A 29-year-old man was involved in a motorcycle versus automobile accident. On admission to our hospital he had paresthesia and slight loss of motor power in both upper limbs and was found to be paraplegic with complete sensory and motor loss below Th6. His injury was classified as a Frankel type A. Radiographs of the spine showed a burst fracture of C4 and vertebral body fractures at Th4-9 with maximun lateral dislocation at Th6/7. Posterior fusion at Th2-10 with a Luque and a Harrington rod was done about 4 weeks after the initial injury. Anterior fusion at C4-5 was done 10 days after initial operation. Eight months after surgery, he recovered to Frankel type D and could walk using a long leg cast.
In patients with quadriplegia, proper treatment is dependent on early diagnosis of the primary lesion. Although it is uncommon, the second or third leveles of injuries are not recognized. Therefore, it is recommended that total spinal radiographs should be taken as soon as possible.