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Fri Jan 12 16:37:52 GMT 2007

I wanted some advice/guidance for medicolegal issue.

37/M scaffolder involved in RTA.Front seat restrained passenger in a car, collision at 40 mph. Banged head against the console on passenger seat (flexion hyper-extension injury). Did not think much of the injury. Treated as a whiplash injury at first. Noted by his friends with progerssive weakness over 6-8/52  in both upper and lower limbs and change in gait pattern. Then went to see a Orthopaedic Surgeon (3/12 later) . MRI cervical spine showed disc prolapse, cord compression and myelopathic changes at C3-4. Subsequently had decompression and fusion at C3-4. Still has motor weakness in the limbs.He has no past H/O neck problems. MRI did not reveal suggestion of pre-existing pathology (facet hypertrophy, ligament thickening,etc) 

The argument is his neurological signs are incidental and not related to RTA.Does anybody have experiences with similar cases? If so could you tell me where I can find references. 

Many thanks

Regards

Roshan Dath
Clincal Fellow in Trauma and Orthopaedics
North Shields,UK
Mobile (+44) 07866606086

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Late onset neurological signs after cervical spine injury