Cervical spine injuries from diving accident: a 10-year retrospective descriptive study on 64 patients

Orthop Traumatol Surg Res. 2013 Sep;99(5):607-13. doi: 10.1016/j.otsr.2013.04.003. Epub 2013 Jul 30.

Abstract

Introduction: Ninety percent of the lesions resulting from diving injuries affect the cervical spine and are potentially associated with spinal cord injuries. The objective is to determine the most frequent lesion mechanisms. Evaluate the therapeutic alternatives and the biomechanical evolution (kyphotic deformation) of diving-induced cervical spine injuries. Define epidemiological characteristics of diving injuries.

Materials and methods: A retrospective analysis over a period of 10 years was undertaken for patients admitted to the Department of Neurosurgery of Montpellier, France, with cervical spinal injuries due to a diving accident. Patients were re-evaluated and clinical and radiological evaluation follow-ups were done.

Results: This study included 64 patients. Cervical spine injuries resulting from diving predominantly affect young male subjects. They represent 9.5% of all the cervical spine injuries. In 22% of cases, patients presented severe neurological troubles (ASIA A, B, C) at the time of admission. A surgical treatment was done in 85% of cases, mostly using an anterior cervical approach.

Discussion: This is a retrospective study (type IV) with some limitations. The incidence of diving injuries in our region is one of the highest as compared to reports in the literature. Despite an increase of our surgical indications, 55% of these cases end up with a residual kyphotic deformation but there is no relationship between the severity of late vertebral deformity and high Neck Pain and Disability Scale (NPDS) scores.

Level of evidence: Level IV, retrospective study.

Keywords: Cervical spine injury; Diving; Diving accidents; Outcome; Spinal cord injury; Surgical treatment.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Bone Transplantation / methods
  • Cervical Vertebrae / injuries*
  • Cohort Studies
  • Decompression, Surgical / methods
  • Diving / injuries*
  • Female
  • Follow-Up Studies
  • Fracture Fixation / adverse effects
  • Fracture Fixation / methods*
  • Fracture Healing / physiology
  • France
  • Humans
  • Injury Severity Score
  • Magnetic Resonance Imaging / methods
  • Male
  • Pain, Postoperative / physiopathology
  • Postoperative Complications / physiopathology
  • Postoperative Complications / therapy
  • Retrospective Studies
  • Risk Assessment
  • Spinal Fractures / diagnosis
  • Spinal Fractures / epidemiology*
  • Spinal Fractures / surgery*
  • Spinal Fusion / methods
  • Spinal Injuries / etiology
  • Spinal Injuries / physiopathology
  • Spinal Injuries / surgery
  • Time Factors
  • Treatment Outcome
  • Young Adult