Question
I recently sustained a fall landing on my upper shoulder and neck area. I have had ankelokinspondilitis for the past 10 years. I heard a distinct crunch upon impact. I went to the ER and they said due to the mobility in my arms that I had not sustained any form of fracture. I have had fractures previously and have not been fully aware due to my physical limitations however not without significant pain and discomfort. I would like to know if it is possible to have fractured my back/spine without it affecting my current state of mobility. There were no xrays done while at the ER.
Thank you in advance for your reply.
Sincerely
Tammy

Answer
Dear Tammy,

Yes a fracture is possible, especially in light of the ankylosing spondylitis you have...however, this usually takes a long time to get to your neck, as it works its way up the spine from the pelvis. As the spine starts to calcify in this condition, a trauma can easily result in a fracture of the newer bone formations...although this may be only minor and classified as a stable fracture.  So possible but not probable.

However, I have seen two cases in six years of practice, where a patient of mine who went to the hospital after an injury and was sent home with nothing more than some pain killers...when they came to my office I found a fracture in their necks, even though their range of motion was not severely affected, and they had all function to their arms..  So this can happen, even though it is unlikley. In defense of the hospital, I must point out here that both of the fractures I found were stable fractures and required no significant medical care.

I would wait a few days to see if the pain issue gets better, and if not then get an x-ray from another doctors office...medical or chiropractic.  The best way to be sure is to take the films...in light of your fracture history.

Hope this helps Tammy.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net