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Cervical Hyperextension Injuries

Shane L. Larson, MD and Brock A Benedict, D.O. Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Class of neck injuries typically seen in rapid, forceful extension of the cervical spine

  • Flexion–extension injuries (“whiplash”) are usually from motor vehicle accidents (MVAs).

  • Other ...

DIAGNOSIS

HISTORY

Usually acute presentation with mechanism of cervical hyperextension and complaints of neck pain, stiffness, or headaches ± neurologic symptoms; include Glasgow Coma Scale (GCS) 

PHYSICAL EXAM

TREATMENT

GENERAL MEASURES

  • Whiplash/WAD

    • Limited or no benefit to cervical collar. If provided, use for <72 hours.

    • No advantage to engaging early multiprofessional intervention (e.g., pain management a...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Follow patients with known injuries using serial imaging under the care of a specialist. 

PATIENT EDUCATION

ThinkFirst Foundation: http://www.thin...

REFERENCES

1
Jara-Almonte G, Pawar C. Emergency department management of cervical spine injuries. Emerg Med Pract. 2021 Oct;23(10):1-28. 
2
Masson de Almeida Prado R, Masson de Almeida Prado JL, Ueta RHS...

ADDITIONAL READING

  • Puvanesarajah  V, Qureshi  R, Cancienne  JM, et al. Traumatic sports-related cervical spine injuries. Clin Spine Surg.  2017;30(2):50–56. [View Abstr...

CODES

ICD10

  • S13.4XXA Sprain of ligaments of cervical spine, initial encounter

  • S13.101A Dislocation of unspecified cervical vertebrae, init encntr

  • S14.109A Unsp injury at unsp level of cervical spinal cor...

CLINICAL PEARLS

  • Use NEXUS or CCR to determine need for imaging in every patient with a potential neck injury.

  • Always perform imaging if clinical judgment suggests the need to do so.

  • Inquire about preexi...

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