importance of full spinal cord screening and assessment of trauma patients involved in motor vehicle accidents: a case report

ABSTRACT

Traumatic spinal cord injury due to motor vehicle accidents is the predominant reason for emergency room visits in central Saudi Arabia1 and developed countries.2 If head and neck trauma is suspected, then cervical spine imaging is commonly performed to rule out spinal fracture.3 But in instances where there seems to be mild trauma, the remainder of the spine is not imaged.3 The proceeding case is about a 45-year-old motor vehicle accident survivor with a history of ankylosing spondylitis. Initial clinical examination revealed an apparent mild traumatic spinal injury without a cervical-spine fracture. To the attending physicians, this finding did not warrant for a thorough neurological examination along with a full imaging scan. Radiography of the thoracic spine was not performed until it became clear that there were symptoms suddenly emerging after patient stabilization. By that time however, it was too late an undisclosed thoracic spine fracture caused significant spinal cord compression, and this in turn led to complete paraplegia. We therefore emphasize that all trauma survivors of road traffic accidents undergo a comprehensive spinal cord scanning and assessment, regardless of the initial severity and symptomology of the injury