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Severe sprains of the sub-axial cervical spine in adolescents: a diagnostic and therapeutic challenge

A report of three cases

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Abstract

Background

Sub-axial cervical spine(C spine) distraction flexion injuries, known as cervical sprains, have been divided into either “benign” or “severe” sprains depending on the integrity of the posterior longitudinal ligament (PLL) of the spinal column. It is a very uncommon injury and rarely reported in the literature. Most of the reports in the literature discuss this injury in the adult age group and so the adolescent age group was also considered to follow the same model of progression of mechanical instability depending on the degree and extent of structures injured, including the PLL as a cutoff factor between a “stable” and an “unstable” injury.

Patients and Methods

We report three cases of adolescents with severe cervical sprains at the C2–C3 level and argue the integrity of PLL as a determinant factor in the sagittal stability of the C spine in this age group.

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References

  1. Allen BL Jr, Ferguson RL, Lehmann TR, O’Brien RP (1982) A mechanistic classification of closed, indirect fractures and dislocations of the lower cervical spine. Spine 7(1):1–27 (Epub 1982/01/01)

    Article  PubMed  Google Scholar 

  2. Roaf R (1960) A study of the mechanics of spinal injuries. J Bone Joint Surg Br Vol 42-B(4):810–823

    Google Scholar 

  3. Roy-Camille R, Saillant G, Berteaux D, Lortat-Jacob A, Bisserie M (1977) Severe ligamentous injury due to trauma of the mobile spinal segment of the cervical column (author’s transl). Journal de chirurgie 113(2):121–130. Epub 1977/01/01. Entorse grave par lesion traumatique du segment mobile rachidien (SMR) de la colonne cervicale

    Google Scholar 

  4. Roy-Camille R, Saillant G, Berteaux D, Bisserie M (1978) Severe strains of the cervical spine operated on by a posterior approach (author’s transl). Revue de chirurgie orthopedique et reparatrice de l’appareil moteur 64(8):677–684. Epub 1978/12/01. Entorses graves du rachis cervical. Traitement par voie posterieure

  5. Paakkala T (1985) Prevertebral soft tissue changes in cervical spine injury. Crit Rev Diagn Imaging 24(3):201–236 (Epub 1985/01/01)

    CAS  PubMed  Google Scholar 

  6. White AA, Southwick WO, Panjabi MM (1976) Clinical instability in the lower spine. A review of past and current concepts. Spine 1:15–27

    Article  Google Scholar 

  7. Louis R (1979) Cervical sprains and cervical herniated discs (author’s transl). La Nouvelle presse medicale 8(22):1843–1849. Epub 1979/05/19. Traumatismes du rachis cervical 1. Entorses et hernies discales

  8. Braakman R, Penning L (1968) The hyperflexion sprain of the cervical spine. Radiologia clinica et biologica 37(6):309–320 (Epub 1968/01/01)

    CAS  PubMed  Google Scholar 

  9. Muchow RD, Resnick DK, Abdel MP, Munoz A, Anderson PA (2008) Magnetic resonance imaging (MRI) in the clearance of the cervical spine in blunt trauma: a meta-analysis. J Trauma 64(1):179–189 (Epub 2008/01/12)

    Article  PubMed  Google Scholar 

  10. Laporte C, Laville C, Lazennec JY, Rolland E, Ramare S, Saillant G (1999) Severe hyperflexion sprains of the lower cervical spine in adults. Clin Orthop Relat Res 363:126–134 (Epub 1999/06/24)

    PubMed  Google Scholar 

  11. Dvorak MF, Fisher CG, Fehlings MG, Rampersaud YR, Oner FC, Aarabi B et al (2007) The surgical approach to subaxial cervical spine injuries: an evidence-based algorithm based on the SLIC classification system. Spine 32(23):2620–2629 (Epub 2007/11/06)

    Article  PubMed  Google Scholar 

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Conflict of interest

None of the authors has any potential conflict of interest.

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Correspondence to Louise C. McLoughlin.

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McLoughlin, L.C., Jadaan, M. & McCabe, J. Severe sprains of the sub-axial cervical spine in adolescents: a diagnostic and therapeutic challenge. Eur Spine J 23 (Suppl 2), 150–156 (2014). https://doi.org/10.1007/s00586-013-2794-5

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  • DOI: https://doi.org/10.1007/s00586-013-2794-5

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