Occult spinal cord injury sustained by high velocity automobile collision.

Medical education, by necessity, frequently emphasizes the resuscitation and relief of life-threatening conditions in the severely injured patient. The increased use of seat-belt retraints has meant that high speed automobile collisions may not necessarily result in major external injury if the occupants are well supported (Dudley, 1986). In such instances, trauma may be sustained as a result of the spine and viscera continuing to move forward following impact. Examples of such injuries are mesenteric detachment of the gut, ruptured solid organs and distraction fractures of the lumbar spine (Dudley, 1986). A case history illustrating several features which may alert the attending clinician to the presence of underlying, initially occult, clinically significant injury is described.