Treatment of Neck Injuries in Musical Performers

Diagnostic Imaging

• CT angiography (CTA) is the first-line imaging modality for evaluating neck injuries when immediate surgical intervention is not required, with high sensitivity (90-100%) and specificity (98.6-100%) for detecting vascular injuries 1
• MRI is valuable for evaluating spinal cord injury, traumatic disk injury, ligamentous injury, and blood within the spinal canal in stable patients 1, 2

Treatment Algorithm

Phase 1: Pain Reduction and Acute Management

• For unstable patients with hard signs (active hemorrhage, expanding hematoma, hemodynamic instability), immediate surgical exploration is indicated 2, 3
• For stable patients with soft signs (nonpulsatile hematoma, dysphonia, subcutaneous emphysema), imaging-guided management is appropriate 2, 4

Phase 2: Rehabilitation

• Neck muscle strengthening exercises are associated with reduced head impact magnitude, and are a key component of physical therapy 5
• Implementation of specific neck muscle training programs as part of a comprehensive neuromuscular training approach can help prevent injuries 5

Prevention Strategies

• The American College of Sports Medicine recommends regular physical fitness activities, such as exercise 1-3 days per week, to help prevent neck injuries in musicians 5
• Education about proper technique, especially for activities that place stress on the neck, can help prevent injuries 5