Severe Thoracic Vertebral Spine Injury as a Complication of Component of Cardiopulmonary Resuscitation

Abstract

Chest compression has been a component of cardiopulmonary resuscitation (CPR) since 1960. Performance of high-quality CPR is critical for survival; however, chest compressions are traumatic and may result in injuries such as rib and sternal fractures. Spinal fractures have rarely been reported. We present a case of a 69-year-old male who suffered a cardiac arrest at home. He underwent 16 minutes of CPR with manual chest compressions, and no electrical shock and medications with return of spontaneous circulation (ROSC). Computed tomography scan showed unstable fracture of T9-T10. The patient was transferred to our Level I trauma center for continued post-arrest management and neurosurgical evaluation. An MRI confirmed the unstable spinal fracture which would have required surgical stabilization. The patient remained comatose, thus he was transitioned to comfort measures and expired. Spinal injuries following CPR are rare but should be considered in the post-arrest management stage. Computed tomography scan is the ideal screening modality.