Abstract

A 29-year-old man presented 45 minutes after sustaining a blow to the right side of his head when his motorcycle slid on gravel and flipped on the side of the road. After walking away from the accident, the patient noted burning pain in his neck. Shortly thereafter, complete quadriplegia with a sensory level at C4 developed. The patient was given a high dose of methylprednisolone and transferred to a tertiary care center. En route, neurological testing demonstrated rapid improvement, and on arrival, all abnormal motor and sensory findings had completely resolved. Radiographic examination and magnetic resonance imaging of the entire spine showed no abnormality. Torg's ratio was >1 at vertebral level C3 through C6. There was no evidence of developmental stenosis, congenital fusion, cervical instability, or intervertebral disk protrusion.

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