Cervical Fracture

What is a cervical fracture?

A cervical fracture is a break in 1 or more of the 7 cervical vertebrae (bones) in your neck. The 7 cervical vertebrae are called C1 through C7. Cervical vertebrae support your head and allow your neck to bend and twist. The vertebrae enclose and protect the spinal cord, which controls your ability to move.


What causes a cervical fracture?

A cervical fracture is usually caused by sudden, forceful impact. The following are the most common causes:

  • Motor vehicle accidents

  • Falls

  • Dives into shallow water

  • Injuries from contact sports

  • Skateboarding injuries

What are the signs and symptoms of a cervical fracture?

  • Pain, tenderness, swelling, or muscle spasms in your neck

  • Problems moving your neck

  • Trouble swallowing

  • Loss of feeling or pinprick pain in your arms or legs

  • Numbness, pain, or tingling at the base of your head

  • Double vision or loss of consciousness

What are common types of cervical fractures?

  • Odontoid fracture: The odontoid is a part of your C2 vertebrae, also called the axis. When the odontoid breaks, you cannot turn and twist your neck freely. Odontoid fractures are common in children.

  • Hangman's fracture: A hangman's fracture is another type of break in the axis.

  • Jefferson fracture: A Jefferson fracture is 3 or 4 breaks in your C1 vertebrae, also called the atlas. Bones in the axis may also be broken.

  • Teardrop fracture: Teardrop fractures are large, triangle-shaped breaks in 1 or more of the lower cervical vertebrae. They can also affect nearby ligaments and discs.

How is a cervical fracture diagnosed?

Your caregiver will ask how your injury occurred. He will ask about your signs and symptoms and feel for painful areas on your neck. Your caregiver will check for problems with your muscles, reflexes, and sense of touch. You may need the following tests:

  • C-spine x-ray: This is a picture of your cervical spine. Caregivers will look for broken bones or other neck problems.

  • CT scan: This test is also called a CAT scan. An x-ray and computer are used to take pictures of your skull and brain. You may be given dye, also called contrast, before the test. Tell the caregiver if you are allergic to dye, iodine, or seafood.

  • MRI: This scan uses powerful magnets and a computer to take pictures of your neck. The pictures will show if you have pressure on or damage to your spinal cord. You may be given dye, also called contrast, before the test. Tell caregivers if you are allergic to dye, iodine, or seafood. Remove all jewelry, and tell caregivers if you have any metal in or on your body. Metal can cause serious injury. Tell caregivers if you cannot lie still or are anxious or afraid of closed spaces.

How is a cervical fracture treated?

  • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.

    • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.

    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.

  • Traction: Traction uses weights to pull your bones back into place and to straighten the cervical spine.

  • Immobilization: This is a method used to keep your head and neck from moving as your cervical fracture heals. Immobilization will limit your movement for months as your injury heals. You may need the following:

    • Halo brace: A halo brace and vest prevent most head and neck movements. The halo brace is attached to your head with pins placed in your skull. It cannot be removed during treatment. Ask your caregiver for more information about halo brace placement and care.

    • Semirigid collar: Semirigid collars use plastic plates to stop side-to-side or up-and-down motion in your neck.

    • Soft collar: A soft collar is a flexible brace placed around the neck. It is often used after a more rigid collar has been worn.

  • Surgery: You may need surgery to repair your cervical fracture. You may also have surgery after immobilization if your fracture has not healed. During surgery, caregivers repair your fracture through an incision in the front or back of your neck. Ask your caregiver for more information about surgeries to treat a cervical fracture.

  • Therapy: A physical therapist and an occupational therapist may exercise your arms, legs, and hands. They may also teach you new ways to do things around the house. A speech therapist may work with you to help you talk or swallow.

What are the risks of a cervical fracture?

  • Wearing a neck brace may lead to skin rashes, sores, and infections. You may have problems swallowing while wearing a halo brace. Halo brace pins can cause scars. Halo pins can puncture the covering of the brain. Halo pins and rods may loosen or break and harm your vertebra and surrounding areas. Traction may move your bones too far out of place. During surgery, you may bleed more than expected. Your brain and spinal cord may be damaged. This can cause paralysis and can be life-threatening.

  • After treatment, you may still have pain or problems turning your head. Your cervical fracture may not completely heal. You may get an infection. You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. These problems can be life-threatening.

When should I call my caregiver?

Call your caregiver if:

  • You have a fever.

  • You see a skin rash, redness, or sores under your brace.

  • You have problems swallowing while you are wearing your halo brace.

  • Your neck pain is not getting better even with treatment.

  • You have questions or concerns about your cervical fracture, medicine, or care.

When should I seek immediate help?

Seek care immediately or call 911 if:

  • You have a sudden, severe headache with nausea and vomiting.

  • You are seeing double or cannot see out of 1 eye.

  • You cannot stay awake.

  • The pins in your halo brace have loosened or look deeper in the skin than before.

  • You feel new weakness or numbness in your hands or fingers.

  • You are short of breath.

  • You cannot feel or move your arms or legs.

  • You have chest pain or trouble breathing that is getting worse over time.

  • You suddenly feel lightheaded and have trouble breathing.

  • You have new and sudden chest pain. You may have more pain when you take deep breaths or cough. You may cough up blood.

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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