[Pitfalls in the diagnosis of spinal injuries]

Injury to the spinal cord remains one of the great disasters which can disrupt any person's life. Although tremendous progress has been made concerning treatment and rehabilitation, our inability to change the irreversible nature of these injuries still underlines the vital importance of their prevention. Saving a patient from potential neurological damage depends upon the early recognition of unstable spinal injuries. Unfortunately, prompt diagnosis is not always the rule. We have identified the following seven diagnostic pitfalls in this regard, and again emphasize a few basic rules in dealing with them: (i) the 'sprained neck'; (ii) the normal radiograph; (iii) head injuries; (iv) multiple injuries; (v) the low cervical region; (vi) high dorsal lesions; and (vii) double spinal injuries.