A rare lumbar spinal column injury: glass injury

Abstract

Penetrating injuries to the vertebral column and the spinal cord are rare. Cauda equina injury caused by broken glass shards is even rarer than expected. In this study, a case of spinal column injury was reported in a 25-year-old female patient with glass shards stabbed in to her back, after falling back on top of the table made of glass. A piece of stabbed glass shards was extracted and the wound was sutured at another hospital before she presented to our emergency service. At the time of presentation, the patient had 2/5 muscle strength on her right leg and hypoesthesia below the L4 level. After emergency surgical intervention, the sensory deficit and the muscle strength have completely improved, and the patient was discharged after 6 days. In penetrating traumas to the lumbar region, emergency physician must keep possible spinal column injury in mind. Key words: Lumbar vertebra/injury, wounds, penetrating/diagnosis ÖZSpinal kolon ve spinal kordun penetran yaralanmaları enderdir. Cam kırılmasına bağlı cauda equina yaralanması beklenenden daha enderdir. Bu makalede cam masa üzerine düşme sonrası, sırtına cam saplanması nedeniyle spinal kolon yaralanması olan 25 yaşında bir kadın hasta sunulmuştur. Hastanın acil servisimize gelmeden önce başka bir hastanede saplanan cam parçasının bir parçası çıkarılmış ve yarası dikilmişti. Hastanın başvurusu sırasında sağ bacakta 2/5 kas gücü ve L4 seviyesinin altında hipoestezisi mevcuttu. Acil cerrahi müdahale sonrası hastada duyu ve motor defisit tamamen düzelmiş ve hasta operasyondan 6 gün sonra taburcu edilmişti. Lomber bölgeye olan penetran travmalarda, acil tıp hekimi spinal kolon yaralanması olabileceğini akılda bulundurmalıdır. Araşt. Hast. Dergisi 2016; 26(3):250-252 doi:10.5222/terh.2016.250 ıntroDuCtıon Injuries to the spinal cord have high morbidity rate and affects commonly young, healthful persons (1) . Stabbing injuries to the spinal cord, also named nonmissile penetrating spinal injuries (NMPSI) are unusual in clinical practice (2) . A nation-wide epidemiological study in Turkey showed that nonmissile penetrating injuries involve %3.3 of all spinal injuries (3) . We present a case with neurological deficit due to penetrating injury in the lumbar region which resolved after surgery. CasE rEportA 25-year-old woman applied to the emergency department (ED) with chief complaint of weakness in the right leg after falling back on the top of the table made of glass. A piece of stabbed glass was removed and the wound was sutured at another hospital before she presented to our ED. Her vital signs were within normal limits and a linear sutured laceration, approximately 4 cm in length, on the right paraspinal region at the L4 level was revealed. At the time of presentation, the patient had muscle strength of 2/5 on

Retained Glass Fragment in the Cervical Spinal Canal in a Patient with Acute Transverse Myelitis: A Case Report and Literature Review

“…The management of glass fragments in the described cases was always surgical (laminectomy, removal of the fragments, and dural closure) if the patient presented to the hospital immediately after injury and exhibited signs of neurological damage and the glass fragment was successfully visualized with imaging [ 7 – 10 , 13 , 15 , 20 – 22 ]. One patient died due to cardiopulmonary insufficiency [ 7 ], while others survived, but some exhibited varying degrees of neurological dysfunction [ 10 , 13 , 20 , 21 ].…”