Broken neck

A broken neck is a fracture of one or more cervical vertebrae. Breaking your neck can be fatal, but fortunately this is certainly not always the case! This mainly depends on the location and severity of the fracture. A broken neck can cause serious problems such as paralysis. It is important to act quickly in the case of a broken neck.

The neck region (cervical spine) consists of seven vertebrae. The first two cervical vertebrae together form a separate joint. The second cervical vertebra is also called the ‘axis’ and plays an important role in turning the head, such as shaking the head to say no.

How does a broken neck occur?

A broken neck is the result of an accident (trauma) or a disease. A traumatic neck fracture almost always occurs due to a hard blow, a fall from a height, or a high-speed collision. In rare cases, a sudden severe twisting of the neck leads to a fracture.

In a non-traumatic fracture, it is usually unclear how the fracture occurred. This is also called a pathological fracture because the fracture may be caused by an underlying disease. This fracture is usually a result of bone loss (osteoporosis) or bone cancer. Due to these diseases, bone quality decreases, and the bone sometimes breaks even with a small blow, collision, or sudden twisting movement.

Characteristics of a broken neck

Several symptoms can occur with a broken neck. There is almost always immediate severe pain in the neck and possibly also in the upper back or shoulders. If broken bone fragments in the neck shift, this can have serious consequences. There is then a risk that bone fragments will damage the spinal cord or nerve tissue.

Damage to or entrapment of the spinal cord or nerves causes pain or altered sensation in one or both arms. Examples include tingling, numbness, loss of strength, and/or paralysis.

In extreme cases, the displaced bone fragment completely cuts through the spinal cord. This is called a spinal cord injury. This damage is irreversible and causes sensory changes and paralysis in the arms, legs, and trunk.

Hangman’s fracture

A hangman’s fracture is another term for a fracture of the second cervical vertebra. This fracture got its name because it is often the result of a suicide attempt by hanging. The exact cause of the fracture is a sudden severe hyperextension of the neck.

Other causes of a fracture of the second cervical vertebra are a traffic accident or a hard blow to the neck. The second cervical vertebra is the most vulnerable cervical vertebra. In almost half of cases, the second cervical vertebra is broken.

How is a broken neck diagnosed?

If a broken neck is suspected, extensive tests are performed. This usually begins with a röntgenfoto. The radiologist then assesses whether there is a fracture and a possible displacement of bone fragments. A röntgenfoto can also provide important information about a pathological fracture. The bone density and possible presence of bone cancer are then assessed on the röntgenfoto.

To further examine bone density in the case of bone loss, a DEXA scan is performed if necessary. If there is also radiating pain and/or signs of paralysis, an MRI scan is made. This shows any damage to the nerve tissue or spinal cord.

Treatment of a broken neck

In the case of a broken neck, treatment starts immediately. It is important that the neck no longer moves and is supported right away. Usually this is done with a hard cervical collar or neck brace. This reduces the chance that bone fragments will shift and cause more damage. The brace also reduces pressure on the nerve tissue and spinal cord. A broken neck always requires hospitalization.

If the surgeon decides not to operate, then wearing a hard cervical collar for at least six weeks is sufficient to allow the fracture to heal. If surgery is needed, the surgeon repairs the broken bone fragments with plates and screws.

After surgery or a period of rest, it is time to restore neck mobility and strength. It is advisable to do this under the guidance of a physical therapist. The physical therapist helps establish rules for daily life and gives movement advice. Other treatment methods the physical therapist may use are massage, mobilizations, and exercise therapy.