Description

Cervical spine injury results in significant morbidity and mortality. Young adults and children are most commonly affected often with concurrent traumatic brain injury. Immobilisation of the cervical spine is integral to initial resuscitation efforts. Accurate clinical assessment of potential cervical spinal cord injury is frequently challenging in unconscious trauma victims and radiological imaging is essential. Plain film radiography alone is no longer considered adequate to clear the neck of a patient with impaired consciousness and clinicians should consider early use of CT or MR imaging if a prolonged period of unconsciousness is anticipated. Cervical spine injuries in children present additional challenges as radiographic abnormality is frequently absent. An outline for initial management, clinical and radiological assessment and the critical care management of adults and children with suspected cervical spine injury is discussed.