TRAUMATIC INJURY TO THE LOWER CERVICAL-SP INE - A DIAGNOSTIC PROBLEM

Even today fractures and dislocations of the lower cervical spine are usually not recognized, or the interpretation of the results of the di agnostic procedures is not correct. These diagnostic failures are ofte n caused by an incomplete representation of the cervical spine in the conventional radiograms, particularly in the lateral projection. Beyon d that, the interpretation of the results of the neurological examinat ion of patients with motoric or sensoric deficits after spine injury c an be incorrect. Ignorance of the distribution of the segmental innerv ation of the upper extremities could lead to the wrong diagnosis of pa raplegia in a tetraplegic patient. Two patients with injuries of the l ower cervical spine are reported, in whom these problems led to an inc orrect diagnosis. With regard to these cases we propose a standard dia gnostic procedure for the clinical and radiological emergency examinat ion of patients with neurological deficits after spine injury. The tec hnical possibilites of obtaining correct radiographs of the lower cerv ical spine are described in detail.