An 85 year old female presented to the emergency department with neck pain after a single car motor vehicle collision where she lost control and struck a tree at 45 mph. She complained of minor diffuse pain on examination but had no gross abnormalities. Radiographs showed a compression fracture of the cervical spine without instability, which is typically treated non-operatively with pain management, early ambulation in a hyperextension orthosis, and avoidance of compression overloads for 12 weeks as an outpatient.

2.  85 yo elderly female
presents to ED w/ neck
pain after single car mvc. Pt
lost control striking tree at
45 mph. Denies LOC.
Short extrication from
vehicle. Pt c/o minor
diffuse pain. No gross
abnormalities.
 T 98.7 P 78 BP 115/68




O2 98% RA RR 18
Gen: WDWN, mild distress
HEENT: bruising to
face, PERRL, EOMI
Back: mild midline cervical
tenderness, no bony
abnormalities or step offs
Neuro: 5/5 strength
throughout, pt moves all
extremities well

3. Copyright © 2009 Heidi & David Nunn
http://imageinterpretation.co.uk/cervical.html

4. • Description
• compression fracture
resulting from flexion.
•
Mechanism
• Anterior or lateral flexion
causing failure of anterior
column
•
Radiographic features
• Buckled anterior cortex.
• Loss of height of anterior
vertebral body.
• Anterosuperior fracture of
vertebral body.
•
Stability
•
© 2000 by the Rector & Visitors of the University of Virginia
http://www.med-ed.virginia.edu/courses/rad/cspine
stable

5.  Non-operative
 Pain management
 Early ambulation in hyperextension orthosis
 Avoidance of compression overloads for 12 wks as an
outpt
http://www.wheelessonline.com/ortho/compression_fractures

6.  Amount of anterior compression should be no more
than 40% relative to posterior body height (otherwise
a burst fx may be present)
http://www.wheelessonline.com/ortho/compression_fractures