A forgotten diagnosis in the emergency department: Spinal cord injury without radiographic abnormality

Abstract

Spinal fracture in spinal cord injury may occur without findings on computed tomography, and this, is called traumatic myelopathy. This condition is defined as spinal cord injury (SCIWORA) without radiographic abnormality of the vertebral column. A 57-year-old male patient with a history of DM was brought to the emergency room by his relatives due to a fall at home. Patient's GCS: 15 and although the sensory examination of the patient was normal, he was tetraplegic. No acute pathological finding was detected in the brain and cervical CT imaging of the patient. While acute pathology was not detected in the cranial MRI of the patient, posterior disc herniation at the C3-4 level secondary to trauma was detected in the cervical MRI. The patient was evaluated by neurosurgery, and emergency surgery was promptly scheduled, following which the patient underwent the procedure.