| racic spine is composed of 12 vertebra. It is | | | | build strength in the muscles of the neck to |
| continuous with the cervical spine above and the | | | | increase stability and better protect the cervical |
| cervical spine below. The thoracic spine is | | | | spine. |
| connected bilaterally to the ribs. These | | | | The surgeon will x-ray the injured person's spine |
| connections add great stability to the thoracic | | | | to find out if the cervical spine is fractured. To |
| spine. The spinal cord passes through the bony | | | | treat the fractured spine, the surgeon first |
| spinal canal and nerves emerge at the interface | | | | reduces it through traction. This process involves |
| between each set of vertebra. Fractures of the | | | | inserting tongs into the skull, attaching a pulley to |
| spine are commonly secondarily to trauma. | | | | the tongs, and attaching small weights to the |
| Weakened bones and bones involved with cancer | | | | other end of the pulley. The weights pull the head |
| can also fracture. Aside from causing structural | | | | away from the shoulders just enough to enable |
| changes in the spine, the spinal cord or nerves | | | | the soft tissues around the spine to push the |
| roots may me damaged or destroyed with these | | | | fractured bone back into place. After the fracture |
| fractures. Thoracic spine fractures may also be | | | | is reduced, the surgeon examines the spinal cord |
| associated with injuries to the heart, lungs and | | | | for damage. Because the spinal cord is soft tissue, |
| great vessels of the chest. | | | | it cannot be seen on an x-ray. Therefore, the |
| A cervical (SER-vi-kl) fracture is also called a neck | | | | surgeon injects a dye into the damaged area that |
| fracture or broken neck. It is a break in one or | | | | coats the spinal cord and other soft tissues so |
| more of your seven cervical vertebrae (neck | | | | they can be seen on an x-ray. |
| bones). Vertebrae are the bones that make up | | | | Screening radiography of the cervical spine is |
| your spine. These bones support your head, and | | | | expensive, costing society as much as $140 million |
| connect it to your shoulders and body. The | | | | annually and usually has a low yield, with only |
| cervical vertebrae enclose the spinal cord. The | | | | 1%—5% of screening studies showing a |
| spinal cord is where the nerves from your brain | | | | fracture In addition, depending on the clinical |
| go to the rest of the body. With a cervical | | | | situation, from 4% to 28% of such screening |
| fracture, the spinal cord may also be damaged.hh | | | | radiographic examinations may lead to further |
| Complete immobilization of the head and neck | | | | imaging, without a fracture being present |
| should be done as early as possible and before | | | | Accordingly, considerable attention has been |
| moving the patient. Immobilization should remain in | | | | focused on developing optimal guidelines for |
| place until movement of the head and neck is | | | | cervical spine imaging. However, the same imaging |
| proven safe. In the presence of severe head | | | | strategy may not be appropriate for all patients. |
| trauma, cervical fracture must be presumed until | | | | Patients with a very low probability of fracture |
| ruled out. Immobilization is imperative to minimize | | | | may not need any imaging whereas those with a |
| or prevent further spinal cord injury. The only | | | | modest probability of injury may require |
| exceptions are when there is imminent danger | | | | radiography. In addition, several authors have |
| from an external cause, such as becoming | | | | suggested that patients with a high probability of |
| trapped in a burning building. Non-steroidal | | | | fracture may benefit from screening computed |
| anti-inflammatory medications such as aspirin or | | | | tomography (CT). The key to determining who |
| ibuprofen are useful in decreasing swelling and pain. | | | | should undergo screening and to selecting the ideal |
| In the long term, physical therapy will be given to | | | | imaging modality is the probability of fracture. |