Unconscious @entity1 with @entity1230 present a major diagnostic and therapeutic problem. The incidence of @entity51 increases if diagnosis of a @entity3510 is delayed or missed. Thoracolumbar @entity174 are commonly the result of high energy injuries and in an unconscious @entity1 the risk of missing such @entity174 is increased considerably. There is little consensus on which blunt @entity130 @entity1 warrant thoracolumbar spine films when no @entity158 , tenderness, @entity51 or cervical spine injuries are identified. We present a retrospective analysis of all @entity1 who were admitted to the Major Injuries Unit at the Birmingham General Hospital and underwent radiological survey of the thoracolumbar spine. Of the 110 @entity1 , all @entity174 were detected in 94 @entity1 with a Glasgow @entity772 Scale (GCS) > or = 11. Of the 16 with a GCS < or = 10, 9 @entity1 had sustained injuries of their thoracolumbar spine 4 of which were not detected initially due to a decreased level of consciousness. The common features amongst the 4 @entity1 with missed injuries were: (1) High velocity injury. (2) Decreased level of consciousness on admission. (3) Associated @entity542 . (4) Pelvis/lower @entity130 . We describe the four cases and identify a group of high risk @entity1 for thoracolumbar @entity174 . Radiological examination of the thoracolumbar spine is essential in this group.

A high risk group for thoracolumbar XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity3510 :: ('MESH:D013124', 'Disease') :: ['spinal injury'] @entity174 :: ('MESH:D050723', 'Disease') :: ['fractures', 'spinal fractures'] @entity542 :: ('MESH:D006259', 'Disease') :: ['head injury'] @entity772 :: ('MESH:D003128', 'Disease') :: ['Coma'] @entity51 :: ('MESH:D009461', 'Disease') :: ['neurological deficit'] @entity1230 :: ('MESH:D009104', 'Disease') :: ['multiple injuries'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain'] @entity130 :: ('MESH:D014947', 'Disease') :: ['extremity injury', 'trauma']
@entity174 :: (MESH:D050723,Disease) :: ['fractures']
