Cervical Spine Immobilisation Following Stab Wounds to the Neck Is Unnecessary

Abstract

OBJECTIVE: This study reviews our experience with penetrating neck injury (PNI) secondary to a stab wound (SW) to clarify the incidence of cervical spinal injury (CSI) and to interrogate the role of cervical spinal motion with cervical collar in these patients. METHODS: A retrospective review of a prospectively captured data set was conducted at the Pietermaritzburg Metropolitan Trauma Service in South Africa from December 2012 to December 2022. All patients who presented with a PNI due to a SW were included. RESULTS: There were 1249 cases of PNI over the 10 year study period. 1028 were due to a SW and 90% were male. The mean age 30 years. The zonal distribution of the external wounds was were 329 (32%) in zone 1, 469 (46%) in zone 2, 164 (16%) zone 3 and 162 (16%) in the posterior triangle of the neck. In eighty two (8%) cases a CSI was sustained. In none of these cases was the CSI unstable. Twenty two (22) patients sustained a spinal cord injury and presented with a neurological deficit. CONCLUSIONS: While there is a significant incidence of spinal cord injury after a cervical SW, there is a very low incidence of cervical spine instability requiring spinal fixation. The routine application of cervical collar following a SW to the neck is unnecessary.