The injury of the posterior support complex of cervical spine for whiplash trauma

Abstract

Introduction. The urgency of this problem is caused by the complexity of visualizing the injuries of the posterior support complex of cervical spine (CS). A delay in diagnosis can lead to chronic pain syndrome, CS instability, manifestation of degenerative-and-dystrophic changes, and neurological deficit which aggravate the trauma clinical course and prevent patient’s proper rehabilitation.
Purpose. To analyze the long-term results of treating patients with CS posterior support complex injury in case of trauma whiplash mechanism.
Materials and Methods. The long-term results of treatment evaluated in 25 patients with CS posterior support complex injury who had trauma whiplash mechanism after road traffic accident without direct impact of the neck with analyzing clinical and X-ray data.
Results. All 25 patients started to work at 6 weeks after trauma, and they had no CS-related complains and symptoms. The range of motion in all the patients was 16-18 points that considered as a good result. Degenerated changes at the level of С5-С6, С6-С7 discs observed in 4 (16 %) cases. Consolidation of spinous process fractures occurred in all the cases. Ossification of supraspinous and interspinous ligaments at the level of the spinous process consolidated fractures observed in 17 (68 %) cases, as well as mild-degree disorder of functional adaptation according to Neck Disability Index found.
Coclusion. The involvement of the posterior support complex occurs in case of whiplash trauma during road traffic accidents. Radiography should be performed in three views, and it is possible to use CT scans in some cases as a standard diagnostic algorithm in order to rule out CS involvements in patients with whiplash trauma. Conservative treatment of patients with such injuries allows to obtain favorable results.