Question
My sister was in a car accident and sustained a c2 fracture.  Her treatment is a neck brace.  She is 67 yrs old and terrified that she is going to do something while going about her daily activities that will result in paralysis.  Should she be concerned?  Can she damage her spinal cord while wearing a neck brace?

Answer
Dear Kathy,

Although vertebral fractures can be very serious, often they are considered to be stable, meaning that they do not impose any threat to the spinal cord.  The C2 vertebra is a specialized vertebra in that it has an extended body which is called the dens, and this portion of the vertebra is the part most commonly fractured. (mostly from car crashes and falls)

There are three main types of fractures of the dens, and two of them are considered stable, meaning that either a halo fixation or a hard collar on the neck is sufficient to allow for healing.  If the hospital staff did not think that surgical intervention or even a halo stabilization was necessary, then your chances of paralysis are virtually zero.  They would have pinned the dens to the rest of the vertebra with a screw, or fused the C1 and C2 vertebra if there was any chance of spinal cord impingement.

Just tell her to do her normal activities with care and caution, and she should be fine.  Worrying about it will only create more issues.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net