Cervical spine injury patterns in three modes of high-speed trauma: a biomechanical porcine model

Cervical spine fractures and dislocations account for a large number of deaths and disabilities in the United States each year. More knowledge of the anatomic injuries produced by known trauma may yield practical information regarding injury mechanisms and treatment alternatives. In this experiment, 16 porcine cervical spine three-vertebrae segments were subjected to flexion-compression, extension-compression, and compression-alone trauma modes. The resultant injuries were scored by anatomic dissection. The results were analyzed for variance with trauma mode using nonparametric analysis. The three modes of trauma were found to have statistically significant differences in the degree of injury to the spine and its structural components. Extension-compression trauma produced the greatest injury scores to the whole spine and to the anterior structures. Flexion-compression trauma produced the highest posterior element injury scores. Compression trauma alone produced the lowest injury scores and no definitive pattern of anatomic injuries. The severity of anatomic injuries in this model relates most to the addition of bending moments to high-speed axial compression of the spine segment.