Abstract
Damage to the spinal cord had not been recognised initially in 15 patients out of a consecutive series of 353 admitted over a decade to the National Spinal Injuries Centre with paralysis due to trauma to the cord. In some patients the missed diagnosis led to mismanagement and a greater neurological deficit. Missed injuries of the spinal cord are seen in patients with multiple injuries and head injuries and in those without any paralysis. Various radiological errors contribute to the failure to recognise the vertebral injury. In addition to causing severe disability to the victim these missed and mismanaged injuries of the spinal cord cost the National Health Service large sums in compensation. A careful evaluation of the history of each accident, with greater awareness of the potential of certain types of accidents to cause spinal cord injury, should reduce the incidence of missed injuries of the spinal cord.
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- Bedbrook G. M. Spinal injuries with tetraplegia and paraplegia. J Bone Joint Surg Br. 1979 Aug;61-B(3):267–284. doi: 10.1302/0301-620X.61B3.225332. [DOI] [PubMed] [Google Scholar]
- Fine P. R., Kuhlemeier K. V., DeVivo M. J., Stover S. L. Spinal cord injury: an epidemiologic perspective. Paraplegia. 1979 Jul;17(2):237–250. doi: 10.1038/sc.1979.47. [DOI] [PubMed] [Google Scholar]
- Huelke D. F., O'Day J., Mendelsohn R. A. Cervical injuries suffered in automobile crashes. J Neurosurg. 1981 Mar;54(3):316–322. doi: 10.3171/jns.1981.54.3.0316. [DOI] [PubMed] [Google Scholar]
- Kraus J. F., Franti C. E., Riggins R. S., Richards D., Borhani N. O. Incidence of traumatic spinal cord lesions. J Chronic Dis. 1975 Oct;28(9):471–492. doi: 10.1016/0021-9681(75)90057-0. [DOI] [PubMed] [Google Scholar]
- Kurtzke J. F. Epidemiology of spinal cord injury. Exp Neurol. 1975 Sep;48(3 Pt 2):163–236. doi: 10.1016/0014-4886(75)90175-2. [DOI] [PubMed] [Google Scholar]
- Minaire P., Castanier M., Girard R., Berard E., Deidier C., Bourret J. Epidemiology of spinal cord injury in the Rhône-Alpes Region, France, 1970-75. Paraplegia. 1978 May;16(1):76–87. doi: 10.1038/sc.1978.13. [DOI] [PubMed] [Google Scholar]
- Ohry A., Brooks M. E., Rozin R. Misdiagnosis of spinal cord injuries--the physiatrist's point of view. Paraplegia. 1980 Feb;18(1):15–20. doi: 10.1038/sc.1980.3. [DOI] [PubMed] [Google Scholar]
- Penning L. Diagnostic clues by x-ray injuries of the lower cervical spine. Acta Neurochir (Wien) 1970;22(2):234–244. [PubMed] [Google Scholar]
- Scher A. T. Cervical spinal cord injury without evidence of fracture or dislocation. An assessment of the radiological features. S Afr Med J. 1976 Jun 12;50(25):962–965. [PubMed] [Google Scholar]
- Scher A. T. Unilateral locked facet in cervical spine injuries. AJR Am J Roentgenol. 1977 Jul;129(1):45–48. doi: 10.2214/ajr.129.1.45. [DOI] [PubMed] [Google Scholar]
- Scher A. T. Unrecognised fractures and dislocations of the cervical spine. Paraplegia. 1981;19(1):25–30. doi: 10.1038/sc.1981.8. [DOI] [PubMed] [Google Scholar]
- Shrosbree R. D. Spinal cord injuries as a result of motorcycle accidents. Paraplegia. 1978 May;16(1):102–112. doi: 10.1038/sc.1978.16. [DOI] [PubMed] [Google Scholar]
- WHOLEY M. H., BRUWER A. J., BAKER H. L., Jr The lateral roentgenogram of the neck; with comments on the atlanto-odontoid-basion relationship. Radiology. 1958 Sep;71(3):350–356. doi: 10.1148/71.3.350. [DOI] [PubMed] [Google Scholar]
- Whalen J. P., Woodruff C. L. The cervical prevertebral fat stripe. A new aid in evaluating the cervical prevertebral soft tissue space. Am J Roentgenol Radium Ther Nucl Med. 1970 Jul;109(3):445–451. doi: 10.2214/ajr.109.3.445. [DOI] [PubMed] [Google Scholar]