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Pol. Merkur. Lek (Pol. Med. J.), 2020, XLVIII/288: 410-414 Maximize

Pol. Merkur. Lek (Pol. Med. J.), 2020, XLVIII/288: 410-414

Title: Analysis of neurological symptoms and mechanisms in dislocation, sprains and strains of joints and ligaments at neck level 

Authors: Jarzyński T, Pękala P, Baranowska A. 

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Analysis of neurological symptoms and mechanisms in dislocation, sprains and strains of joints and ligaments at neck level

Jarzyński T, Pękala P, Baranowska A.

Department of Orthopedics, Mazovian Rehabilitation Center STOCER, Konstancin-Jeziorna, Poland

Spinal injuries can be divided into contusions, sprains of intervertebral joints, their dislocation and also damage to ligaments and muscles attachment, and fractures. Typical injuries of the cervical spine include trauma caused by a rapid hyperextension of the neck with the following hyperflexion, often referred to as „whiplash” injury, mostly as a result of traffic accidents. The annual incidence is estimated to be up to 600 per 100 000 inhabitants of Western Europe and North America. The most frequent sprain and strain injuries concerns patients aged 21-60 years. The clinical picture in the course of whiplash injury can be miscellaneous. The most frequent accompanying symptoms are neck pain with restricted mobility, headache and neurological symptoms.
The aim of the study
was to analyze the mechanisms of trauma, possible complications and analysis of physical examination in patients after cervical sprains, strains and dislocations treated in Mazovian Rehabilitation Center STOCER.
Material and methods
. The basis for the analysis was a database of 10 587 traumatic patients who reported to the Emergency Department (ED) of the Mazovian Rehabilitation Center STOCER from 1 January 2017 to 31 December 2017. 340 patients with whiplash injury of the cervical spine depending on the mechanism of trauma were selected from the database. Patients with accompanied by atlantoaxial complex injuries were excluded. In summary 307 patients were included to the analysis. The examined group of patients was divided according to the therapeutic management, including neurological complications.
Results
. We analyzed 307 patients with cervical trauma. 24 patients required admission to the Neuroortopaedic Department. 22 patients underwent surgical treatment. There was a significant correlation between cervical sprains and age of the patient. The indications for hospitalization was spine instability complicated by spinal dislocation or subluxation. Neurological complications were presented in 6.84% of patients with cervical sprains.
Conclusions
. Patients with cervical sprains injuries represent 3.21% of all patients reporting for ED. They also represent 8% of all traumatic admissions to the Neuroortopedic Department. Cervical sprains affect a similar percentage of women (48.21%) and men (51.79%). The most common causes are those related to traffic accidents. 71.34% of cases are drivers or passengers involved in such an accident. Neurological symptoms are found in 6.84% of patients with cervical sprains. No new neurological symptoms have appeared in any patient since admission to the ED or Neuroortopaedic Department. Axial compression is not diagnostic for cervical sprains and does not correlate with the severity of injury.

Key words: cervical sprains, strains, whiplash

Pol Med J, 2020; XLVIII (288); 410–414