A middle-aged male presented after a fall from height under the influence of alcohol—ambulatory, alert, and without neurological deficit. Apart from neck pain, clinical examination appeared reassuring. However, lateral cervical spine radiography revealed significant vertebral malalignment suggestive of fracture dislocation in the lower cervical spine, indicating an unstable injury despite preserved neurological function. This case highlights the importance of radiology in trauma evaluation, where clinical findings alone may be misleading.
Intoxication can mask symptoms, and a normal neurological examination does not exclude severe cervical spine instability. Early imaging, strict immobilization, and timely referral remain critical to prevent catastrophic secondary spinal cord injury. In trauma care, early use of comprehensive imaging can significantly influence management decisions and…