Cervical Spine Injury of Sri Lankan Origin

Abstract

Abstract— According to the World Health Organization, 250,000 – 500,000 people suffer from spinal cord injuries around the world every year, of which up to 90% are traumatic and preventable. Here we discuss a unique case scenario occurred during traditional Sinhala and Tamil New Year festival. It is a common practice to organize ‘new year games’ during this season of which climbing of ‘sliding tree’ is a popular game. However there has been a recent trend to replace this with a different event, where a flag is hung at a high level and a group of people have to make a pyramid where the person at the top has to grab the flag. Our patient, a 55 year old farmer, after consumption of substantial amount of alcohol, was forming the base of the pyramid with a group of his friends. On their shoulders, they were bearing the weight of their friends forming two more stories up. Suddenly one person on the top lost his balance and fell on the head of this patient. Our patient was fallen on the ground and could not get up or move his limbs. He was taken to the local hospital on a three wheeler from where he was transferred to the National Hospital of Sri Lanka. He was quadriplegic with weak diaphragmatic breathing, and computed tomography revealed grade III spondylolysthesis of fourth cervical vertebra over the fifth. With clinical and radiological features of complete cord transection, he succumbed to death within hours of admission. Making human pyramids by ordinary people without a formal training can be extremely dangerous, especially when they are under the influence of alcohol. We strongly suggest that such games should be banned and not allowed among ordinary people.

Keywords— Cervical spine injury, Sri Lanka