Life threatening spinal shock and complete neurological recovery following minor spinal cord trauma in a patient with pre-existing cervical canal stenosis: Case report

Abstract

Mild to moderate trauma to the spinal cord that is complicated by existing cervical canal stenosis or spondylosis can be a life threatening event. It is against this background that we present a 41 year old male with cervical spinal stenosis who developed marked quadriparesis and respiratory embarrassment following collision with a colleague. He was admitted to the intensive care unit, electively sedated, paralysed and ventilated for a period of 48 hours. During the initial 24 hours of admission, he received methylprednisolone as per the National Acute Spinal Cord Injury Studies (NASCIS) protocol. Forty five hours later he had regained full neurological and respiratory function, allowing extubation and subsequent discharge from the intensive care unit. While patients with cervical spinal cord trauma in a setting of cervical canal stenosis or spondylosis can deteriorate dramatically, early recognition of this condition and prompt management using methylprednisolone, cervical stabilisation and ventilatory support during the initial window of opportunity will enable them make a full recovery.