Savall Frederic, Mokrane Fatima-Zohra, Dedouit Fabrice, Capuani Caroline, Guilbeau-Frugier Céline, Rougé Daniel, Telmon Norbert
Service de Médecine Légale, Centre Hospitalier Universitaire Rangueil, Avenue du Professeur Jean Poulhès, Toulouse Cedex 4 31403, France.
Service de Radiologie, Centre Hospitalier Universitaire Rangueil, Avenue du Professeur Jean Poulhès, Toulouse Cedex 4 31403, France.
Forensic Sci Int. 2014 Aug;241:123-6. doi: 10.1016/j.forsciint.2014.05.018. Epub 2014 May 29.
We report two cases of spine injury following a low-energy trauma in persons with ankylosing spondylitis (AS) and discuss the forensic considerations. A 60-year-old man presented with a wide anterior fracture of the superior endplate of T8 after an accidental fall down three wooden steps. A 93-year-old man presented with disjunction between C6 and C7 and 90-degree spinal angulation after a fall from a standing height or a fall from a bed. Post-mortem multislice computed tomography (MSCT) was performed before autopsy in both the cases. MSCT and autopsy findings were in agreement with a past medical history of AS. A spine injury occurring after a low-energy trauma is unusual and could be suspicious. In the forensic literature we found only a single case, which concerned multiple spinal fractures after a fall from a bicycle at low speed. Such specific mechanisms must be studied and known to the forensic expert. In this context, MSCT is a useful tool to investigate the spine and knowledge of the victim's entire past medical history is essential.
我们报告了两例强直性脊柱炎（AS）患者在低能量创伤后发生脊柱损伤的病例，并讨论法医相关考量。一名60岁男性在意外从三级木台阶上跌落之后，出现T8椎体上终板广泛的前缘骨折。一名93岁男性从站立高度跌落或从床上跌落之后，出现C6和C7椎体分离以及90度脊柱成角。两例均在尸检前进行了尸体多层计算机断层扫描（MSCT）。MSCT和尸检结果与既往AS病史相符。低能量创伤后发生脊柱损伤并不常见，可能会引起怀疑。在法医文献中，我们仅发现一例相关病例，涉及一名患者在低速骑自行车摔倒后发生多处脊柱骨折。此类特殊机制必须加以研究并为法医专家所熟知。在此背景下，MSCT是用于研究脊柱的有用工具，了解受害者完整的既往病史至关重要。
