Mr of cord transection

Spinal cord transection following breech or difficult cephalic deliveries has been well described. It is important to be aware that spinal cord transection in children may occur following severe trauma such as motor vehicle accidents often without evidence of underlying skeletal injury. We report three pediatric cases, one of which showed no evidence of underlying skeletal injury and two where the level of cord transection was below and remote from the site of a cervical fracture. When a neurologic deficit does not correlate with a known bony or ligamentous level of injury or is present despite normal routine plain radiographs, further imaging is warranted to exclude a remote cord transection as demonstrated in our patients.