Compressive cervical spine injury: the effect of injury mechanism on structural injury pattern and neurologic injury potential

Abstract

Cervical spine trauma resulting in spinal cord injury is a particularly devastating musculoskeletal injury. Every year thousands of individuals are added to the ranks of those afflicted by it. And, the associated socioeconomic costs are extremely high. Researchers have put forth a considerable amount of effort to better understand, prevent, diagnose, and treat these injuries. However, some would argue that progress is hampered by difficulties and inconsistencies in communication among researchers. Specifically, there is no universally accepted method for classifying cervical spine injuries. Arguably the most commonly used classification is the "mechanistic classification," which describes injuries based on the mechanisms responsible for producing them. Although, the mechanistic classification is commonly used, its fundamental hypothesis that different injury mechanisms produce distinct injury patterns classifiable by mechanism alone remains untested. Furthermore, the relationship between injury mechanism and neurologic injury potential, which would make a valuable addition to the mechanistic classification, remains unexplored. Therefore, the objective of this research was to investigate the effect of compressive cervical spine injury mechanisms on structural injury patterns and neurologic injury potential. The results demonstrate that different compressive injury mechanisms produced distinct injury patterns. And, that the injury patterns are accurately classifiable by the mechanism responsible for creating them. The results also suggest that neurologic injury potential is not significantly affected by injury mechanism in compressive cervical spine trauma. In addition, this study resulted in the development of a Quantitative Mechanistic Classification scheme. This classification scheme provides a way to classify an injury pattern by the mechanism that created it using the intact/injured status of a small subset of the structures comprising the cervical spine.