Cervical Dislocation Fracture – Part II – The Symptoms

Orthopaedic & Spine Center

Mark W. McFarland, DO

In part one of this article series, we discussed what a cervical dislocation fracture is, how it can happen and exactly how serious of an injury it can be.  In part two, I’d like to discuss the symptoms of a cervical dislocation fracture and how a tiny distance can make a huge difference when it comes to the level of the spinal cord and nerve roots that are injured.

A patient with a cervical dislocation fracture at levels C1-C4 will display these symptoms:

  • Catastrophic paralysis which may involve the face, neck, chest, trunk, arms, hands, legs
  • Inability/difficulty breathing without assistance
  • Sometimes, inability/impaired speaking
  • Loss of bladder and bowel control
  • Inability/difficulty coughing

A patient with a cervical dislocation fracture at level C5:

  • May be able to breathe (weakened) and speak normally
  • Can bend their elbows and lift their arms
  • Wrists and hands and lower body will still have some or total paralysis

A patient with a cervical dislocation fracture at level C6:

  • Will have paralysis in hands, trunk, and legs, but can bend wrists back
  • Can speak normally and use diaphragm, breathing is still weakened
  • Voluntary bladder and bowel control is still absent, but may be able to manage on their own with special equipment

A patient with a cervical dislocation fracture at level C7:

  • Will be able to normally move their shoulders
  • Most can straighten their arms
  • Will be able to have some elbow and finger extension
  • Voluntary bladder and bowel control is still absent, but may be able to manage on their own with special equipment
  • Paralysis still exists in hands, trunk, and legs

A patient with a cervical dislocation fracture at level C8:

  • Will have some hand movement and can grasp and release objects
  • Voluntary bladder and bowel control is still absent, but may be able to manage on their own with special equipment
  • Paralysis still exists in trunk and legs

We’ve discussed before how the body is controlled by the brain, which communicates through the “information highway” of the spinal cord and the nerves which emanate from it to all parts of the body.  So, when a catastrophic injury occurs that basically shuts down that highway, breaks the highway in pieces or puts pieces of debris in the highway, as a spine surgeon, I must figure out the best way to allow that information to flow again safely. That may be with surgery, to repair the broken pieces and align them, or I may have to remove boney debris.  I may need to treat swelling and inflammation with drugs so that the delicate spinal cord and nerves aren’t damaged further. These patients may also be on life support (ventilator) to help them breathe or may have other serious injuries that have to be prioritized according to severity.

Understanding the above symptoms and their corresponding levels of spinal injury, along with diagnostic imaging, help me to put together the best treatment plan for my patient, to ensure that they have the best chance for healing from their devastating injury. By stabilizing their broken spinal bones and providing anti-inflammatory support, we give the spinal cord and nerves the opportunity to regenerate and start communicating with the body again.

In the next article, I’ll discuss the actual in-hospital treatment that occurs for a cervical dislocation fracture, including surgery.