Rehabilitation

What happens as I recover?

Healing of the bony injury takes approximately three months to achieve 80% of eventual strength, enough to return to light normal activities. Bracing is usually continued for this length of time. After that there are slow improvements that may continue for up to 18 months.

The healing of the soft tissue components of a neck injury are even more important than they are in other injuries. If the muscles and ligaments are torn, the mechanics of the cervical spine may never fully recover. If there is a nerve injury or spinal cord injury the recovery is often incomplete. A nerve or spinal cord injury affects recovery far more than the bone injury.

The spectrum of outcomes after a neck fracture goes from complete recovery and full return to normal function in three to six months to permanent paralysis and a wheelchair existence. It is usually possible to determine, quite early, which of these outcomes will occur. Both of these extremes require physical therapy but, of course, of very different types. Those destined for full recovery need to undertake an early exercise program that will safely maintain the function of the unaffected limbs and then exercise the neck and upper extremities to recover strength, range, and endurance. By contrast, those with a spinal cord injury need early rehabilitation focusing on strengthening the remaining function of the arms and learning mobility in a wheelchair. Maintaining independence despite paralysis is the goal of rehabilitation.

Apart from the permanent nerve injuries, the main long-term concern from neck fractures is post traumatic arthritis. If the joints of the neck are injured or if the disc is disrupted, neck mechanics will not be normal. Over time, this may result in pain and stiffness of the neck. Arthritis in the neck may cause formation of bone spurs around the joints. In time, these may interfere with nerve or spinal cord function. Fusion at the time of the acute injury is intended to prevent this type of outcome.