Shielding of the spinal cord by cervical and facial structures in penetrating trauma.

Penetrating trauma to the cervical spine can result in major neurological deficits due to spinal cord damage. Discussed are four civilian cases of dramatic penetrating cervical injuries without spinal cord involvement. These injuries occurred in the anteroposterior direction, and the facial structures and/or vertebral bodies appeared to have provided some protection to the spinal cord. It is proposed that the cervical spinal cord may be less vulnerable to penetrating injuries in the anteroposterior plane due to incrementally collapsible compartments of facial soft tissue and bony sinus structures which can absorb kinetic energy and dissipate momentum.