Broken neck

A broken neck is a fracture of one or more cervical vertebrae. Breaking your neck can have a fatal outcome, 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 case of a broken neck.

The neck region (cervical spine) consists of seven vertebrae. The first two cervical vertebrae together form a special joint. The second cervical vertebra is also called the 'axis' and plays an important role in rotating the head, such as when shaking your 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 arises from a hard blow, a fall from a height or a high-speed collision. In rare cases a sudden severe twist of the neck leads to a fracture.

With a non-traumatic fracture it is usually unclear how the fracture arose. We also call this a pathological fracture. This is because the fracture may have been caused by an underlying disease. Usually this fracture is a result of osteoporosis or bone cancer. Due to these diseases the bone quality decreases and the bone sometimes breaks even after a small knock, collision or sudden twisting movement.

Characteristics of a broken neck

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

Damage or entrapment of the spinal cord or nerves causes pain complaints or altered sensation in one or both arms. Examples are tingling, numbness, weakness and/or paralysis.

In extreme cases the displaced bone fragment completely cuts through the spinal cord. There is then a spinal cord injury. This damage is irreversible and causes altered sensation 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 has been given this name because it is often the result of a suicide attempt by hanging. The precise cause of the fracture is a sudden severe overstretching 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 the cases the second cervical vertebra is broken.

How is a broken neck diagnosed?

If a broken neck is suspected, extensive examination is carried out. This usually starts with an X-ray. The radiologist then assesses whether there is a fracture and a possible displacement of bone fragments. An X-ray can also provide important information about a pathological fracture. The X-ray is then used to assess bone density and the possible presence of bone cancer.

To further investigate bone density in the case of osteoporosis, a DEXA scan is made if necessary. If there is also radiating pain and/or signs of paralysis, an MRI scan is performed. 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 straight away. Usually 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 the pressure on the nerve tissue and spinal cord. A broken neck always requires hospital admission.

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

After the operation or period of rest, it is time to restore neck mobility and strength. It is sensible to do this under the guidance of a physiotherapist. The physiotherapist helps with setting rules for daily life and gives exercise advice. Other treatment forms the physiotherapist may use are massage, mobilisations, and exercise therapy.