The cervical spine consists of 7 vertebrae, which are limited by intervertebral discs. The cervical spine is surrounded by ligamentous structures that give the cervical spine support and stability. The cervical spine has a lordotic (hollow spine) shape and protects the nerve channel from which the nerves of the extremities originate, but in which cerebrospinal fluid (liquor) is also found.
The first two vertebrae, the atlas and axis, have their own form, which is necessary due to their function. These two vertebrae together with the base of the skull form the upper cervical joints and perform a double-chin movement and a forward pushing of the head as a movement. Together with the subsequent vertebrae, they make lateral inclination, rotation, flexion and extension of the cervical spine possible. More about cervical trauma can be found under Cervical Trauma – Therapy and Treatment
Treatment and physiotherapy
The cervical spine is heavily strained due to adjacent muscles that influence the arms and thus the work with the arms. Especially one-sided activities above the head, desk work or little movement cause too much tension in the area of the cervical spine. In the event of a severe trauma, traffic accident, fall from a high height onto the head or other accidents, fracture of the vertebral bodies can occur and, in the worst case, result in paraplegia, since the fragment can slide into the spinal canal.
Immediately after the accident, correct treatment should be carried out. The cervical spine should be stabilized to prevent further deterioration. Neurological tests, MRI and CT examinations follow to show the extent of the injury.
In case of a stable fracture, a corset is often prescribed, which the patient has to wear for a long period of time to stabilize the spine and to avoid the movements that could cause aggravation. In the case of an unstable fracture or fragments that have come loose, surgical treatment with a stabilizing osteosynthesis is required. Thereafter, training in physiotherapy begins.
It is particularly important to follow the doctor’s instructions. At the beginning, exercises of the extremities for thrombosis, decubitus and pneumonia prophylaxis can be performed, in which the cervical spine does not have to be moved. As soon as the cervical spine can be loaded, cautious isometric tension exercises can be started.
The head lies on the support and the patient presses the head into the support. At the beginning, no more load is allowed, so that the stabilization can be improved by tensing the deep supporting muscles. As soon as the head can be moved, the rotation can be continued with isometric tension.
To do this, turn the head as far to the side as possible, move it back a little, then grab the outside of the cheek with the hand and try to turn the head back against the pressure of the hand on the cheek. A general strength training program for the shoulder-arm complex can be done as preparation for the increasing load. However, it is important that the load does not run too extremely into the cervical spine.
Passive measures are not advisable at the beginning because the muscles have to work on stabilization. In the late phase, manual techniques can improve the mobility of the cervical spine. You may also be interested in this: Therapy of a spinous process fracture.
