The role of tertiary neurosurgical intervention in non-missile penetrating injuries of the spine (original) (raw)

Spectrum of complex non-Missile Penetrating Spinal Injury: A Series of Four cases with Review of Literature

AIM: Penetrating Spinal injury has been considered rare and accounts for less than 1.5% of traumatic injuries of the spinal cord. Non-missile penetrating spinal injury (NMPSI) is even rare subset of PSI and their optimum management is unclear. Author shares experience of four unusual cases of complex NMPSI, their complications and discuss their management. Material and Methods: Four NMPSI caused by nail gun, thorn prick, & two by knives (one of them retained) respectively, managed in last eight years were analysed in terms of mode, sites, severity, presentations, complications, management & prognosis. Results: All four were male with age range from 8- 33 years. Two by assault by knives over dorsal spine, one accidental cervical nail injury and one by accidental thorn prick injury in lower dorsal spine. Three were operated to remove foreign bodies & one was managed conservatively. All patients improved with no complication except one who developed trophic ulceration resulting in ampu...

E Case Series Results of Management of Penetrating injuries of the Spine in Northern Nigeria: A Case Series

EC EMERGENCY MEDICINE AND CRITICAL CARE, 2021

Background: Missile and non-missile penetrating injuries of the spine are rare. We present a case series of 3 patients managed at our facility with penetrating injuries of the spine in the last 5 years. Objective: To highlight the need for urgent surgical intervention in patients with worsening neurological signs following penetrating injuries to the spine. Materials and Methods: Three patients presented within the study period (January 2016 to January 2021). There were 2 males and 1 female. Orthogonal plain radiograph was sufficient to define the location and level of injury. The injuring objects were made of ferromagnetic materials so none of the patients had an MRI scan pre-operatively. CT myelography was also not done as none of the patients could afford it. ASIA Impairment Scale was used as outcome measures. Results: 1 had a missile injury (arrow) while 2 had non missile penetrating injuries (knife and scissors). All three had neurological impairment and presenting in spinal shock. The sub-axial cervical spine and the thoracolumbar spine were affected. All presented within 24 hours of injury. All three had emergency surgical retrieval of the injuring objects with one post-operative death from complications of aspiration pneumonitis recorded. The remaining two had significant post-operative neurological recovery and discharged home as ASIA D. Conclusions: Penetrating injuries with neurologic impairment are rare. Early surgical intervention with retrieval of the impaling objects is recommended.

SPINAL INJURIES: Experience of a local Neurosurgical Centre

PAKISTAN JOURNAL OF MEDICAL …, 2008

Objectives: To find out the pattern of traumatic spinal injuries and their management in patients admitted to a neurosurgical unit of a tertiary care hospital in a developing country. Methodology: All patients admitted with spinal injuries between July, ...

Penetrating spinal injury: reports of two cases

Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, 2009

Penetrating spinal cord injuries caused by stab wounds are rare. Such injuries may result from a direct lesion of the neural elements of the spinal cord, cord infarcts or, more rarely, intradural or epidural hematoma. In the present study, two cases with spinal cord and L4 root injuries caused by a knife are presented. The first case, a 22-year-old male, referred to our emergency outpatient clinic with a stab wound injury at the mid-section of his back. Neurological examination of this patient showed paraplegia, and spinal MRI displayed a total spinal cord lesion at the T7-T8 level. The wound was primarily sutured; however, during follow-up, CSF (cerebrospinal fluid) leakage continued and the patient was operated. The ruptured dura mater was primarily sutured in a surgical intervention that involved T7-T8 total laminectomy. The second patient referred to our emergency outpatient clinic with a torso injury caused by a sharp knife. The knife was embedded 2-3 cm deep at the wound site ...

Is spinal immobilisation necessary for all patients sustaining isolated penetrating trauma?

Injury, 2003

Introduction: Previous work suggests that patients with isolated penetrating trauma rarely require spinal immobilisation. This study aimed to identify the incidence of mechanically unstable, or potentially mechanically unstable, spinal column injuries in penetrating trauma patients. The study also aimed to identify the incidence of spinal cord injury as a result of penetrating trauma in Scotland.

A prospective study on acute spinal injuries

Neurosurgical review, 1989

This work examines demographic and clinical characteristics of 163 consecutive cases of acute spinal injuries in a small area of Western Turkey, since 1982. These include all spinal injuries with or without neurological symptoms. Combined conservative and surgical methods were used for treatment. Age, sex, etiology, site of injury, radiologic findings, neurological status, and outcome are compared with the other studies. The results have been found to be parallel to those of the other studies except for some regional differences like an excess of tractor accidents.

Pattern of Spine Trauma Presented to Spine Unit of Tertiary Care Hospital

2018

Objective: To present pattern of spine trauma in terms of etiology, age, gender, level of injury, neurological deficit type of treatment given and complications. Methods: This study was performed at Spine Unit, department of Orthopaedic & Spine Surgery, Hayatabad Medical Complex/ Khyber Girls Medical College, Peshawar and Aman Hospital Peshawar from June 2013 to June 2016. All patients treated for spine trauma were included in the study excluding those who denied to participate. The data was acquired from the hospital record and analyzed with the help of SPSS. Results: Total of 326 patients were included with age ranging from 5 years to 75 years having a mean age of 32.99 + 13.49 SD. Out of the total, 240(73.6%) were male and 86 (26.4%) were female. Etiology in majority of the cases was fall from height, RTA and FAI with frequencies of 199(61%), 120(36.8%) and 7 (2.1%) respectively. Most common level of injury was thoracolumbar spine involving 260 (79.8%) cases while in 66 (20.2 %)...