Incidence of Cervical Spine Injuries Associated with Maxillofacial Trauma and its Association with Facial Injury Severity

Maxillofacial injuries are among the most common that present to the emergency department together with associated injuries to other systems. Trauma to maxillofacial region should raise a high suspicion for cervical spine injury. The presence or absence of cervical spine injury has important implications in trauma patients. Therefore, we conducted a study to assess the incidence of cervical spine injuries in maxillofacial trauma and to relate the severity of maxillofacial trauma.

A prospective analysis was conducted on 270 maxillofacial fracture patients who reported to casualty. All the patients were evaluated for facial injury severity scale (FISS), epidemiological demographic and clinical characteristics, the presence of cervical spine injuries and their severity.

Of the 270 maxillofacial fracture patients, 2.96% had associated cervical spine injuries (CSI). Majority of CSI cases were caused by road traffic accidents (75%). Most of CSI occurred in association with mandibular fractures (55.2%), and most injuries occurred at the level of C6/C7 (62.5%). Most of the CSI had moderate FISS (87.5%). Neurological deficits were observed in 6 cases (75%) in which 5 patients had motor deficits and one patient had sensory deficient. Majority of patients had sustained major neurological deficits like quadriplegia (50%) followed by upper limb weakness and then tenderness.

All the patients who sustained maxillofacial injuries must be evaluated for cervical spine injuries to prevent life threatening conditions like neurological morbidities and even mortality. From our study, we concluded that as severity of facial injury increases, the chances of CSI also increase.