Senior Scholars Program
Title
Intraspinal penetrating stab injury to the middle thoracic spinal cord with no neurologic deficit
UMMS Affiliation
Department of Orthopedics and Physical Rehabilitation
Publication Date
2012-05-01
Document Type
Article
Subjects
Adolescent; Decompression, Surgical; Dura Mater; Humans; Laminectomy; Male; Nervous System Diseases; Postoperative Complications; Spinal Cord Injuries; Spine; Thoracic Vertebrae; Time Factors; Treatment Outcome; Wounds, Stab
Disciplines
Body Regions | Orthopedics | Rehabilitation and Therapy | Surgery
Abstract
The annual incidence of traumatic spinal cord injury worldwide is estimated to be 35 patients per million. Nonmissile penetrating spinal injuries most commonly occur in the thoracic region, and the majority has neurologic deficits on admission. The management of patients who lack neurologic deficits is controversial due to the risk of neurologic status alteration intraoperatively. However, failure to intervene increases the risk of infection, delayed onset of neurologic deficits, and worsening functional outcome.A 17-year-old boy presented with an intradural T7-T8 knife penetration injury to the spinal cord with no neurologic deficit. Rapid surgical intervention was critical because the knife was lodged between the 2 hemispheres of the spinal cord. The patient was intubated in the lateral position, transferred to the prone position on a Jackson table, and underwent surgical decompression with laminectomy 1 level above and below the injury site, removal of the knife blade in the original path of trajectory, and repair of the dural tear with a collagen matrix. The patient sustained no neurologic sequelae from the penetrating knife injury. He was able to ambulate at discharge and had no complications. To our knowledge, this is the only report of a patient with intradural spinal cord penetration by a foreign object (knife blade) presenting with a normal neurologic preoperative examination that persisted throughout the course of postoperative care.
DOI of Published Version
10.3928/01477447-20120426-40
Source
Orthopedics. 2012 May;35(5):e770-3. doi: 10.3928/01477447-20120426-40. Link to article on publisher's site
Journal/Book/Conference Title
Orthopedics
Related Resources
PubMed ID
22588426
Repository Citation
Li, Xinning; Curry, Emily J.; Blais, Micah; Ma, Richard; and Sungarian, Arno S., "Intraspinal penetrating stab injury to the middle thoracic spinal cord with no neurologic deficit" (2012). University of Massachusetts Medical School. Senior Scholars Program. Paper 148.
https://escholarship.umassmed.edu/ssp/148