Div 1Cervical spine injuries

Division 1—Cervical spine injuries

General comment for items 80 to 84 This Division does not apply to the following injuries (that are dealt with in items 1 to 3): • quadriplegia • paraplegia • hemiplegia or severe paralysis of more than 1 limb. There must be clinical findings present at the time of examination. Clinical findings must be consistent with radiological objective evidence where present. • Cervical spine injuries, other than those dealt with in items 1 to 3, range from cases of very severe disability to cases of a minor strain, with no time off work and symptoms only suffered for 2 or 3 weeks • Symptoms associated with nerve root compression or damage cannot be taken into account in assessing an ISV under items 80 to 82 unless objective signs are present of a permanent nerve root compression or damage, or other specific imaging findings as defined— • CT and/or MRI scans or other appropriate imaging evidence of disc herniation (as distinct from merely a disc bulge and/or annular tear), and residual and corresponding objective neurological impairment, for example— • sensory loss • loss of muscle strength and/or corresponding atrophy • impaired reflexes

Extreme cervical spine injury

These are extremely severe injuries that cause gross limitation of movement and serious interference with performance of daily activities. The injury will involve significant upper or lower extremity impairment and may require the use of an adaptive device or prosthesis

•	A total neurological loss at a single level
•	Severe multilevel neurological dysfunction
•	Structural compromise of the spinal canal with extreme upper or lower extremity motor and sensory impairments
•	Fractures involving more than 50% compression of a vertebral body with neural compromise

•	An ISV at or near the bottom of the range will be appropriate if there is whole person impairment of about 35%
•	An ISV at or near the top of the range will be appropriate if there is a cervical spine injury causing monoplegia of the dominant upper limb and whole person impairment of at least 60%.

Serious cervical spine injury

•	The injury of the cervical spine will cause serious neurological upper extremity impairment or serious permanent impairment of the cervical spine for which there is radiological evidence
•	The injury may involve—
(a)	a change of motion segment integrity; or
(b)	bilateral or multilevel nerve root compression or damage; or
(c)	a fracture involving more than 25% compression of 1 vertebral body or a fusion (either traumatic or post‑surgical);or
(d)	an injury showing objective signs of nerve root damage after surgery.

Loss of motion in a motion segment because of a surgical or post‑traumatic fusion

(a)	the injured person has had surgery and symptoms persist; or
(b)	there is a fracture involving 25% compression of 1 vertebral body.
•	An ISV in the middle of the range will be appropriate if there is a fracture involving about 50% compression of a vertebral body, with ongoing pain
(a)	the injured person has had a fusion of vertebral bodies that has failed, leaving objective signs of significant residual nerve root damage and ongoing pain, affecting 1 side of the body; and
(b)	there is whole person impairment of about 28%.