The American journal of sports medicine
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Case Reports
Axial loading injuries to the middle cervical spine segment. An analysis and classification of twenty-five cases.
Injuries to the cervical spine at the C3-C4 level involving the bony elements, intervertebral disks, and ligamentous structures are rare. We present 25 cases of traumatic C3-C4 injuries sustained by young athletes and documented by the National Football Head and Neck Injury Registry. Review of the cases reveals that the response of energy inputs at the C3-C4 level differ from those involving the upper (C1-C2) and lower (C4-C5-C6-C7) cervical segments. ⋯ The other four patients, two who underwent an open reduction and laminectomy and two treated closed with skeletal traction, remained quadriplegic. In the four instances of bilateral facet dislocation where reduction was achieved by either closed or open methods, although there was no neurologic recovery, all four patients survived their injuries. However, the three patients who were not successfully reduced died.