Spinal cord injury: patients who had an accident, walked but became spinal paralysed.

Out of 1410 patients admitted to the spinal cord injury unit (SARAH) for rehabilitation during a 10-year period (1981-90) 10 had a missed spinal trauma lesion and became paralysed after having overcome the initial injuries and being allowed to walk. Patients were admitted to hospital with a history of being able to walk after an accident and subsequently developing a neurological deficit. Seven patients had radiological findings compatible with instability of the spine. Four had a head injury with coma and an undetected spinal fracture at the first evaluation in the emergency room. Other associated factors were: spinal stenosis, prolapsed disc, infection, foreign bodies, procedures for reduction and stabilization of the fractured spine. We emphasize the need for very careful clinical study and investigation for the diagnosis of multiinjured patients, especially when there is a concurrent brain injury.