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Published on: January 5, 2015
Cervical Spine Immobilisation Following Stab Wounds to the Neck Is Unnecessary
Leon Kong1, Victor Kong2,3,4, Jonathan Ko2
1Department of Surgery, Waikato Hospital, Hamilton, New Zealand.
Objective:
This study reviews our experience with penetrating neck injury (PNI) secondary to a stab wound (SW) to clarify the incidence of cervical spinal injury (CSI) and to interrogate the role of cervical spinal motion with cervical collar in these patients.
Methods:
A retrospective review of a prospectively captured data set was conducted at the Pietermaritzburg Metropolitan Trauma Service in South Africa from December 2012 to December 2022. All patients who presented with a PNI due to a SW were included.
Results:
There were 1249 cases of PNI over the 10 year study period. 1028 were due to a SW and 90% were male. The mean age 30 years. The zonal distribution of the external wounds was were 329 (32%) in zone 1, 469 (46%) in zone 2, 164 (16%) zone 3 and 162 (16%) in the posterior triangle of the neck. In eighty two (8%) cases a CSI was sustained. In none of these cases was the CSI unstable. Twenty two (22) patients sustained a spinal cord injury and presented with a neurological deficit.
Conclusions:
While there is a significant incidence of spinal cord injury after a cervical SW, there is a very low incidence of cervical spine instability requiring spinal fixation. The routine application of cervical collar following a SW to the neck is unnecessary.
