Ribs Can Damage the Spinal Cord in a Bicycle Accident

Ribs Can Damage the Spinal Cord in a Bicycle Accident

The ribs are important bones in the body because they protect the heart, lungs, and chest cavity from injury due to outside forces. However, damage to the ribs can also lead to injury to nearby structures as well. While the heart and lungs are at risk, the ribs can also damage the spinal cord.

The chest cavity contains numerous vital organs in the body, such as the heart and lungs, which can be damaged by traumatic injuries to the ribs. For example, bone fractures in the ribs can release fragments of bone that can cause catastrophic personal injuries including:

Collapsed Lung: Also called a pneumothorax in the medical world, a rib fracture can turn the rib into a sharp spear which can puncture the lung. When this happens, air can leave the inside of the lung and compress it from the outside, preventing the lung from inflating properly. This can make it impossible to breathe, leading to a life-threatening situation.

Cardiac Tamponade: A rib fragment can also puncture the heart, allowing liquid to leave the heart and surround the heart from the outside. When this happens, the heart is unable to pump effectively, and the body becomes starved for oxygen and other vital nutrients due to this lack of blood supply.
While these injuries are well-known to the medical community, other associated injuries are possible. A recent case report demonstrated that damage to the ribs can also lead to spinal cord issues as well.

A Case Report: Ribs Intrusion Into the Spinal Canal

The report detailed a middle-aged man who complained to his primary physician of a progressive deformity in his rib cage and difficulty with sensory function at the ends of his limbs. He stated that this had been going on for some time and was unsure of why it was happening. After taking a thorough history, his physician discovered that he had been involved in a serious bicycle accident at the age of 15. He was biking down the road when a truck failed to look both ways and pulled out in front of him. He collided with the front of the vehicle and was thrown from his bicycle, landing on the pavement with extreme force. He sustained a skull fracture along with multiple rib fractures which healed over time. In recent years, he noticed that his rib cage was progressively getting smaller. The physician ordered a series of images which demonstrated that the ribs had healed from the accident decades ago. However, they had not healed properly. The heads of the ribs, which join with the sternum, had dislocated from their proper anatomic location. They were slowly moving out of position and had started to impact the spinal canal, intruding on space that is typically occupied by the spinal cord. This led to the man's sensory issues that brought him to see his physician that day.

Long-Term Impacts of Injuries

Fortunately, the gentleman was able to make a full recovery. He was taken to the operating room where an experienced surgeon was able to move his ribs away from the spinal cord and back to their proper location. The ribs were then held in their correct position using surgical equipment. While this is a successful outcome, many people aren't as lucky. Damage to the spinal cord can lead to chronic medical problems including:

Pain: Many people experience some degree of pain for the rest of their lives as a result of damage to nerves leaving the spinal cord.

Paralysis: People can also lose important motor function if the nerves in their spinal cord are compromised. This can create major quality of life issues for those who lose the use of their arms or legs.

Infection: When people cannot move or sense what is going on with their body, they are prone to developing diseases. This can land people in the hospital for weeks on end.

Image Attribution: used with permission under the 1.0 version of the Universal Public Domain Dedication of the Creative Commons License, from Wikimedia Commons.
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