• Agabe Emmy Nkusi, Sévérien Muneza, David Hakizimana, Steven Nshuti, and Paulin Munyemana.
• Rwanda Neurosurgical Centre, King Faisal Hospital, Kigali, Rwanda; Directorate of Perioperative Services, King Faisal Hospital, Kigali, Rwanda; Neurosurgery Training Program, Department of Surgery, University of Rwanda, Kigali, Rwanda.
• World Neurosurg. 2016 Mar 1; 87: 269-76.

ObjectivesThis study was aimed at 1) reporting cases of missed cervical spine injuries treated at a tertiary-level hospital, King Faisal Hospital, Rwanda (KFH-R), and 2) identifying the causes of delaying the diagnosis.MethodsWe prospectively collected data from patients with a missed or delayed cervical spine and/or cord injury treated at King Faisal Hospital, Kigali for a 12-month period (January 2012 to December 2012). The total number of cervical spine injury patients treated at our center was retrieved from the hospital admission registry.ResultsForty-two patients with cervical spine or spinal cord injuries were treated at KFH-R in 2012, and 4 of them had a missed or delayed diagnosis. Clinical and radiologic findings of all 4 patients are presented, and the reasons for delaying diagnosis are identified.ConclusionThis study found that the cervical spine injuries were missed in 9.5% of the cervical spine trauma patients and resulted in a longer hospital stay for all 4 patients and severe disability in 1 patient (25%). The reasons for missed diagnoses in this study were 1) lack of cervical spine radiographic evaluation, 2) inadequate cervical spine radiographs to show the level of injury, 3) poor sensitivity of cervical spine plain radiography, 4) poor physical examination, 5) the presence of a distracting injury, and 6) poor sensitivity of radiographs and computed tomography scans for soft tissue injuries.Copyright © 2016 Elsevier Inc. All rights reserved.

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