Spinal cord injury resulting from scuba diving

Abstract

With the recent increase in the number of scuba divers, there has come a concomitant increase in the cases of decompression sickness. About 24% of these cases have some neurological consequence involving the spinal cord and the potential to render a victim permanently paraplegic. The initial symptoms may be obvious or insidious and progressive. Victims have presented themselves to a physician days later complaining only of low back pain. If not suspected, the diagnosis may be overlooked and a victim may become permanently paraplegic. Twenty-five cases of spinal injuries resulting from decompression illness over a 5-year period treated at the University of South ern California Catalina Marine Science Center are reviewed. Emergency treatment was required and consisted of recompression and O2 therapy under pressure in a hyperbaric chamber to immediately pre vent the progression of the illness and lead to a reversal of pathology in the majority of cases. It is recommended that hyperbaric treatment be initiated early to best prevent progression of the disease, how ever, late treatment is helpful, even after 10 days. Adjunct therapy advised consists of 100% O 2 by mask, Ringer's solution, dextran 40, dexamethasone, and rapid sea-level transport of a victim to a de compression chamber. If air transport is used, the altitude should be maintained at 800 feet or less, or aircraft capable of sea-level pressurization should be used. It is also advised that one not drive or fly for a period of time after scuba diving. It is hoped that increased awareness of this problem on the part of physicians will accomplish prompt and thus more ef fective treatment.