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168
CHAPTER 7
INJURIES TO THE NECK (CERVICAL SPINE)
D F Graham
INDEX
41. Introduction
The main principles.
42. Definition and nomenclature
43. Incidence and prevalence
44. Statistical methodology and the validity of published research reports
45. The Biomechanics of the Acute Cervical Sprain Injury
Rear impact; linear and rotational forces; frontal impact; forces involved; seat belts; head restraints; impact velocity; summary.
46. Pathogenesis
Extension; flexion; lateral flexion; shearing stresses to discs.
47. Pathology
The muscles; the ligaments; the intervertebral discs; the zygapophyseal or facet joints; the cervical spine, atlas, axis and base of skull; other tissues; pre-vertebral haematoma; tinnitus, dizziness and vertigo; devastating spinal cord injury; the brain; the temporo-mandibular joint; the role of trigger points in fibromyalgia and myofascial pain; summary.
48. The Clinical Presentation
The acute symptoms; continuing symptoms; neck pain; referred pain; discal pain; headaches; paraesthesia; weakness; dizziness; vertigo; visual disturbance; concentration and memory disturbance; psychological symptoms; neurosis, summary.
49. Accident and Emergency
The Quebec classification of Whiplash Associated Disorder; Grade 0 patients; Grade 1 patients; Grade 2-3 patients; Grade 4 patients.
50. Investigation
X-rays; the lateral view; oblique and flexion/extension views; tomograms; radiation; computerised tomog raphy CAT and MRI scans.
51. Treatment
Reassurance; medications; mobilisation; conservative management; collars; neck