Cervical Dislocation Fracture – Part IV – Rehabilitation and Life After Injury

Orthopaedic & Spine Center

Mark W. McFarland, DO

After the emergent phase of injury and the immediacy of treating life-threatening injuries, after the surgeries have been performed and the subsequent acceptance of a new way of life, comes the challenge – living life after a cervical dislocation fracture.  In this article, I’d like to address those realities, but also the hope and inspiration that exists for those who are facing this future or for those who care for and live with them.

Soon after the traumatic injury occurred, I or another physician would have assessed the patient using the ASIA (American Spinal Injury Association) Impairment Scale, which gives a grade of A-E, for neurologic injury.  A indicates a total loss of function and E indicates no loss of function.  These assessments will take place throughout the patient’s rehabilitation and life.

The higher on the spinal cord that the injury occurs, the more neurologic dysfunction may be present. As a result, patients and their families can expect the following may result from their cervical dislocation fracture at these levels:

High Cervical Nerves (C1-C4)

  • Patient will have tetraplegia or quadriplegia
  • Patient will require complete assistance with ADLs (eating, dressing, getting in and out of bed, bathing)
  • Patient will require 24/7 personal care
  • May be able to use specially equipped breath/mouth powered wheelchairs
  • Cannot drive a car
  • Patient will have no control over bowel or bladder

Low Cervical Nerves (C5-C8)

C5C6

  • Patient will have tetraplegia or quadriplegia
  • Patient will require assistance with ADLs
  • Patient will be able to navigate independently in a power wheelchair
  • Patient may be able/can move themselves in and out of bed and wheelchair with assistive equipment
  • Patient will have no control over bowel or bladder, but can manage with special equipment
  • May be able to drive an adapted vehicle

C7-C8

  • Patient will have tetraplegia or some quadriplegia
  • Patient can do ADLs except for most difficult tasks
  • Patient will be able to navigate independently in a power wheelchair
  • Patient can move themselves in and out of bed and wheelchair with assistive equipment
  • Patient will have no control over bowel or bladder, but can manage with special equipment
  • May be able to drive an adapted vehicle

In 2022, the outlook for patients who have neurological deficits from cervical dislocation fractures has never been better, because of the amount of research that is been done on so many fronts. Pioneers like Christopher Reeves, (aka, Superman), who was a quadriplegic, helped researchers by volunteering for extensive physical therapy studies and workouts designed to help his body regenerate nerves.

Research into the use of stem cells to regenerate damaged neurons has shown promise.  Electric cell signaling is showing great results in stimulating nerve growth.  The use of bionics and computer-assisted devices is allowing more freedom for those who had previously been bedridden, or wheelchair bound.