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October 13, 1969

Spinal Cord Tear in Breech Delivery

Author Affiliations

Flint, Mich

JAMA. 1969;210(2):347. doi:10.1001/jama.1969.03160280087029

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To the Editor:—  I was interested in the article, "Laceration of the Spinal Cord Related to Breech Delivery," by Allen et al (208:1019, 1969).Some years ago, I saw a typical case of this tragic obstetrical complication in a 3-week-old infant. At that time, I did a myelogram and the radiographic manifestations of complete intraspinal extramedullary block was also present. I could find no references as to the significance of the block, but Dr. Sidney Carter (pediatric neurology) assured me that this had been found several times on his service, and emphasized that surgical exploration of the area was unnecessary.We chose to do nothing, and the child eventually died of respiratory complications. At autopsy, the classical pathological manifestations of cord disruption with meningeal adhesions was present.The point of this letter is to urge that after clinical and myelographic diagnosis of cervical cord disruption after breech delivery, surgical