The Journal of Emergency Medicine, Vol. 34, No. 3, pp. 283–285, 2008
Copyright © 2008 Elsevier Inc.
Printed in the USA. All rights reserved
0736-4679/08 $–see front matter

doi:10.1016/j.jemermed.2007.06.034

Clinical
Communications: Adults

THORACIC SPINE COMPRESSION FRACTURE AFTER TASER ACTIVATION
Christian M. Sloane,

MD,

Theodore C. Chan,

MD,

and Gary M. Vilke,

MD

Department of Emergency Medicine, University of California, San Diego Medical Center, San Diego, California
Reprint Address: Christian M. Sloane, MD, Department of Emergency Medicine, UC San Diego Medical Center, 200 West Arbor
Drive, Mailcode #8676, San Diego, CA 92103

e Abstract—The TASER is a less lethal weapon seeing
increased use by police jurisdictions across the country. As
a result, subjects of TASER use are being seen with increasing frequency in emergency departments across the country. The potential injury patterns of the device are important for emergency physicians to understand. This report
describes the case of an officer who complained of back
pain after a single 5-s TASER discharge during a routine
training exercise. Subsequent evaluation led to the diagnosis of an acute thoracic vertebral compression fracture. We
discuss the potential mechanisms of injury in this case.
Because we were unable to find any cases like this in our
review of TASER-related injuries, we liken it to compression fractures that have been documented after seizures.
We recommend that physicians consider obtaining back
radiographs to rule out a vertebral compression fracture in
any individual who has sustained a TASER discharge and
has ongoing or persistent back pain. © 2008 Elsevier Inc.

there is a relative paucity of medical data in the peerreviewed medical literature. The devices are generally
regarded as safer than conventional firearms (1).
As the device is used on more subjects, various injuries have been reported. Here we report the first case of
a thoracic spine vertebral compression fracture caused by
a standard deployment of the TASER.

CASE REPORT
A 37-year-old man (5’ 9Љ tall, 190 lbs) was participating
in a training class in the use of the TASER X-26® as part
of his employment as a law enforcement official. One
component of the training gives the officers the opportunity to experience a voluntary deployment of the device as used in an actual situation. The officer was shot
using a standard TASER cartridge in the probe mode
from approximately 10 feet away, with the barbs contacting him in the back, one over the left scapula and one
over the back just to the right of midline. He experienced
a full 5-s TASER deployment. As per protocol, the
officer was supported under each axilla by spotters who
assisted to prevent the subject from falling and injuring
himself during the activation. The support was effective
in this case and the officer did not fall either before or
after the exposure.
After the exposure, the officer experienced what the
physicians on site interpreted as a vasovagal episode, as
evidenced by pallor, diaphoresis, and dizziness. Blood

e Keywords— conductive energy devices; police; TASER;
stun guns

INTRODUCTION
The TASER® (TASER International, Scottsdale, AZ) is
one of a collection of less lethal weapons used by law
enforcement that are collectively known as CEDs (conducted energy devices). Their use is becoming more
widespread as more municipalities and jurisdictions
adopt CEDs in their use of force continuum. Although
the manufacturer emphasizes the safety of the TASER,

RECEIVED: 8 May 2007; FINAL
ACCEPTED: 11 June 2007

SUBMISSION RECEIVED:

4 June 2007;
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C. M. Sloane et al.

Figure 1. Plain radiograph of thoracic spine demonstrating
T7 compression fracture (arrow denotes fracture).

pressure taken at the time was low (84/50 mm Hg) and
pulse was 94 beats/min. The patient never lost consciousness. He was assisted to a position of comfort, which for
him was supine on the floor with his legs flexed. He did
not fall. His vagal symptoms resolved, but when he tried
to get up he complained of severe midline thoracic back
pain. When symptoms persisted after a period of observation, emergency medical services were accessed and
the officer was transported to a local hospital for evaluation of continued back pain after voluntary TASER
exposure.
In the Emergency Department, the patient had normal
vital signs but continued to complain of pain in the mid
to low thoracic spine as well as the lumbar spine. Examination showed mild point tenderness over the spine at
T7–T10 as well as L2–3. His neurologic examination
was intact, including normal motor, sensory, and deep
tendon reflexes. Plain films of the thoracic spine confirmed a compression fracture of T7 with anterior wedging (Figure 1). Lumbar films were negative. The radiologist also commented on diffuse osteopenia greater than
expected for the patient’s age. A subsequent magnetic
resonance imaging scan confirmed an acute compression
fracture (Figure 2). The patient was treated with narcotic
analgesia and non-operatively managed by an orthopedic
spine specialist. His symptoms improved.
The patient had reported no medical problems, no
history of previous back pains or back issues, no medication use, and no history of frequent fractures or recurrent steroid use.

It weighs approximately 18 ounces, and is powered by
either NiCad batteries or high-output alkaline Duracell
Ultra® batteries (The Gillette Company, Bethel, CT).
The energy output of the device is 26 watts total, 1.76
joules per pulse, 36 milliamps, 50,000 volts. It uses an
automatic timing mechanism to apply the electric charge
for 5 s. When the trigger is depressed, a compressed
nitrogen cartridge (1800 lb/in2) fires two probes at an
initial velocity of 180 feet per second.
The TASER delivers its electrical discharge energy
through a sequence of dampened sine-wave current
pulses each lasting about 11 ms. The electrical discharge
is transmitted from the TASER gun through thin copper
wires to the end probes. The probes, also known as barbs
or darts, consist of a thick metal base and thin metal shaft
with a barb on the end similar to a fish hook. They are
designed to penetrate and stick in skin or clothing. The
device will deliver its current and obtain the desired
effect as long as the probes are within 2 inches of the
victim’s skin. The manufacturer recommends 12–18 feet
distance with the police model to obtain a minimum 4-inch
spacing that optimizes obtaining the desired effect.
The current TASER works by incapacitating one’s
ability to maintain volitional control of the body by
causing electro-physical, involuntary contraction of skel-

DISCUSSION
The device used in this event was the TASER X-26®.
The X-26 is a handheld device resembling a handgun
that is intended to be used on subjects up to 21 feet away.

Figure 2. Magnetic resonance imaging scan of the thoracic
spine demonstrating acute T7 compression fracture without
spinal canal compromise (arrow denotes fracture).

Spine Fracture after TASER Activation

etal muscle tissue. It overrides the nervous system, resulting in loss of motor control by the subject. The
TASER directly stimulates motor nerve and muscle tissue, causing incapacitation regardless of the subject’s
mental focus, training, size, or drug intoxication state.
Various injuries have been reported after the use of
the TASER, the most controversial of which is death of
a subject after a TASER activation. Causality has not
been definitely linked solely to the TASER. Other injuries such as puncture wounds to the phalanges of the
hands and the eye also have been reported (2– 4). There
is one report of a pregnant woman who underwent a
miscarriage days after receiving a TASER deployment
(5). To our knowledge, no injuries have been reported
relative to the musculoskeletal system not related solely
to the barbs or penetration. In a search of the MEDLINE
database, we were unable to find any other cases of a
vertebral compression fracture as a result of a TASER
deployment.
The TASER creates intense involuntary contractions
of skeletal muscle, causing the subject to lose the ability
to directly control the actions of the voluntary muscles.
This is an electrical effect and it terminates as soon as the
electrical discharge is halted. We feel confident that this
injury was a result of the TASER deployment. The
patient had no complaints of back pain before the deployment and denied prior back injuries. The pain began
immediately after the exposure. The pain was severe
enough to cause a vagal reaction. The magnetic resonance imaging scan confirmed the acute nature of the
injury.
How did this occur in the absence of a fall? We
suspect that the location of the barb contact points being
in the back across the relatively large paraspinous muscle
groups may have led to the abrupt forceful contractions
of those muscles or other muscles of the torso, resulting
in an acute compression fracture of the vertebral body.
This is similar to the proposed mechanisms for compression fractures that have been reported after seizures
(6 – 8). It is interesting that the radiologist commented on

285

osteopenia in this young man’s radiographs, which, if
confirmed, may have placed him at increased risk. It is
documented that in epileptics who sustain compression
fractures after a seizure, decreased bone mineral density
is often to blame. In these cases, it is often secondary to
the negative effects of long-term anticonvulsant therapy
on bone mineral density (7).
We suspect that this type of injury has occurred before
but has never been reported, either because the individuals never sought medical attention or radiographs were
not performed and the symptoms attributed to a strain.
The natural course of many slight compression fractures
is such that they improve without the need for any
intervention.
TASERs are a less lethal technology that have reduced gun use by police officers, but can be associated
with physical injuries similar to any other less lethal
weapons. Given this current case report, we recommend
that physicians consider obtaining back radiographs to
rule out a vertebral compression fracture in any individual who has sustained a TASER discharge and has ongoing or persistent back pain.
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