Spinal Concussion in Adults: Transient Neuropraxia of Spinal Cord Exposed to Vertical Forces
OBJECTIVE: The aim of the study is to discuss along with literature knowledge the post-traumatic clinical progression of cases with symptoms of transient spinal cord impact and cases of spinal concussion following exposure of the vertebral column to vertical forces. MATERIALS AND METHODS: A total of 43 cases, all falls from height, were diagnosed with spinal concussion. It was determined that the vertebral column had been exposed to the effects of vertical forces, and the spinal cord had been affected by vertical forces. In all cases, spinal magnetic resonance imaging and dynamic X-ray examinations were performed at the time of admission. Clinical symptoms of the cases were recorded by scoring based on the Torg Grading System. RESULTS: Cases were started on conservative treatment because radiologic symptoms that would explain the clinical symptoms could not be detected. Most frequently encountered were the neurologic symptoms related to the upper thoracic and lower cervical segments being affected. In 7 cases, urinary incontinence was also detected. Symptoms related to the spinal cord being affected were completely recovered in 1-3 days in all cases. CONCLUSION: As a result of the vertebral column being affected by vertical forces, the most frequently affected are the thoracic segments of the spinal cord. These cases show similarities to real spinal cord injury without radiographic abnormality cases when evaluated along with clinical and radiologic symptoms. Absolute differential diagnosis from real spinal cord injury without radiographic abnormality cases cannot be made until total neurologic recovery takes place.