Acute Traumatic Posterior Dislocation of an Intervertebral 1)isc with Paralysis

As the speed of automobile travel has increased and accidents at high velocities have become more common, a corresponding rise has been noted in the frequency of injuries to the spine and spinal cord. Much attention has always been given to fractures and fracture-dislocations of the spine, causing paralysis, because the diagnosis is quite obvious in the roentgenographic examination. However, very little comment has been made about acute traumatic displacement of an intervertebral disc in the causation of paraplegia. Perhaps this is due in part to the fact that the disc herniation is not apparent on the roentgenogram. At any rate, physicians have not been paying sufficient attention to this entity in the dif-ferential diagnosis of spine injuries. Many papers have been written about compression of the spinal cord or the cauda equina by herniated discs, but in most of these cases the patients have had a history of gradual progression of symptoms for an interval of days or weeks between the initial trauma and the onset of paraplegia . 4 915 A few isolated cases of acute traumatic herniation of an intervertebral disc have been reported. In 1911, Middleton and Teacher presented the case of a man who had lifted a weight, heard a cracking in his back, an