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from the American Academy of Orthopaedic Surgeons

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Cervical Fracture (Broken Neck)

There are seven bones that make up the cervical vertebrae (neck). They support the head and connect it to the shoulders and body. A fracture, or break, in one of the cervical vertebrae is commonly called a broken neck.

Cervical fractures usually result from high-energy trauma, such as automobile crashes or falls. In elderly people, ground-level falls, such as falling off a chair, can result in a cervical fracture. Athletes are also at risk. A cervical fracture can occur if:

  • A football player "spears" an opponent with his head
  • An ice hockey player is struck from behind and rams into the boards
  • A gymnast misses the high bar during a release move and falls
  • A diver strikes the bottom of a shallow pool

Any injury to the vertebrae can have serious consequences because the spinal cord, the central nervous system's connection between the brain and the body, runs through the center of the vertebrae. Damage to the spinal cord is very serious and can result in paralysis or death. Injury to the spinal cord at the level of the cervical spine can lead to temporary or permanent paralysis of the entire body from the neck down.

Emergency Response

In a trauma situation, the neck should be immobilized until X-rays are taken and reviewed by a physician. Emergency medical personnel will assume that an unconscious individual has a neck injury and respond accordingly. The victim may experience shock and either temporary or permanent paralysis.

Conscious patients with an acute neck injury may or may not have severe neck pain. They may also have pain spreading from the neck to the shoulders or arms, resulting from the vertebra compressing a nerve. There may be some bruising and swelling at the back of the neck. The physician will perform a complete neurological examination to assess nerve function and may request additional radiographic studies, such as magnetic resonance imaging (MRI) or computed tomography (CT), to determine the extent of the injuries.

Treatment

Treatment will depend on which of the seven cervical vertebrae are damaged and the kind of fracture sustained.

  • A minor compression fracture can be treated with a cervical brace worn for 6 to 8 weeks until the bone heals.
  • A more complex or extensive fracture may require traction, surgery, 2 to 3 months in a rigid cast, or a combination of these treatments.

Prevention

Improvements in athletic equipment and rule changes have reduced the number of sports-related cervical fractures. You can help protect yourself and your family if you:

  • Always wear a seat belt when you are driving or are a passenger in a car.
  • Never dive in a shallow pool area, and be sure that young people are properly supervised when swimming and diving.
  • Wear the proper protective equipment for your sport and follow all safety regulations, such as having a spotter and appropriate cushioning mats.
  • For elderly people, conduct a home inspection to ensure a safe environment. Small changes, like taping down rugs and placing assistive devices near toilets and showers/tubs, can help reduce the risk of falls.

Last Reviewed

August 2021

Contributed and/or Updated by

Daniel K. Park, MD, FAAOS

Peer-Reviewed by

Thomas Ward Throckmorton, MD, FAAOS

AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS Find an Orthopaedist program on this website.