Systematic Interpretation of the Spinal Radiograph Case 2

You are asked to assess a 56-year-old man in resus who has fallen from some scaffolding. On assessment he is alert and conscious but unable to move his legs and has weakness in his arms.

His observations are:

• HR 61
• BP 90/45
• SpO₂92% in air
• GCS 15

On examination he has power grade 5/5 in C6 and above, grade 3/5 in C7 and C8, and grade 0/5 below this. He is unable to feel any stimulus below C7.

In what order should the management steps be taken?

Lateral, peg and AP cervical spine x-rays are taken in the resuscitation room (Figs 1-3).

Click on the x-rays to enlarge.

Report your findings below.

Fig 1: Lateral view	Fig 2: Peg view	Fig 3: AP view