Cervical Spine Fractures (C2)

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Permalink Reply by Zahara Zawawi on March 22, 2009 at 5:44pm

Yes I would, if the pt. was able to do the maneuver ( he is not paralyzed or has extreme neck pain). I don’t know of any contraindication to doing PFT in a pt. with C2 fracture.

But there are many factors to consider. These are what came to mind: the severity of the injury, the type of fracture, whether it is stable or unstable and whether the pt. is wearing a hard color or a halo-vest.

Because the diaphragm is supplied by C3, C4, C5 any injury above that level (C2) could result apnea so the pt. would be ventilated. But that depends on the severity of the injury.

I don’t know the types of fracture but I know there are different type, each with specific symptoms ranging from being asymptomatic to having severe neck pain to frank paralysis.

During high levels of ventilation ( like the VC maneuver) the accessory muscles are used and since the spernocleidomastoid and trapezius nerve supply comes from C2, I suppose a C2 fracture could impair the function of these muscles and would affect the pt’s VC as would wearing a halo-vest or hard-collar. But I don’t view that as a contraindication to performing the maneuver.

I can’t think of a reason that would make performing VC on these pts dangerous or harmful to them. But I am not sure.

That’s the best I could come up with. So, if you know the correct answer please share it.

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Permalink Reply by Ronald Taylor on March 22, 2009 at 6:59pm

Hi Zahara
Thankyou for your reply: I agree with your comments: Recently a physio came to me about doing VC's on a patients with C2# but I was concerned regarding any contrainidication I know that disc problems may be a
contraindication . This was required hourly on the patient my concern is to who was going to perform the VC and are they experienced because having just anyone do this may put the patients at risk and as I am the only RT in the hospital I cannot be there all the time so you see my situation I will be discussing this with the pulmonologist this week.

Thanks
Ron

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Permalink Reply by Shahid Khan on September 17, 2010 at 7:39am

Although this has been explained by fellow member. I am just curious why? is VC being done. VC is done identify the progress of GB or mysthenia gravis types of diseases. Is their a chance that this patient fracture could be healed and impenge upon the phrenic nerve?

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