ABSTRACT
X-ray examination is mandatory for all accident victims complaining of pain or stiffness in the neck or back, all patients with head injuries or severe facial injuries, patients with rib fractures or severe seat-belt bruising, and those with severe pelvic or abdominal injuries. If the spinal injury is unstable, it should be held secure until the tissues heal and the spine becomes stable. Fractures of the atlas are associated with injury elsewhere in the cervical spine in up to 50% of cases. Most injuries of the thoracolumbar spine occur in the transitional area between the relatively rigid thoracic spine and the more mobile lumbar spine. Patients complaining of back pain following an injury or showing signs of bruising and tenderness over the spine, as well as those suffering head or neck injuries, chest injuries and pelvic fractures, should undergo a careful examination of the spine and a full neurological examination, including rectal examination.
