Cervical Lesions and Neurological Deterioration

Risk Factors and Complications

• A missed or delayed diagnosis produces 10 times higher rates of secondary neurological injury (10.5% vs. 1.4%) 1
• Up to 4.3% of cervical fractures may be missed, with 67% of these patients suffering neurological deterioration 1
• 29.4% of cases with delayed diagnosis develop permanent neurological deficits 1
• Before widespread adoption of Advanced Trauma Life Support guidelines, up to 10% of initially neurologically intact patients developed deficits during emergency care 1

Imaging and Evaluation

• The American College of Radiology recommends that if the underlying pathology involves the cord, there may be weakness, hyperreflexia, spasticity, and sensory loss in addition to ataxia 2
• Cervical MRI is most sensitive for detecting soft tissue injuries and cord compression, according to Praxis Medical Insights 3
• CT scan has 98% sensitivity for fractures when clinically suspected, as reported by Praxis Medical Insights 3
• Plain radiographs have limited sensitivity (36%) for cervical injuries, as noted by Praxis Medical Insights 3