Cervical sprain

Cervical sprain is an injury common in road accidents or in trauma by falling. Ligament sprain is an injury and the diagnosis of cervical sprain involves damage to ligaments and capsular structures connecting the joint faces and cervical vertebrae. A neck sprain is difficult to distinguish from a neck muscle tension, and the two injuries frequently occur simultaneously. Cervical lesions occur in 15% of footballers, more frequently in the defensive line. Sports accidents are in second place after the road as the cause of cervical sprain.
The clinical picture in cervical sprain is similar to that of all injuries musculotendinoase. Pain and stiffness are the main complaints.The patient complains of stiff neck, sore throat located. At the time of injury or the patient may experience pain, this drop to several minutes. Pain and swelling are visible as blood builds up in muscle fibers. Neck movements are painful. Irradiation shoulder pain or occipital region is common, but no numbness in my arms.
All patients involved in road accidents receive cervical collar prior to transport to hospital. Controls therapy relieves pain and inflammation through application of local ice compresses, administration of anti-inflammatory and analgesics, muscle relaxants. Relative rest is recommended the region involved, the specific physical therapy, stabilization.Mortality is rare if not associated brain or spinal trauma, vascular lesions, or respiratory compromise. Morbidity includes neck pain syndromes, disability in acute and chronic sprains.
Pathogenesis and causesIt is one of the most common musculoskeletal problems encountered. One of the reasons is its acceleration and deceleration. Represents an accidental injury to passengers motor vehicles.
The mechanism of acceleration and deceleration:At the moment of impact before the vehicle suddenly accelerates to over 100 m following the direction of the trunk and shoulders patient induced a similar acceleration of the car seat. Patient's head, on which no force acts not remain static in space. It follows the forced extension of the neck, shoulders as they head before an anterior direction. With this extension is outdated and that the inertia of the head accelerates forward. Thus forcing the neck and head acceleration increased flexion. Cause damage to the frontal impact of C2-3, C4-5 and C6-7 and C7-T1.Impact forces involved meet with a speed of 32 kilometers per hour cause the human head acceleration of 12 G during extension.If the head is a rotating light head impact forces on the rear wing rotation before extension, and stress as cervical structures zigoapofizeala joint capsule, intervertebral discs and Alar ligament complex.
Signs and symptoms of cervical sprainThe patient complains of stiff neck, sore throat located. At the time of injury or the patient may experience pain, this drop to several minutes. Pain and swelling are visible as blood builds up in muscle fibers. Neck movements are painful. Irradiation shoulder pain or occipital region is common, but no numbness in my arms.Torticollis can be observed on physical examination. Stretching the affected muscle movements that produce or ligaments is limited.Palpation of the affected area shows sensitivity. Pain during rotation, flexion or extension against a resistance indicates that inflammation or destruction of muscle fibers.
Cervical spine sprain physical exam:Cervical-tissue swelling is common in cervical sprain, is palpeaza a swelling in the posterior neck musclesCervical-tissue texture changes occur: viscosity, hardness, increased muscle tensionWarmth is felt by local tissue inflammationThe apparent limit of normal cervical spine motion-Root signs are present when practiced Spurling maneuver (compression of the cervical spine under pressure), reproduction of symptoms suggesting incarceration nerve root compression by herniated disc or arthritic changes than a sprain.Classification of severity of cervical sprains:0-no blame on the neck or physical signs1-pain in the neck, stiffness or tenderness only, with no other signs2-blame and musculoskeletal signs (decreased range of motion of the neck and tenderness in certain points)3-blame and neurological signs (weakness, sensory and reflex changes)4 allegations fracture and / or dislocation.
Most encountered symptoms are headache and sore throat suboccipitala induced motion. Neck pain at the time of the accident is minimal and at 12-72 hours after its debut. Headache is a common symptom. Increased muscle tone is observed on palpation. Other accused include signs and symptoms: dizziness, blurred vision, pain in shoulders, tinnitus weakness or heaviness in arms, tingling and numbness in arms, pain disorders due somului.Impaired memory and intellectual concentration of power still remains misunderstood.
Complications of cervical sprain:-Mieloradiculopatia is a complication of cervical flexion-extension in patients with spondylosis-Spinal compression is rare but can cause cvadriparezaDisc-herniation 2 years after accidentDiscoligamentare-injuryRing-cracks before Alar portion of the posterior longitudinal ligamentJoints, fractures, intra-articular meniscus contusion.Disease progression:Mortality is rare if not associated brain or spinal trauma, vascular lesions, or respiratory compromise. Morbidity includes neck pain syndromes. disability in acute and chronic sprains.Long-term complications include chronic pain, headaches, depression, disability. In patients with chronic symptoms that do not respond to salvage therapy progressive articular injections zigoapofizeale help identify a treatable process by radiofrequency denervation.