| | Cervical spinal cord injury | Brachial plexus injury ("Burner" or "Stinger") |
| Mechanism | - Axial spine compression (eg, diving, gymnastics, wrestling, or hockey)
- Motor vehicle collision
- Falls with excessive neck flexion or extension
| - Stretch injury to the neck typically during tackling in American football or rugby
- Direct blow to the supraclavicular fossa (rugby)
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| Symptoms | - Neck pain or stiffness
- Unilateral or bilateral paresthesias, weakness, or paralysis
- Lower extremity symptoms
- May be transient or persistent
| - Only unilateral symptoms involving the upper extremity
- Transient supraclavicular pain, paresthesias, or weakness (usually resolves after a few minutes)
|
| Physical examination | - Posterior midline neck tenderness
- Decreased active neck range of motion
- Abnormal neurologic examination often consisting of spinal sensory level above the nipple, flaccid paralysis with absent reflexes in the acute phase subsequently followed by quadriparesis,
- Often associated with head injury
| - No posterior midline neck tenderness
- Pain localized to the neck musculature that may limit neck motion
- Compression or percussion of the top of the head may reproduce symptoms (Spurling test)
- Upper extremity weakness typically fully resolves but may persist
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