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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 |