26th August 2020

A 23-year-old bricklayer is brought into the Emergency Department by two newly qualified paramedics

A 23-year-old bricklayer is brought into the Emergency Department by two newly qualified paramedics. He arrives on a stretcher with cervical spine immobilisation having fallen approximately 10 feet off a ladder onto a breezeblock. On examination, his cervical spine is not tender, he has no evidence of fracture in his long bones but when log rolled his back is very tender on the left side at approximately L2 level. There is no deformity. A neurological exam is carried out as part of the secondary survey, the results are as follows:

L Side:

• Power 2/5 all myotomes
• Reflexes absent
• Sensation (pinprick, temperature, light touch) all intact
• Loss of proprioception distally

R Side: 

• Power 4/5 all myotomes (owing to pain)
• Reflexes normal
• Sensation reduced in L2-S5 dermatomes, proprioception intact

Which of the diagnoses above is responsible for the presentations described? Select the SINGLE most appropriate option from the list above.