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March 25, 1968

Compression Fracture of L-2 With Cauda Equina Injury

Author Affiliations

From the Fracture Clinic, Massachusetts General Hospital, Boston.

JAMA. 1968;203(13):1127-1131. doi:10.1001/jama.1968.03140130039010

Dr. Patrick J. Logue: This was the first Massachusetts General Hospital admission for this 36-year-old Negro laborer who was admitted shortly after noon with a history of a fall of 12 feet. While eating his lunch on scaffolding at a construction site near the hospital, the structure collapsed. He described unconsciousness, lasting "a few minutes" and back pain without radiation to the legs.

On admission to the Emergency Ward he was fully alert and complaining of severe pain in the low back. The mental status was clear, and the patient was oriented to time and place. Cranial nerve function was normal. There was hypalgesia to pinprick over dermatomes L-3 to S-2 in the right lower extremity. Position and vibratory senses were intact. Detailed muscle examination was not performed because of the patient's pain, but flexion and extension of toes, ankles, and knees were described as present bilaterally. Deep tendon reflexes