+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Vertebral artery injuries following cervical spine trauma: a prospective observational study



Vertebral artery injuries following cervical spine trauma: a prospective observational study



European Spine Journal 20(12): 2202-2209



The purpose of this study was to report on the incidence, diagnosis and clinical manifestation of VAI following cervical spine injuries observed in a prospective observational study with a standardized clinical and radiographical protocol. During a 16-year period, 69 (mean age: 43 ± 20.7 years; 25 female, 44 male) of 599 patients had cervical spine injury suspicious for VAI due to facet luxation and/or fractures extending into the transverse foramen. Diagnosis and management of these patients followed a previously published protocol (Kral in Zentralbl Neurochir 63:153-158, 2002). Digital subtraction angiography (DSA) was performed in all 69 patients. Injury grading of VAI was done according to Biffl et al. (Ann Surg 231:672-681, 2000). All patients with VAI were treated with anticoagulation (heparin followed by ASS) for 6 months. In cases suspicious for VAI, the incidence of VAI detected by DSA was 27.5% (n = 19 of 69 patients). VAI Grade I occurred in 15.8%, Grade II in 26.3%, Grade IV in 52.6% and Grade V in 5.2%. Of 19 patients, 4 (21%) had clinical signs of vertebrobasilar ischemia. Two patients died in hospital after 4 and 21 days respectively. Of 69 patients, 33 (47.8%) with suspected VAI had unstable spine injuries and were treated surgically. In patients with cervical spine fractures or dislocations crossing the course of the vertebral artery, VAI are relatively frequent and may be associated with significant morbidity and mortality. VAI were identified by DSA in 27.5%. Despite anticoagulation therapy, 5.8% became clinically symptomatic and 2.9% died due to cerebrovascular ischemia.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 036139749

Download citation: RISBibTeXText

PMID: 21717238

DOI: 10.1007/s00586-011-1887-2


Related references

Vertebral artery injury after cervical spine trauma: a prospective study. Zentralblatt für Neurochirurgie 63(4): 153-158, 2003

Vertebral artery injury after cervical spine trauma: A prospective study using computed tomographic angiography. Surgical Neurology International 2: 39, 2011

Traumatically induced vertebral artery occlusion associated with cervical spine injuries: prospective study using magnetic resonance angiography. Spine 30(17): 1955-1962, 2005

The presence of nonthoracic distracting injuries does not affect the initial clinical examination of the cervical spine in evaluable blunt trauma patients: a prospective observational study. Journal of Trauma 71(3): 528-532, 2011

Risk factors for vertebral artery injuries in cervical spine trauma. Orthopedic Reviews 6(3): 5429, 2014

Closed cervical spine trauma associated with bilateral vertebral artery injuries. Archives of Orthopaedic & Trauma Surgery 119(7-8): 478-481, 1999

Injuries to the cervical spine causing vertebral artery trauma: case reports. Journal of Trauma 31(1): 127-133, 1991

Vertebral artery occlusion associated with cervical spine trauma. A prospective analysis. Spine 22(2): 188-192, 1997

Long-term evaluation of vertebral artery injuries following cervical spine trauma using magnetic resonance angiography. Spine 23(7): 789-94; Discussion 795, 1998

To screen or not to screen: vertebral artery injuries in blunt cervical spine trauma. World Neurosurgery 80(3-4): 309-310, 2013

Value of complete cervical helical computed tomographic scanning in identifying cervical spine injury in the unevaluable blunt trauma patient with multiple injuries: a prospective study. Journal of Trauma 47(5): 896-902; Discussion 902-3, 1999

Vertebral artery injuries associated with cervical spine injuries: a review of the literature. Journal of Spinal Disorders and Techniques 21(4): 252-258, 2008

Cervical spine trauma: a cause of vertebral artery injury. Journal of Trauma 20(10): 904-905, 1980

Vertebral artery injury in cervical spine trauma. Injury 32(7): 565-568, 2001

Vertebral artery injuries in cervical spine surgery. Spine Journal 14(8): 1520-1525, 2014