Unstable Cervical Spine Fracture (Neck Fracture)

What Is It?

A cervical spine fracture is a break or crack in one of the seven bones in your neck (vertebrae). These bones support your head and protect your spinal cord, which runs through the center of the spine. A fracture is called unstable if it causes the bones to move out of place. Unstable fractures can press on the spinal cord, increasing the risk of serious nerve damage, including paralysis from the neck down.

Causes

Unstable cervical fractures can happen due to:

• Motor vehicle or motorcycle accidents.

• Diving headfirst into shallow water.

• Sports injuries, especially in contact or high-fall sports (football, soccer, skating, skiing).

• Falls, especially in older adults.

• Direct trauma to the head or neck.

• Weak bones (osteoporosis).
  
  

Symptoms

You may notice:

• Severe neck pain and stiffness.

• Pain radiating to the shoulders, arms, or legs.

• Swelling or bruising at the back of the neck.

• Weakness, numbness, or loss of sensation in arms, legs, or torso.

• Paralysis of arms or legs.

• Difficulty breathing.

• Loss of bladder or bowel control (incontinence).
  
  

How It Is Diagnosed

Doctors use:

• Medical history and symptom review, especially after an injury.

• Physical exam to check for swelling, bruising, or misaligned vertebrae.

• Neurologic exam to check reflexes, movement, and sensation below the injury.

• Imaging tests, such as CT scan or MRI, to see the fracture clearly.
  
  

Treatment

Treatment depends on the fracture type, location, and your symptoms. It may include:

• Immobilization with a rigid neck brace.

• Halo brace – a device with pins to keep your neck in place while the fracture heals.

• Surgery to stabilize the vertebrae using screws, plates, or bone grafts.

• Cervical collar to support the neck during recovery.

• Physical therapy to regain strength and mobility.

• Occupational therapy to help with daily activities.
  
  

Home Care Instructions

Neck Brace or Collar:

• Wear it exactly as instructed. Do not remove it unless told.

• Check skin daily for redness or irritation.

• Keep it clean and dry. Cover it if it’s not waterproof during bathing.

Pain, Stiffness, and Swelling:

• Use ice packs if instructed:

  • Place ice in a bag, wrap in a towel, and apply for 20 minutes, 2–3 times a day.

  • Remove immediately if skin turns bright red.

Activity:

• Ask your doctor when it’s safe to drive or lift objects.

• Follow guidance on returning to normal activities.
  
  

General Care:

• Take all medications as prescribed.

• Prevent constipation by staying hydrated, eating high-fiber foods, and using prescribed medicines.

• Avoid tobacco or nicotine products; they slow bone healing.
  
  

When to Contact Your Doctor

Call your doctor if you have:

• Pain that isn’t controlled with medicine.

• Fever or chills.

• Skin irritation from your neck brace.

• Loose or damaged neck support.

• Loss of bladder or bowel control.

Seek emergency care immediately if you experience:

• Difficulty breathing.

• Sudden weakness or inability to move arms or legs.

• Severe pain or new numbness/tingling.
  
  

Summary

• An unstable cervical fracture is a serious neck injury that may damage the spinal cord.

• Prompt diagnosis, immobilization, and sometimes surgery are essential to prevent permanent nerve damage.

• Follow all medical instructions, attend follow-up visits, and report any new symptoms promptly.