Open Water Cervical Spine Injury.

Area of Science:

• Emergency Medicine
• Sports Medicine
• Neurosurgery

Background:

• Acute cervical spine injuries pose a significant challenge, especially in dynamic environments like open water sports.
• The aquatic setting introduces unique hazards and complicates the delivery of timely, coordinated medical care.
• Effective management requires rapid recognition, extraction, and transport to a trauma center.

Purpose of the Study:

• To report a case of acute central cord syndrome following a traumatic cervical spine injury during a triathlon.
• To discuss the management and neurologic recovery of a patient with severe distal weakness.
• To analyze the risks and benefits of Spinal Motion Restriction (SMR) in aquatic environments.

Main Methods:

• Case report of a patient with a direct head and neck impact during an open water triathlon.
• Prehospital medical rescue team intervention including prompt extraction and transport.
• Magnetic Resonance Imaging (MRI) for diagnosis and surgical planning.
• Surgical treatment for acute central cord syndrome.

Main Results:

• The patient presented with severe distal weakness, more pronounced in the upper extremities.
• Prompt surgical intervention led to improved neurologic recovery.
• The case highlights the importance of a coordinated prehospital and hospital response.

Conclusions:

• Swift and coordinated response is critical for optimal neurologic preservation in acute cervical spine injuries.
• Spinal Motion Restriction (SMR) in aquatic environments presents unique challenges and controversies.
• Early diagnosis and surgical management can lead to favorable neurologic outcomes in central cord syndrome.