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Cervical Hyperflexion Injury
Kevin R. Moore, MD; Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Definitions

              • Injury from cervical hyperflexion with compression or hyperflexion with distraction/shearing

            IMAGING

            • General Features

              • Fluoroscopic Findings

                • MR Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Staging, Grading, & Classification

                          CLINICAL ISSUES

                          • Presentation

                            • Natural History & Prognosis

                              • Treatment

                                Selected References

                                1. Alawadhi A et al: Lateral medullary syndrome due to left vertebral artery occlusion in a boy postflexion neck injury. Child Neurol Open. 6:2329048X19867800, 2019
                                2. Davidson C et al: Traumatic cervical spine injury during sexual activity. J Surg Case Rep. 2019(6):rjz202, 2019
                                3. Gunda D et al: Pediatric central nervous system imaging of nonaccidental trauma: beyond subdural hematomas. Radiographics. 39(1):213-28, 2019
                                4. Yue JJ et al: Teardrop fracture following head-first impact in an ice hockey player: case report and analysis of injury mechanisms. Int J Spine Surg. 10:9, 2016
                                5. Aarabi B et al: Management of acute traumatic central cord syndrome (ATCCS). Neurosurgery. 72 Suppl 2:195-204, 2013
                                6. Berry C et al: Compressive flexion and vertical compression injuries of the subaxial cervical spine. Semin Spine Surg. 25(1): 36-44, 2013
                                7. Gelb DE et al: Initial closed reduction of cervical spinal fracture-dislocation injuries. Neurosurgery. 72 Suppl 2:73-83, 2013
                                8. Hadley MN et al: Introduction to the guidelines for the management of acute cervical spine and spinal cord injuries. Neurosurgery. 72 Suppl 2:5-16, 2013
                                9. Ivancic PC: Neck injury response to direct head impact. Accid Anal Prev. 50:323-9, 2013
                                10. Walters BC et al: Guidelines for the management of acute cervical spine and spinal cord injuries: 2013 update. Neurosurgery. 60 Suppl 1:82-91, 2013
                                11. Ivancic PC: Head-first impact with head protrusion causes noncontiguous injuries of the cadaveric cervical spine. Clin J Sport Med. 22(5):390-6, 2012
                                12. Dusseldorp JR et al: Unrecognized ligamentous instability due to high-energy, low-velocity mechanism of injury. J Clin Neurosci. 17(1):139-41, 2010
                                13. Hoit DA et al: Angiographic detection of carotid and vertebral arterial injury in the high-energy blunt trauma patient. J Spinal Disord Tech. 21(4):259-66, 2008
                                14. Lekovic GP et al: Litigation of missed cervical spine injuries in patients presenting with blunt traumatic injury. Neurosurgery. 60(3):516-22; discussion 522-3, 2007
                                15. Miyanji F et al: Acute cervical traumatic spinal cord injury: MR imaging findings correlated with neurologic outcome--prospective study with 100 consecutive patients. Radiology. 243(3):820-7, 2007
                                16. Bono CM et al: Measurement techniques for lower cervical spine injuries: consensus statement of the Spine Trauma Study Group. Spine (Phila Pa 1976). 31(5):603-9, 2006
                                17. Laporte C et al: Severe hyperflexion sprains of the lower cervical spine in adults. Clin Orthop. (363):126-34, 1999
                                18. Murakami H et al: Central cord syndrome secondary to hyperflexion injury of the cervical spine in a child. J Spinal Disord. 8(6):494-8, 1995
                                Related Anatomy
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                                Related Differential Diagnoses
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                                References
                                Tables

                                Tables

                                KEY FACTS

                                • Terminology

                                  • Imaging

                                    • Top Differential Diagnoses

                                      • Pathology

                                        • Clinical Issues

                                          TERMINOLOGY

                                          • Definitions

                                            • Injury from cervical hyperflexion with compression or hyperflexion with distraction/shearing

                                          IMAGING

                                          • General Features

                                            • Fluoroscopic Findings

                                              • MR Findings

                                                • Imaging Recommendations

                                                  DIFFERENTIAL DIAGNOSIS

                                                    PATHOLOGY

                                                    • General Features

                                                      • Staging, Grading, & Classification

                                                        CLINICAL ISSUES

                                                        • Presentation

                                                          • Natural History & Prognosis

                                                            • Treatment

                                                              Selected References

                                                              1. Alawadhi A et al: Lateral medullary syndrome due to left vertebral artery occlusion in a boy postflexion neck injury. Child Neurol Open. 6:2329048X19867800, 2019
                                                              2. Davidson C et al: Traumatic cervical spine injury during sexual activity. J Surg Case Rep. 2019(6):rjz202, 2019
                                                              3. Gunda D et al: Pediatric central nervous system imaging of nonaccidental trauma: beyond subdural hematomas. Radiographics. 39(1):213-28, 2019
                                                              4. Yue JJ et al: Teardrop fracture following head-first impact in an ice hockey player: case report and analysis of injury mechanisms. Int J Spine Surg. 10:9, 2016
                                                              5. Aarabi B et al: Management of acute traumatic central cord syndrome (ATCCS). Neurosurgery. 72 Suppl 2:195-204, 2013
                                                              6. Berry C et al: Compressive flexion and vertical compression injuries of the subaxial cervical spine. Semin Spine Surg. 25(1): 36-44, 2013
                                                              7. Gelb DE et al: Initial closed reduction of cervical spinal fracture-dislocation injuries. Neurosurgery. 72 Suppl 2:73-83, 2013
                                                              8. Hadley MN et al: Introduction to the guidelines for the management of acute cervical spine and spinal cord injuries. Neurosurgery. 72 Suppl 2:5-16, 2013
                                                              9. Ivancic PC: Neck injury response to direct head impact. Accid Anal Prev. 50:323-9, 2013
                                                              10. Walters BC et al: Guidelines for the management of acute cervical spine and spinal cord injuries: 2013 update. Neurosurgery. 60 Suppl 1:82-91, 2013
                                                              11. Ivancic PC: Head-first impact with head protrusion causes noncontiguous injuries of the cadaveric cervical spine. Clin J Sport Med. 22(5):390-6, 2012
                                                              12. Dusseldorp JR et al: Unrecognized ligamentous instability due to high-energy, low-velocity mechanism of injury. J Clin Neurosci. 17(1):139-41, 2010
                                                              13. Hoit DA et al: Angiographic detection of carotid and vertebral arterial injury in the high-energy blunt trauma patient. J Spinal Disord Tech. 21(4):259-66, 2008
                                                              14. Lekovic GP et al: Litigation of missed cervical spine injuries in patients presenting with blunt traumatic injury. Neurosurgery. 60(3):516-22; discussion 522-3, 2007
                                                              15. Miyanji F et al: Acute cervical traumatic spinal cord injury: MR imaging findings correlated with neurologic outcome--prospective study with 100 consecutive patients. Radiology. 243(3):820-7, 2007
                                                              16. Bono CM et al: Measurement techniques for lower cervical spine injuries: consensus statement of the Spine Trauma Study Group. Spine (Phila Pa 1976). 31(5):603-9, 2006
                                                              17. Laporte C et al: Severe hyperflexion sprains of the lower cervical spine in adults. Clin Orthop. (363):126-34, 1999
                                                              18. Murakami H et al: Central cord syndrome secondary to hyperflexion injury of the cervical spine in a child. J Spinal Disord. 8(6):494-8, 1995