resume usual activities gradually after surgery. Don't drive until healing is complete.
DIET
Drink only water before manipulation or surgery to correct the dislocation. Solid food in your stomach makes vomiting while under general anesthesia more hazardous.
During recovery, eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity.
REHABILITATIONBegin daily rehabilitation exercises after clearance from your doctor. See section on rehabilitation exercises.
CALL YOUR DOCTOR IF
You have any neck injury--especially if any part of your body becomes numb, pale, or cold after injury. This is an emergency!
Any of the following occur after treatment:
Loss of feeling below the dislocation site.
Blue or gray skin color, particularly under the fingernails or toenails.
Swelling above or below the neck collar.
Nausea or vomiting.
Constipation.
Any of the following occur after surgery:
Increased pain, swelling or drainage in the surgical area.
Signs of infection (headache, muscle aches, dizziness, or a general ill feeling and fever).
New, unexplained symptoms develop. Drugs
used in treatment may produce side effects.
Neck dislocations that you can "pop" back into normal position occur repeatedly.
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