Non-missile penetrating injuries of the spine

Thakur, RC; Khosla, Virender K.; Vk, Kak

doi:10.1007/bf01403200

Cited by 66 publications

(78 citation statements)

References 5 publications

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“…4 In most cases the weapon is withdrawn by the attacker. Rarely, in some patients the weapon or a part of it can still be lodged in place, which needs to be removed.…”

Section: Discussionmentioning

confidence: 99%

Direct withdrawal of a knife lodged in the thoracic spinal canal in a patient with normal neurologic examination: is it safe?

Şakar

Doğrul

Niftaliyev

et al. 2016

Spinal Cord Ser Cases

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Stab wound injuries to the spinal cord are rare, although they commonly cause complete or incomplete neurological deficits. Normal neurological examination with a knife traversing the spinal canal is extremely rare. Here we report on a patient with a knife lodged in the thoracic spine with normal neurological examination and describe direct withdrawal of the knife with excellent results that have not been reported to date. A 50-year-old male patient was admitted to the emergency service because of his sustaining a stab wound to thoracic 3-4 level due to a knife traversing the spinal canal and still lodged in the vertebral bodies. His neurological examination was normal. The knife was withdrawn in the operating room under general anesthesia without bleeding or cerebrospinal fluid leakage. After withdrawal neurological examination was normal and control magnetic resonance imaging showed no abnormalities. Surgical exploration is suggested for spinal stab wounds if there is a retained body. Some authors recommend exploration even no foreign body is detected. Incomplete or complete cord injuries deserve surgical exploration, but in a patient with normal neurological examination direct withdrawal can be a safe option. Exploration of the wound surgically may have risks associated with enlarging the incision, muscle dissection, enlarging dural tear and bony removal, which may have long-term adverse effects. The operation team must be ready for urgent exploration. Cerebrospinal fluid leakage, excessive bleeding or any neurological deficit after removal must mandate surgical exploration. Long-term close follow-up of the patient has paramount importance for late complications such as infection and pseudomeningocele development.

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“…4 In most cases the weapon is withdrawn by the attacker. Rarely, in some patients the weapon or a part of it can still be lodged in place, which needs to be removed.…”

Section: Discussionmentioning

confidence: 99%

Direct withdrawal of a knife lodged in the thoracic spinal canal in a patient with normal neurologic examination: is it safe?

Şakar

Doğrul

Niftaliyev

et al. 2016

Spinal Cord Ser Cases

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“…Penetran spinal yaralanmalarda lokal yara bakımı, analjezi, geniş spektrumlu antibiyotik ve tetanoz proflaksisi tavsiye edilmektedir. Kanal içinde yabancı cisim ya da kemik fragmanları varlığında, epidural yada intradural abse ve 4 günden daha uzun süren BOS kaçağı varlığında cerrahi girişim önerilmektedir (10)(11)(12) . Olgumuzda ilk başvurduğu hastanede lokal yara bakımı yapılmış.…”

Section: Discussionunclassified

A Case of Cerebrospinal fluid leakage and Pneumocephalus Secondary to Thoracic spine Knife Injury

Bozkurt

Altun

Şenel

et al. 2015

sscd

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Pnömosefali intrakraniyal kavitede hava varlığı olarak tanımlanır. Bu durum kafa travması, kurşun ve spinal bıçak yaralanması gibi birkaç spesifik mekanizma sornası ortaya çıkar. Sırtta olan bıçak yaralanmaları spinal kanala ulaşarak spinal korda zarar verebilir. Hatta spinal korda zarar vermese bile BOS kaçağı ve pnömosefaliye neden olabilir. Bu durum enderdir fakat yaşamı tehdit eden menenjite yol açabilir. Bu makalede sırtta bıçak yaralanma sonrası geç dönemde ortaya çıkan BOS kaçağı ve pnömosefalisi olan bir olgu sunulmuştur. A Case of Cerebrospinal Fluid leakage and Pneumocephalus Developed Secondary to Thoracic Knife Injury of the SpinePneumocephalus is defined as the presence of air in the intracranial cavity. This condition emerges secondary to several specific types of mechanism of injury such as head trauma, missile injuries and spinal stab wounds. Stab wounds of the back can reach to spinal canal and damage the spinal cord. Even if it doesn't damage the spinal cord, it can cause leakage of cerebrospinal fluid and pneumocephalus. This condition is rare but it can lead to life-threatening conditions such as meningitis. In the present study a case with delayed CSF leakage and pneumocephalus developed after stab wound of the back. (1)(2)(3) . Penetran spinal travma, epidural anestezi ve lomber ponksiyon sonrası tanımlanmış az sayıda pnömosefali olgusu vardır (4)(5)(6)(7)(8) . Pnömosefali tanısı için bilgisayarlı beyin tomografisi altın standarttır (1) . Keywords: Headache, CSF leakage, pneumocephalus J Nervous Sys Surgery 2015; 5(3-4):74-78Penetran spinal travma BOS fistülünün gelişmesi-ne neden olabilir (6,9,10) . Biz penetran sırt yaralanmasını takiben geç dönemde gelişen BOS fistülü ve pnömosefali hastasını sunmayı amaçladık.

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“…2) A recent study found 22% of penetrating spinal injuries occurred in the thoracic region, and 23 of 84 patients with thoracic penetrating injuries had associated visceral injury. 7) Gunshot wounds cause most penetrating spinal injuries, but stab wounds cause 7-26% of all penetrating spinal injuries, [5][6][7] and seem to be more frequent in thirdworld countries. 3) Stab injuries most commonly occur in young men, and usually involve the cervical and upper dorsal spine.…”

Section: Discussionmentioning

confidence: 99%

“…3) Stab injuries most commonly occur in young men, and usually involve the cervical and upper dorsal spine. 5) Penetrating injuries to the thoracic great vessels occur in 2% of cases of stab wounds to the chest, 1) but combined injury of both spinal cord and aorta by a dorsally placed stab is extremely rare. 4) Injuries to the great vessels are the most dangerous penetrating thorax traumas.…”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Combined Stab Injury of the Spinal Cord and the Aorta-Case Report-

Şimşek

Kılınçer

Sunar

et al. 2004

Neurol. Med. Chir.(Tokyo)

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A 32-year-old man presented with a combined penetrating stab injury of the spinal cord and the aorta caused by a knife wound in his back at the low thoracic level. The knife had broken, and part of the blade had been retained in the wound, passing through the spinal canal and into the aortic lumen. The patient was treated in two steps: the aorta was repaired by a thoracotomy, then spinal exploration was carried out through a laminectomy. Because of the tamponade effect of the foreign body, it was necessary to delay removal of the blade until vascular control had been achieved. Any sign of a penetrating body passing through the spine should suggest careful evaluation to detect any visceral injury, and multidisciplinary treatment should be planned.

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Non-missile penetrating injuries of the spine

Cited by 66 publications

References 5 publications

Direct withdrawal of a knife lodged in the thoracic spinal canal in a patient with normal neurologic examination: is it safe?

Direct withdrawal of a knife lodged in the thoracic spinal canal in a patient with normal neurologic examination: is it safe?

A Case of Cerebrospinal fluid leakage and Pneumocephalus Secondary to Thoracic spine Knife Injury

Surgical Management of Combined Stab Injury of the Spinal Cord and the Aorta-Case Report-

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