Abstract
Introduction
Dual lesion spinal cord injury (SCI) is the presence of two distinct regions of injury to the spinal cord, which can occur simultaneously or as a sequela of initial injury. Dual lesion SCI appears to be a rather rare occurrence with a paucity of cases described. As such, there is limited information available regarding presentation, evaluation, long-term rehabilitation management, and prognostication of these patients.
Case presentation
Presented is a case of a 25-year-old woman with a gunshot wound injury to the T5 vertebra with associated cord damage, initially classified as T6 ASIA Impairment Scale (AIS) B. A subsequent cervical spinal stroke, in the setting of cord edema, resulted in a motor incomplete cervical SCI. As such, she underwent additional functional decline.
Discussion
Patients with dual lesion SCI present with unique challenges in evaluation and management. This case highlights key factors for the acute care and rehabilitation teams to consider when addressing these challenges.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
National Spinal Cord Injury Statistical Center. Spinal cord injury facts & figures at a glance. 2008. http://www.spinalcord.uab.edu/show.asp?durki=116979.
Knievel S, Reeves R. Poster 320: dual spinal cord injury from a single accident: a case report. Arch Phys Med Rehabil. 2008;89:e127.
Akman M, Karatas M, Kilinç S, Agildere M. Double spinal cord injury in a patient with ankylosing spondylitis. Spinal Cord. 1999;37:305–7.
Atılgan M. Double-level spinal cord injury without vertebral fracture or dislocation: a case report. Ulus Travma Acids Cerrahi Derg. 2012;18:80–2.
Salehani A, Baum G, Howard B, Holland C, Ahmad F. Floating thoracic spine after double, noncontiguous three-column spinal fractures. World Neurosurg. 2016;91:670.e7–11.
Csókay A, Pentelényi T, Tator C, Barros T, Masry W, Ramani P. Treatment of severe double spinal cord injuries. Spinal Cord. 2001;39:492–7.
Pellise F, Bago J, Villanueva C. Double-level spinal injury resulting in “en bloc” dislocation of the lumbar spine. A case report. Acta Orthop Belg. 1992;58:349–52.
Cho S, Lenke L, Hanson D. Traumatic noncontiguous double fracture-dislocation of the lumbosacral spine. Spine J. 2006;6:534–8.
Graillon T, Pech-Gourg G, Adetchessi T, Metellus P, Dufour H, Fuentes S. Double traumatic cervical spine lesion (odontoid fracture and spinal cord injury) and Klippel-Feil syndrome. Neurochirurgie. 2012;58:372–5.
Izzo R, Guarnieri G, Guglielmi G, Muto M. Biomechanics of the spine. Part I: spinal stability. Eur J Radiol. 2013;82:118–26.
Kirshblum S, Biering-Sorensen F, Betz R, Burns S, Donovan W, Graves D, et al. International Standards for Neurological Classification of Spinal Cord Injury: cases with classification challenges. J Spinal Cord Med. 2014;37:120–7.
Author information
Authors and Affiliations
Contributions
Each of the named authors contributed significantly to the production of this report.
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing interests.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary information
Rights and permissions
About this article
Cite this article
Chaggar, R.S., McKinley, W.O. Dual lesion spinal cord injury in a polytrauma patient: a case report. Spinal Cord Ser Cases 7, 91 (2021). https://doi.org/10.1038/s41394-021-00455-w
Received:
Revised:
Accepted:
Published:
DOI: https://doi.org/10.1038/s41394-021-00455-w