Birth injury of the cervical spine in newborns: consequences

Causes and pathogenesis of cervical injuries

Injury to the cervical spine can be caused by a blow to the neck area or an extreme extension or flexion movement of the head. Typically, spinal injuries caused by excessive head movement are called "whiplash" in the case of a car accident and "diver's injury" due to hitting the head on the bottom of a body of water. Such spinal injuries are usually accompanied by severe impairment of the spinal cord and can lead to death.

Injuries to the first two cervical vertebrae are considered the most severe and dangerous. The first cervical vertebra, also called the atlas, is often injured as a result of a sudden fall on the head. In this case, the occipital bone of the skull puts strong pressure on it, and the posterior and anterior arches break. The patient complains of acute pain in the neck, back of the head and crown of the head. The second cervical vertebra, called the axis, breaks when the neck is suddenly bent. Complications from this injury range from neck pain to paralysis of the limbs.

The cervical spine includes seven vertebrae, of which the lower ones are most often damaged - 4, 5 and 6. This usually happens due to sharp flexion of the neck. Signs of a (cervical) injury include severe neck pain, excessive tension in the neck muscles, and limited head rotation.

Consequences of neck injury during childbirth

In older children:

• Poor learning ability, clinical attention deficit disorder mimicking ADHD.
• Developmental delay in any form.
• Headaches, complaints of heaviness in the head.
• Deficient motor skills, up to paralysis and paresis of the limbs.
• Social maladjustment.

In adults:

• Chronic pain syndrome, back and limb pain.
• Headaches, migraines, noise and ringing in the ears.
• Dizziness, loss of coordination, etc.

Birth injuries of the cervical spine

During childbirth, the baby is exposed to mechanical stress, which can cause serious spinal injury. Incorrect position of the fetus or its excessive weight, post-term pregnancy and other reasons can lead to subluxation in the joints of the first two vertebrae, displacement of their bodies or damage to the intervertebral discs. Complications of injury may be as follows:

• disruption of the normal functioning of cerebral blood flow,
• violation of venous outflow,
• development of spasms,
• disruption of the functioning of the central nervous system, which is accompanied by a delay in the development of the child.

Due to the injury, the child may later begin to hold his head up, crawl, or walk. In addition to problems with the formation of the musculoskeletal system, he also experiences delayed speech development. Disturbances in the normal functioning of the central nervous system negatively affect memory and concentration. That is why injuries to the cervical spine that occur immediately after the birth of the baby should be treated immediately.

Symptoms indicating a cervical spine injury in a newborn:

• problems with motor development;
• decreased or complete absence of several reflexes;
• problems with self-feeding;
• spasms of the limbs, lack of flexion reflexes;
• digestive disorders (constipation, flatulence, diarrhea);
• headache, loss of consciousness;
• tachycardia occurs periodically;
• the child develops more slowly than his peers - he usually raises his head later, begins to sit down and stand up on his own;
• the speech and mental development of the baby is disrupted;
• the spine is formed incorrectly, which is accompanied by its deformation, different leg lengths, and flat feet.

Diagnostics

A neck injury in a baby can be detected after birth. It is worth considering some signs:

• redness and swelling of the neck;
• the neck looks either very short or very long;
• muscle spasms appear on the back of the head or neck;
• irregularities of the cervical spine.

Symptoms that are difficult to notice right away:

• the body and limbs of the newborn are very relaxed;
• the baby breathes heavily and hoarsely, groans;
• the appearance of a blue tint in the nose area;
• nervousness in the behavior of the newborn, disturbed sleep and constant crying;
• difficult to agree to feeding, constant regurgitation;
• cardiac arrhythmia.

It is important to correctly and timely diagnose natal trauma

These signs indicate natal damage to the cervical spine. For accurate diagnosis, it is worth using ultrasound and X-ray examination, Dopplerography. As a result, information about blood flow in the head and neck area is obtained. After the examination, you can find out where birth injuries are located and how severe they are.

Treatment of birth cervical injury

Injury to the cervical spine almost always provokes serious health complications for the child. That is why its treatment should begin from the first days of a newborn’s life. The most suitable treatment methods are considered osteopathic, which allow you to gently and delicately eliminate the problem. During the examination of the baby, the doctor identifies tension in different layers of tissue, then creates tension and a fulcrum, thereby allowing the tissues to straighten.

Particular attention is paid to the tissues of the head, since it is in them that blood vessels pass and part of the cerebrospinal fluid flows out. It is worth noting that even during a safe and normal birth, the baby’s head (especially the occipital bone) experiences severe stress as it makes its way through the birth canal. The neck rests on the base of the skull, and the base of the head consists of a large number of cartilages. During childbirth, these cartilages may shift, which leads to pinching of cranial vessels and nerves.

Osteopathic techniques for treating a newborn are selected individually. Their use allows you to relax muscles and eliminate pain, activate blood circulation, which will promote rapid healing. The main preventive method of birth trauma is considered to be regular monitoring of the pregnant woman by the attending physician and timely elimination of health problems.

How does it manifest?

A birth injury to the cervical spine in a young patient can be noticed immediately after birth. The first signs of injury include: the appearance of swelling and redness in the neck, a too short or too long neck, excessive tension in the muscle tissue and at the back of the head, while the neck itself is in an injured state.

In addition to noticeable symptoms, signs of damage include relaxation of the whole body, although it is normal for the baby to develop hypertonicity after a month of life. The baby’s breathing process is complicated; groans, hoarseness and other extraneous sounds may occur. The nose area may become blue.

Birth trauma can manifest itself in different ways - it all depends on the type of damage

The baby may notice excessive anxiety, constant tearfulness, night cries, poor sleep, reluctance to breastfeed, and regular regurgitation. In some cases, a heart rhythm disturbance is detected. The diagnosis of natal neck injury can only be made after a complete detailed examination of the newborn. Ultrasound, radiography and Doppler ultrasound are performed. After the examination, an accurate diagnosis can be made, the degree of injury, the level of severity and the nature of the lesion can be determined.

Principles of treatment of cervical injuries

Treatment of cervical spine injury should begin with diagnosing the injury. The patient must receive emergency first aid aimed at maintaining normal blood circulation and breathing. It is important to correctly immobilize the spinal injury—the patient should be placed in a neutral position and splinted. When moving the patient, his head should also occupy a neutral position - rotation, flexion and extension of the neck should be avoided in every possible way.

Conservative treatment of neck injuries involves the use of immobilizing bandages and cervical orthoses. As soon as possible after injury (the first few hours), a procedure of closed reposition of the cervical spine should be performed, aimed at restoring the correct anatomy of the spine. In severe cases, surgical intervention is prescribed. Indications for surgery are uncomplicated dislocations and subluxations, compression of the spinal cord due to displacement of the vertebral bodies and its fragments, and chronic dislocations of the cervical vertebrae.

Care

Women should know all the intricacies of caring for a baby who has experienced birth trauma in order to avoid possible negative phenomena. There are a lot of treatment methods. The choice of one method or another depends on the type of injury, its severity and influencing factors. If the damage is very serious, and the young mother does not have basic medical skills, in many cases, nannies with medical education and extensive experience in caring for sick children are hired.

In case of limb injury:

• special care is not required;
• registration with a pediatrician;
• observation by a surgeon during the first 2 months;
• prevent re-injury of the bone;
• 2 weeks after birth, take an x-ray to ensure proper bone fusion;
• be regularly examined at a dispensary;
• massage for preventive purposes.

Care will vary depending on the type of injury.

For intracranial injury:

• complete rest and careful care;
• if the injury is severe, it is worth placing the baby in an incubator;
• in case of convulsive seizures, choking, uneven breathing, exclude the baby’s movements;
• all procedures, including feeding, swaddling, skin treatment, are carried out in the crib;
• damage to the head during childbirth, both external and internal, requires a special method of feeding, which occurs using a pipette or spoon, depending on the severity of the injury. In addition, tube feeding is prescribed.

Spinal cord injury poses a great danger to a child's life. Proper care will ensure your baby has a long life:

• resort to methods to eliminate bedsores;
• regularly treat the urinary system;
• beware of infectious diseases;
• sometimes conduct a study to identify uropathy.

Damage to soft tissues. We are talking about injury to muscles, skin and subcutaneous tissue. These include: scratches, hemorrhages, which in most cases are not dangerous and are easily healed after local treatment. In many cases, the damage affects the sternoclavicular muscle, the fibers of which are at risk of tearing.

In case of tissue damage:

Consequences and symptoms

Some injuries make themselves felt in the first hours and days after the birth of a child. If you do not take into account minor injuries to soft tissues in the form of abrasions or petechiae, then immediately after childbirth only serious birth injuries are diagnosed, in particular:

• torticollis;
• head asymmetry;
• clubfoot;
• fractures, etc.

But most injuries appear only after a certain time, often a long one. For example, disturbances in the functioning of the central and peripheral nervous systems can only be noticed after certain developmental milestones have been passed. These include delayed speech and psycho-speech development, various autism spectrum disorders, epilepsy, etc. This is precisely the main danger of such birth injuries, because when they appear, changes in the functioning of the nervous system can already be serious and it is not always possible to completely eliminate.

Although their signs may be present already in the first days and weeks of a child’s life. A newborn may experience difficulty sucking the breast, often cry, sleep for a long time or, on the contrary, little by little, etc. But such manifestations do not always cause parents and doctors to sound the alarm, since they are often perceived within the normal range.

Signs of birth injuries can appear not only at different times, but also be of a different nature. Up to a year in a baby, their presence may be indicated by:

• profuse, frequent regurgitation;
• weak weight gain;
• intestinal colic;
• frequent crying;
• restless sleep;
• increased excitability, restless behavior;
• delayed motor development.

But similar symptoms are present in most children, which leads us to believe that birth injuries of varying severity are present in 80% of newborns.

After a child reaches 2-3 years of age, birth trauma can cause the following:

• increased nervous excitability, hyperactivity;
• speech delays and speech disorders of various types;
• developmental delays;
• enuresis;
• nervous tics;
• strabismus.

Some injuries received during childbirth may only make themselves felt at school age. Then parents may notice in their child:

• disorders of behavior, attention, memory, ability to think;
• difficulties of varying severity in learning;
• headache;
• increased fatigue;
• frequent infectious diseases caused by weak immunity.

In any case, if a child develops alarming symptoms at any age, parents should show him or her to a neurologist.

Expert Opinion of a Doctor

Subsequently, birth injuries that are not detected and treated in a timely manner can result in disorders of psycho-speech and motor development, attention deficit hyperactivity disorder, scoliosis, vegetative-vascular dystonia, visual and hearing impairment, migraines and other chronic diseases.

Personal: Goncharenko Irina Mikhailovna

Neurologist, osteopath, chiropractor

Experience: 16 years

Ask a Question

How is childbirth normal?

Normally, during natural childbirth, the fetus leaves the uterus through the narrow cervical canal, and then the vagina, head first, paving the way for the body. Literally, the child must squeeze through a “tunnel” that does not suit his parameters, in which enormous pressure is exerted on him from all sides.

Since this is how nature intended the process of childbirth in humans, it provided a mechanism that allows the child to pass all tests without damage. All bones of the fetal skull remain unconnected. Therefore, when passing through the birth canal, they can shift without breaking, and after leaving the mother’s womb, they can gradually restore their normal position. In addition, the entire body of the fetus is built in such a way that its proportions allow it to overcome all the difficulties of birth without damage. But, unfortunately, not everything always goes as nature intended.

Preventing Injuries

In order to insure the child from injury to the cervical spine, mothers can adhere to some preventive rules even during the neonatal period. Moreover, such preventive aspects need to be remembered not only by mothers, but also by the doctors observing them. The rules are as follows:

• Planning pregnancy and conception before its immediate moment;
• Treatment of underlying diseases in parents before conception;
• Attending extensive examinations and gynecological consultations on a regular basis;
• Providing only professional medical care, the doctor must prevent pathologies and not let things take their course;
• Maintaining a balanced and proper diet;
• Maintaining a healthy lifestyle for the mother while carrying a child (it is better to give up smoking, alcohol and bad habits);
• Prompt and maximally harmless treatment for the fetus of diseases contracted during pregnancy.

All pathological disorders in the child’s condition must be identified before his birth. This will help optimize the birth process and minimize the risk of injury to the baby.