[Injuries of the brachial plexus and neighboring peripheral nerves in vertebral fractures and other trauma of the cervical spine]

Abstract

On the one hand, out of 115 patients admitted to hospital with 162 various fractures of the cervical spine without injury to the spinal cord, only 3 (2.6%) had an associated lesion to the brachial plexus or nerves in the vicinity. On the other hand, among 500 consecutive patients with injuries to the brachial plexus, 55 (11%) presented fractures of the cervical spine (including T1 and the 1st rib), whiplash injuries, severe distortions and dislocations, and contusions of that vertebral segment. Five (1% resp. 9%) had spinal cord injuries, including four patients with partial Brown-Sequard's syndrome, which was caused by multilevel root avulsions of the brachial plexus. In rather severe trauma to the lower cervical spine and concomitant brachial plexus lesion, root avulsions must be expected in 83% of cases, and in almost half of these patients three or more roots are avulsed from the spinal cord. Fractures around the shoulder-girdle as well as arterial ruptures are also significant for this severe nerve injury. Of these patients 39 (71%), were victims of motorcycle accidents.