1. 25 yo healthy male college student
Sustained cervical spine injury at noon on 12/15/00 snow boarding.
Landed on his head going off a jump.
Immediate complete loss of all motor and sensory function.
Hypotensive and bradycardic at scene.
Steroids started at local hospital, patient airlifted to DHMC

2. X-ray: lateral cervical spine

3. In ED; Complete C 6 tetraplegia, Frankel A
Bulbocavonosus reflex present

4. Gardner -Wells tongs placed for traction

5. Sensation was lost when traction decreased for the MRI
Traction of up to 70 pounds failed to reduce bilaterally jumped and locked C6-7.
During traction, patient noted presence of sensation in feet, no motor function noted
Sensation was lost when traction decreased for the MRI

6. X-ray X2 with traction

7. Cervical MRI

8. MRI

9. MRI

10. Patient taken to operating room by 9 pm that evening
Post-op F/U: Significant neurologic improvement, distal greater than proximal, left greater than right
1 Month F/U: Patient ambulating. Bladder function returning. Fine motor and intrinsics recovered on left, and improving on right side.
Frankel D

11. X-ray at 1 month

12. X-ray at 1 month

13. X-ray at 1 month

14. 9/2/00: 20 yo Male
Unrestrained backseat passenger, MVA + ETOH
Self-extricated from vehicle.
Sustained fracture L3, pulmonary and liver contusions
Exam: Sensory: mild numbness right anterior-medial knee region. Motor: Normal; rectal tone normal.

15. X-ray on admission

16. X-ray on admission

17. X-ray on admission

18. CT Scan-Acute

19. CT Scan-Acute

20. CT Scan-Acute

21. CT Scan-8 mos

22. CT Scan-8 mos

23. CT Scan-8 mos

24. Treatment options discussed
TLSO fit, patient mobilized about hospital day 5
Discharged 9/8/00

25. Follow-up on 1/11/01
Exam: normal
No pain in back or legs

26. X-rays: L spine w/flexion-extension views

27. Neutral

28. Flexion

29. Extension

30. 20 yo Male
S/P 14 Foot fall off roof 12/22/00
ED exam: Decreased bilateral anterior thighs, weakness graded 4/5 bilateral hip flexion
Steroid protocol started
Frankel D

31. X-rays

32. X-rays

33. X-rays

34. X-rays

35. CT Scan

36. CT Scan

37. CT Scan

38. MRI

39. MRI

40. Treatment options discussed
Taken to operating room for reduction and stabilization L1 to L3

41. MRI

42. MRI

43. X-rays

44. X-rays

45. Clinical Follow-up:
Frankel E

46. 11 yo Male
Evaluated for persistent low back pain
Previously seen by several physicians without successful treatment

47. X-ray L spine

48. X-ray L spine

49. X-ray L spine

50. X-ray L spine

51. Bone Scan

52. Bone Scan

53. CT Scan L5

54. CT Scan L5

55. Treatment options reviewed Clinical F/U 6 weeks later