Partial tetraplegic syndrome as a complication of a mobilizing/manipulating procedure of the cervical spine in a man with Forestier's disease: a case report

<p>Abstract</p> <p>Introduction</p> <p>Even if performed by qualified physical therapists, spinal manipulation and mobilization can cause adverse events. This holds true particularly for the cervical spine. In light of the substantial risks, the benefits of cervical spine manipulation may be outweighed by the possibility of further injury.</p> <p>Case presentation</p> <p>We present the case of a 56-year-old Caucasian man with Forestier's disease who went to see a physiotherapist to relieve his aching neck while on a holiday trip. Following the procedure, he was transferred to a local hospital with a partial tetraplegic syndrome due to a cervical 6/7 luxation fracture. Reportedly, the physiotherapist took neither a detailed history, nor adequate diagnostic measures.</p> <p>Conclusions</p> <p>This case highlights the potentially dangerous complications associated with cervical spine mobilization/manipulation. If guidelines concerning cervical spine mobilization and manipulation practices had been followed, this adverse event could have been avoided.</p

Medical image of the week: diffuse axonal injury

No abstract available. Article truncated at 150 words. An 18-year-old man without any significant past medical history presented to the emergency room trauma bay as an unrestrained passenger involved in a head-on collision at 85 mph. In the emergency room, he was found to have a GCS of 6 and was intubated for airway protection. A non-contrast CT of the head demonstrated hyperdense foci in the frontal lobes at the gray-white junction (Figure 1A) and a hyperdense focus in the pons (Figure 1B) consistent with punctate hemorrhages. An MRI of the brain with a gradient recall echo (GRE) sequence (Figure 2) demonstrated more pronounced hypointense foci consisent with hemorrhage. In the setting of the patient’s deceleration injury, the summation of his clinical and imaging findings was consistent with diffuse axonal injury. Diffuse axonal injury (DAI) is pattern of closed head injury that results in a traumatic shear injury to the neuronal axons secondary to sudden deceleration and change ..