Missed and Mismanaged Injuries of the Spinal Cord

Pradeep Matthew Poonnoose, Ganapathiraju Ravichandran, Martin Raymond McClelland
2002 Journal of Trauma  
Objective: The purpose of this study was to determine the incidence of missed and mismanaged injuries of the spinal cord, to identify factors contributing to a failure to recognize such injuries, and to assess the consequences of such failures. Methods: Missed and mismanaged injuries were defined using previously validated statements. All medical records and radiographs of patients with acute traumatic spinal cord injury admitted to the Regional Spinal Cord Injury Unit in Sheffield, United
more » ... ffield, United Kingdom, over a period of 10 years from 1989 were evaluated. Pa-tients with no neurologic deficits were excluded from the study. Results: Of the 569 patients, the diagnosis of spinal cord injury was missed in 52 instances (9.1%). The patients were mismanaged in 34 instances, and the treatment offered to 30 was considered negligent. In 26 of 52 (50%), mismanagement resulted in neurologic deterioration. The study identified several factors that contributed to a failure to recognize a spinal cord injury. These include ambience and circumstances surrounding the injury, inadequate neurologic assessment, associated injuries, and radiographic errors.
doi:10.1097/00005373-200208000-00021 pmid:12169940 fatcat:wqr5jbqb4rglppvihpxrkokoqa