Lap‐belt injury with complete avulsion of the spinal cord and cauda equina

Tubbs, R. Shane; Golden, Blake; Doyle, Scott; Grabb, Paul A.; Oakes, W. Jerry

doi:10.1002/ca.20211

Cited by 4 publications

(3 citation statements)

References 7 publications

(8 reference statements)

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“…To our knowledge there have been only a handful of similar cases reported in literature, all among children and adolescents who sustained injuries in motor vehicle accidents. [ 7 8 9 10 11 ] The authors of relevant articles and reviews emphasize the violent mechanism of injury and a significant risk of intra-abdominal visceral injuries. [ 7 ]…”

Section: Discussionmentioning

confidence: 99%

Complete avulsion of spinal cord and cauda equina: A case report

Miękisiak¹

2015

J Craniovert Jun Spine

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Pure ligamentous flexion-distraction injuries of the lumbar spine are relatively rare and even less commonly associated with neurologic compromise. They are largely related to the use of lap belt restrains during motor vehicle accidents. We report a 19-year-old female backseat passenger wearing a lap belt who was involved in a head-on collision. On admission she was paraplegic, with a T12 sensory level and no motor and sensory function of S4-S5 (American Spinal Injury Association (ASIA) A). Plain X-ray and computerized axial tomography (CAT) spine showed a flexion-distraction injury at the L3-L4 level. During surgery in the interspinous space a conus medullaris was identified, which was completely severed from the spinal cord. The patient underwent a fusion procedure and made a good recovery. Twelve months after surgery she was able to walk with a knee-ankle-foot orthosis, she has no motor function below knees, no sensation below L2, and no voluntary bladder control. Although described type of injury is very rare, one should always have in mind devastating consequences of inadequate or improperly worn seatbelts.

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Section: Discussionmentioning

confidence: 99%

Complete avulsion of spinal cord and cauda equina: A case report

Miękisiak¹

2015

J Craniovert Jun Spine

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“…However, in severe pelvic fractures, there are traction lesions to the lumbosacral plexus and its spinal nerve roots, the cauda equina, which could be avulsed from the medullary conus in lap belt injury from a violent forward flexion of the lumbar spine (Huittinen, 1972;Tubbs et al, 2006). The brachial plexus which is innervating the upper extremity is little protected from traction forces due to the loose suspension of the shoulder girdle.…”

Section: Clinical Injurymentioning

confidence: 99%

“…Spinal root avulsion injuries in humans occur most frequently to spinal cord segments supplying nerve fibers to the extremities, as brachial plexus (Rosson, 1987), lumbosacral plexus (Huittinen, 1972), or cauda equina and the medullary conus (Tubbs et al, 2006). Road traffic accidents and severe traction during complicated births are the most common causes of such injuries and both can result in permanent paralysis and pain (Berman et al, 1998).…”

Section: Introductionmentioning

confidence: 99%