[Spinal cord injury after a fall in patients with cervical spinal canal stenosis]

In patients with pre-existent cervical spinal canal stenosis, minimal trauma, leading to neck hyperextension, can cause a significant increase of spinal cord compression. However, spinal cord injury is generally associated with major trauma and is usually not expected in patients with minor trauma. The resulting symptoms are diverse, making it even more difficult to diagnose. To illustrate the variety in symptoms at presentation, we describe two male patients aged 66 and 69. Rapid diagnosis is important as acute neurosurgical intervention may be indicated. Physical neurological examination, and in particular testing peripheral reflexes, can contribute to the rapid diagnosis of spinal cord injury. Cervical spine CT should not only be assessed for acute traumatic injury, but also for possible stenosis of the cervical spinal canal.