Evaluation of Challenges in the Diagnosis of Spinal Injury Complicated with Trauma

Nao Tsukamoto, Keisuke Ishii*, Shozo Kanezaki, Osamu Matsunari, Tomotaka Shibata, Keiko Kurosawa, Sanshi Tanabe, Yusuke Nabeta, Haruka Fukuda and Teruo Sakamoto

Advanced Trauma, Emergency and Critical Care Center, Oita University Hospital, Japan

^*Correspondance to: Keisuke Ishii 

 PDF  Full Text DOI: 10.25107/2474-1647.2778

Abstract

Introduction: Spinal injury is often complicated with severe and multiple traumatic injuries. However, a diagnosis of Spinal injury can be difficult without available neurological findings. We examined spinal injury patients with trauma and investigated challenges in diagnosis and treatment. Patients and Methods: Of 8,154 cases with trauma that presented to our center between October 01, 2012 to September 30, 2015, 118 were spinal injury. Of these 118 cases of spinal injury, neurological findings were not obtained in 19 cases. Here, we investigated the reasons for being unable to diagnose these cases as spinal injury. Result: In all 19 cases, we were unable to obtain neurological findings due to disturbance of consciousness. Disturbance of consciousness was due to shock in 8 cases, head injury in 4 cases, patient psychiatric background in 3 cases, hypothermia in 2 cases, out of hospital cardiopulmonary arrest in 3 cases, and intoxication in 1 case. Diagnosis of vertebral fracture and spinal injury was obtained by computed tomography images at the first medical examination in 17 of the 19 cases. In 1 case not diagnosed at the first medical examination, disturbance of consciousness was due to accidental hypothermia and shock. Paralysis was observed after consciousness recovery, and spinal cord injury was diagnosed by magnetic resonance imaging. Conclusion: In the emergency room, attention should be given to patients with disturbance of consciousness and severe multiple injuries to consider a diagnosis of spinal injury.

Keywords

Trauma; Spinal injury; Spinal cord injury; (SCIWORA) Spinal Cord Injury Without Radiographic Abnormality; Disturbance of consciousness; Emergency room

Cite the article

Tsukamoto N, Ishii K, Kanezaki S, Matsunari O, Shibata T, Kurosawa K, et al. Evaluation of Challenges in the Diagnosis of Spinal Injury Complicated with Trauma. Clin Surg. 2020; 5: 2778..