Cervical Trauma by Robert F. Heary;

Author:Robert F. Heary; [Неизв.]
Language: eng
Format: epub
Publisher: Thieme Medical Publishing Inc.
Published: 2019-08-08T20:00:00+00:00

14.3.4 Cervical Cord Neurapraxia or Transient Quadriplegia

Distinct from burners, a traumatic injury to the neck may result in transient bilateral or sensory or motor deficits which has been termed cervical cord neurapraxia or transient quadriplegia. Neurological symptoms involving more than one extremity should prompt concern for spinal cord involvement. Cervical spinal cord neurapraxia has been estimated to occur in 7 per 10,000 football players. 21 It is thought to be the result of transient spinal cord compression or concussive cord injury causing physiologic conduction block without anatomic disruption of neuronal tracts. Episodes can last from minutes to several days. 22 These injuries may occur from momentary cord compression endured during extreme neck flexion or extension. Hyperextension can cause an inward buckling of the ligamentum flavum resulting in cord compression.

Transient quadriplegia may herald an underlying anatomic abnormality such as congenital, developmental, or degenerative cervical stenosis (▶ Fig. 14.3). Athletes may also have congenital conditions such as Klippel–Feil syndrome which refers to a failure of cervical vertebral segmentation, resulting in a reduced number of segments among which to dissipate load. 23,24 This predisposes the spine to traumatic injury. Developmental dens hypoplasia, or os odontoideum, may contribute to atlantoaxial instability and increase the risk for traumatic upper cervical SCI. Of note, regardless of the presence of transient quadriplegia, both Klippel–Feil syndrome and dens hypoplasia are absolute contraindications to participation in contact sports. Horizontal C3–C4 cervical facet orientation and relative hypermobility of the neck in extension have also been implicated as contributing factors for transient quadriparesis. 25

Download

Copyright Disclaimer:
This site does not store any files on its server. We only index and link to content provided by other sites. Please contact the content providers to delete copyright contents if any and email us, we'll remove relevant links or contents immediately.