CERVICAL-SPINE INJURIES FROM HIGH-VELOCITY FORCES - A PATHOANATOMIC AND RADIOLOGIC STUDY

The detailed analysis of the radiologic and pathoanatomic data from 10 human cadaver head-neck complexes defined the type and extent of expe cted cervical spine injuries after high-velocity flexion-compression l oads to the cranium. All specimens demonstrated multiple injuries with both contiguous and noncontiguous patterns. Although all preparations showed evidence of axial compression, a multiplicity of other force v ectors, including noncontiguous occurrences of flexion, extension, and shear, were documented. These findings indicate that the injury patte rn is not a sequential process but a reaction to changes in the segmen tal interrelations of the various vertebral column components, includi ng varying vector applications of injurious forces at the segmental le vel. The presence of moderate or severe spondylotic alterations restri cted the distal transmission of injury forces with the principal injur y patterns occurring at or proximal to the initial level of severe spo ndylotic involvement. These data emphasize the need for increased awar eness of the presence of multiple cervical spine injuries, both contig uous and noncontiguous, and that separate levels of compromise may not share similar mechanisms of injury.