Many emergency room doctors handle cervical injuries as part of their practice. Fortunately, the incidence of serious neck injuries is not high. The incidence of death and disability, however, is high. This means that ER doctors must have the knowledge and skill to care for patients with neck injuries at a moment’s notice.
Some stable fractures can be treated using a cervical halo that supports the fractured areas until they are healed enough to allow for movement. Unstable fractures may need emergency surgery to repair the fractured areas so as to minimize the neurological deficit. If there are multiply fractured areas, a spinal fusion is done so as to hold together as many bony fracture pieces as possible so that the cervical area is held together as much as possible.
Surgery is advised in displaced fractures or in some situations in which the disc has herniated. Neurological deficits may need surgery to correct them. Any time there are multiple fractured areas, there is an increased incidence of a spinal fusion being needed.
If the treatment involves soft tissue strains alone, the patient often gets better with just ice and/or heat as well as rest, followed by gentle exercises to resolve the injury. The criteria showing a return to normal health involve the following:
- Minimal tenderness or no tenderness
- Neck is straight without pain
- Full range of motion of the neck
- Normal posture
- Normal neurological examination
- No neurological systems