Spinal Trauma and Spinal Cord Injury

  • Pia C. SundgrenEmail author
  • Adam E. Flanders


The majority of the spinal injuries (60 %) affect young healthy males between 15 and 35 years of age with cervical spine injuries to be most common. The main cause for spinal injuries is blunt trauma most commonly due to motor vehicle accidents (48 %), followed by falls (21 %), and sport injuries (14.6 %). Assault and penetrating trauma account for approximately 10–20 % of the cases. Injuries to the spinal column and the spinal cord are a major cause of disability, affecting predominately young healthy individuals with important socioeconomic consequences, and the costs of lifetime care and rehabilitation exceed one million US dollars per patient excluding financial losses related to wages and productivity. Over the past several decades, the mean age of the spinal cord-injured patient has increased which is attributed to a substantially greater proportion of injuries related to falls in the elderly.


Trauma Spinal injury Spinal cord injury MRI CT Vertebral body fractures Ligamentous injury Traumatic disc herniation SWICORA Neurological deficits 


  1. 1.
    Riascos R, Bonfante E, Cotes C, Guirguis M, Hakimelahi R, West C (2015) Imaging of Atlanto-Occipital and Atlantoaxial Traumatic Injuries: What the Radiologist Needs to Know. Radiographics 35(7):2121–2134. doi: 10.1148/rg.2015150035 CrossRefPubMedGoogle Scholar
  2. 2.
    Hill MW, Dean SA (1993) Head injury and facial injury: is there an increased risk of cervical spine injury? J Trauma 34:549–554CrossRefGoogle Scholar
  3. 3.
    Pope AM, Tarlov AR (1991) Disability in America: toward a national agenda for prevention. National Academy Press, WashingtonGoogle Scholar
  4. 4.
    Riggins RS, Kraus JF (1997) The risk of neurological damage with fractures of the vertebrae. J Trauma 17:126–130CrossRefGoogle Scholar
  5. 5.
    Castellano V, Bocconi FL (1970) Injuries of the cervical spine with spinal cord involvement (myelic fractures): statistical considerations. Bull Hosp J Dis Orthop Inst 31:188–198Google Scholar
  6. 6.
    Rogers WA (1957) Fractures and dislocations of the cervical spine; an end-result study. J Bone Joint Surg 39:341–351PubMedGoogle Scholar
  7. 7.
    Diaz JJ Jr, Gillman C, Morris JA Jr et al (2003) Are five-view plain films of the cervical spine unreliable? A prospective evaluation in blunt trauma in patients with altered mental status. J J Trauma 55:658–663CrossRefPubMedGoogle Scholar
  8. 8.
    Griffen MM, Frykberg KAJ et al (2003) Radiographic clearance of blunt cervical spine injury: plain radiograph or computed tomography scan? J Trauma 55:222–226CrossRefPubMedGoogle Scholar
  9. 9.
    Holmes JF, Mirvis SE, Panacek EA, NEXUS Group (2002) Variability in computed tomography and magnetic resonance imaging in patients with cervical spine injuries. J Trauma 53:524–529CrossRefPubMedGoogle Scholar
  10. 10.
    Kligman M, Vasili C, Roffman M (2001) The role of computed tomography in cervical spine injury due to diving. Arch Orthop Trauma Surg 121:139–141CrossRefPubMedGoogle Scholar
  11. 11.
    Schenarts PJ, Diaz J, Kaiser C et al (2001) Prospective comparison of admission computed tomographic scan and plain films of the upper cervical spine in trauma patients with altered mental status. J Trauma 51:663–668CrossRefPubMedGoogle Scholar
  12. 12.
    Berne JD, Velmahos GC, El Tawil Q et al (1999) Value of complete cervical helical computed tomographic scanning in identifying cervical spine injury in the unevaluable blunt trauma patient with multiple injuries: a prospective study. J Trauma 47:896–902CrossRefPubMedGoogle Scholar
  13. 13.
    Van Goethem JW, Maes M, Ozsarlak O et al (2005) Imaging in spinal trauma. Eur Radiol 15(3):582–590CrossRefPubMedGoogle Scholar
  14. 14.
    Flanders AE, Schaefer DM, Doan HT et al (1990) Acute cervical spine trauma: correlation of MR imaging findings with degree of neurological deficit. Radiology 177(1):25–33CrossRefPubMedGoogle Scholar
  15. 15.
    Sliker CW, Mirvis SE, Shanmuganathan K (2005) Assessing cervical spine stability in obtunded blunt trauma patients: review of medical literature. Radiology 234:733–739CrossRefPubMedGoogle Scholar
  16. 16.
    Wilmink JT (1999) MR imaging of the spine: trauma and degenerative disease. Eur Radiol 9:1259–1266CrossRefPubMedGoogle Scholar
  17. 17.
    Denis F (1983) The three column spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine 8(8):817–831CrossRefPubMedGoogle Scholar
  18. 18.
    Mcafee PC, Yuan HA, Fredrickson BE et al (1983) The value of computed tomography in thoracolumbar fractures. An analysis of one hundred consecutive cases and a new classification. J Bone Joint Surg Am 65(4):461–473PubMedGoogle Scholar
  19. 19.
    Magerl F, Aebi M, Gertzbein SD et al (1994) A comprehensive classification of thoracic and lumbar injuries. Eur Spine J 3(4):184–201CrossRefPubMedGoogle Scholar
  20. 20.
    Lee JY, Vaccaro AR, Lim MR et al (2005) Thoracolumbar injury classification and severity score: a new paradigm for the treatment of thoracolumbar spine trauma. J Orthop Sci 10(6):671–675CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Dvorak MF, Fischer CG, Fehlings MG, Rampersaud YR, Oner FC, Aarabi B, Vaccaro AR (2007) The surgical approach to subaxial cervical spine injuries: an evidence-based algorithm based on the classification system. Spine 32(23):2620–2629CrossRefPubMedGoogle Scholar
  22. 22.
    Rogers LF (1971) The roentgenographic appearances of transverse or chance fractures of the spine: the seat belt fracture. Am J Roentgenol 111:844–849CrossRefGoogle Scholar
  23. 23.
    Gertzbein SD (1992) Scoliosis Research Society: multicenter spine fracture study. Spine 17:528–540CrossRefPubMedGoogle Scholar
  24. 24.
    Diaz JJ, Aulino JM, Collier B et al (2005) The early work-up for isolated ligamentous injury of the cervical spine: does computed tomography scan have a role. J Trauma 59:897–904CrossRefPubMedGoogle Scholar
  25. 25.
    Burney RE, Maio RF, Maynard F et al (1993) Incidence, characteristics, and outcome of spinal cord injury at trauma centers in North America. Arch Surg 128:596–599CrossRefPubMedGoogle Scholar
  26. 26.
    Dawodu ST (2009) Spinal cord injury–definition, epidemiology, pathophysiology. Medscape Reference.
  27. 27.
    Bondurant FJ, Cotler HB, Kulkarni MV et al (1990) Acute spinal cord injury. A study using physical examination and magnetic resonance imaging. Spine 15(3):161–168CrossRefPubMedGoogle Scholar
  28. 28.
    Kulkarni MV, McArdle CB, Kpanicky D et al (1987) Acute spinal cord injury: MR imaging at 1.5 T. Radiology 164(3):837–843CrossRefPubMedGoogle Scholar
  29. 29.
    Schouman-Claeys E, Frija G, Cuenod CA et al (1990) MR imaging of acute spinal cord injury: results of an experimental study in dogs. AJNR Am J Neuroradiol 11(5):959–965PubMedGoogle Scholar
  30. 30.
    Ramon S, Dominguez R, Ramirez L et al (1997) Clinical and magnetic resonance imaging correlation in acute spinal cord injury. Spinal Cord 35(10):664–673CrossRefPubMedGoogle Scholar
  31. 31.
    Cotler HB, Kulkarni MV, Bondurant FJ (1988) Magnetic resonance imaging of acute spinal cord trauma: preliminary report. J Orthop Trauma 2(1):1–4CrossRefPubMedGoogle Scholar
  32. 32.
    Sato T, Kokubun S, Rijal KP et al (1994) Prognosis of cervical spinal cord injury in correlation with magnetic resonance imaging. Paraplegia 32(2):81–85CrossRefPubMedGoogle Scholar
  33. 33.
    Marciello MA, Flanders AE, Herbison GJ et al (1993) Magnetic resonance imaging related to neurologic outcome in cervical spinal cord injury. Arch Phys Med Rehabil 74(9):940–946PubMedGoogle Scholar
  34. 34.
    Goldberg AL, Rothfus WE, Deeb ZL et al (1988) The impact of magnetic resonance on the diagnostic evaluation of acute cervicothoracic spinal trauma. Skeletal Radiol 17(2):89–95CrossRefPubMedGoogle Scholar
  35. 35.
    Wittenberg RH, Boetel U, Beyer HK (1990) Magnetic resonance imaging and computer tomography of acute spinal cord trauma. Clin Orthop Relat Res 260:176–185PubMedGoogle Scholar
  36. 36.
    Schaefer DM, Flanders A, Northrup BE et al (1989) Magnetic resonance imaging of acute cervical spine trauma. Correlation with severity of neurologic injury. Spine 14(10):1090–1095CrossRefPubMedGoogle Scholar
  37. 37.
    Kriss VM, Kriss TC (1996) SCIWORA (spinal cord injury without radiographic abnormality) in infants and children. Clin Pediatr (Phila) 35:119–124CrossRefGoogle Scholar
  38. 38.
    Manary MJ, Jaffe DM (1996) Cervical spine injuries in children. Pediatr Ann 25:423–428CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of Diagnostic Radiology, Institution for Clinical Sciences/RadiologyLund UniversityLundSweden
  2. 2.Department of RadiologyThomas Jefferson University HospitalPhiladelphiaUSA

Personalised recommendations