I’m giving a lecture tomorrow morning on c-spine anatomy. I have a few ideas but what would people ou there suggest as an enlightening clinical case. So not just trauma but other c-spine pathology too.
Let me know ideas in the comments
Teaching with the hive mind
27 Sep
One case that will always stick in my mind is of an old chap that I saw on a night shift. He had fainted after falling off the toilet. The resident wanted me to review his findings and send him home. The patient had a bit of neck pain but he thought nothing of it. The resident had neglected to mention his ankylosing spondylitis and had been reassured by his lack of neurology.
He had already been sent around for some plain films (why I still don’t know) and so I wandered around to x-ray to chat with him. I hastily sent for a collar whe. I saw his pars fracture. He had snapped his bamboo neck in two with 8mmspinal cord impingement. The neurosurgeons didn’t believe his lack of neurological involvement but he was one lucky guy.
I’ve had a much lower thresholdmfor imaging cervical spines in rheumatoid and ank spond cases since.
would you believe me if I said I had the same case! a guy gets brought in after falling asleep on the toilet and bumping his head. Fully conscious with a touch of neck pain but sitting upright in a collar in the seat. I start to remove the collar to examine him and he tells me has ank spond, and i put the collar right back on! Fracture peg on x-ray.
Consider ank spond added to the lecture!
thanks
andy