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Posted on 08-11-2014

Types of Vertebral Fractures Following Whiplash Injuries

As a Baltimore Chiropractor that spends the majority of my time treating patients with whiplash presenting with headaches, neck pain, and back pain following Baltimore auto accidents (Baltimore car accidents), I spend a lot of time assessing acute injuries, particularly in the neck. One of the tools that I use to grade the severity of an injury is an x-ray. Often patients appear frustrated when I tell them that I need to take x-ray films because they like to say "there's no way anything is broken." In some cases, these patients have been to a hospital and a doctor tells them that they don't need x-rays. While it is true that the vast majority of x-rays do not reveal fractures or dislocations (or any other abnormalities that would otherwise contra-indicate chiropractic spinal manipulation), there are some instances where fractures can be seen on x-ray following a Baltimore auto accident in a patient presenting with whiplash.

The first type of vertebral fracture is called a clay shoveler's fracture. Usually this occurs at the base of the neck, around C6 or C7. This is a small fracture of the tip of the spinous process when the head "whips" back suddenly and smashes into the vertebrae below it. It was originally named for (as you might have guessed) people who shoveled clay for a living who developed these lesions while working. Needless to say these spinal levels should not undergo chiropractic manipulation, but instead, referred to an orthopedist for treatment recommendations.

The second type of vertebral fracture is called an end plate fracture. These are typically harder to find on an x-ray, and often require other forms of advanced imaging such as MRI to properly diagnose. These type of fracture is important for two reasons. Firstly, the fracture itself can be painful and can be the main cause of a patients neck pain. Secondly, the end plate is a structure that serves to help supply blood and nutrients to the intervertebral discs. Once fractured, the endplate has been shown to decrease its blood supply to a given disc due to scar tissue formation, and thus accelerate the degenerative process of the disc. In addition to pain, these types of injuries cause a vertical height decrease in that spinal level, and the neck as a whole, which can lead to a myriad of problems above and below the level of the lesion.

While it is true that cervical spine fractures are rare following Baltimore auto accidents and are not commonly seen in Baltimore whiplash patients, it is prudent of the health care provider to make sure that it is safe to proceed with treatment prior to beginning therapy. Often hospitals do not see the need to take x-rays, but by not taking films, they miss important diagnoses and patients can suffer longer than needed with undiagnosed neck fractures.

If you, or someone you know, has been injured in a Baltimore auto accident and have neck pain following whiplash, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be happy to help!

Dr. Gulitz

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