Intended for healthcare professionals


Fractures of the thoracolumbar spine in major trauma patients

BMJ 1999; 318 doi: (Published 08 May 1999) Cite this as: BMJ 1999;318:1287

ATLS manual does recognise importance of distracting injuries

  1. Ray McGlone, Instructor in advanced trauma life support (
  1. Royal Lancaster Infirmary, Lancaster LA1 4RP
  2. University of Birmingham, Birmingham B15 2TT

    EDITOR—Meek is right to highlight the potential danger of missing fractures of the thoracolumbar spine in patients with trauma if the need for x ray investigations is based purely on the clinical examination. But he is wrong to say that the Advanced Trauma Life Support Manual for Physicians“does not recognise the importance of a distracting injury in masking the symptoms and signs of spinal fracture.”1

    I believe that the quotation he gave was from the introductory section of the chapter on spinal trauma. The following quotes are from the same chapter.2 “Any patient with an altered level of consciousness or cognitive dysfunction (GCS <15), …

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