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Spine injury following a low-energy trauma in ankylosing spondylitis: A study of two cases

Forensic Science International
DOI: 10.1016/j.forsciint.2014.05.018
  • Spine Injury
  • Low-Energy Trauma
  • Ankylosing Spondylitis
  • Multislice Computed Tomography
  • Post-Mortem
  • Autopsy
  • Criminology
  • History
  • Medicine


Abstract 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.

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