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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2014 October;27(5):313-6
Thoracic spinal cord injury caused by a stab wound
Toprak H., Serter A., Aralaşmak A., Kocakoç E.
Department of Radiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
Penetrating spinal cord injuries caused by stab wounds are rare in the population. However, the diagnosis is easy, the urgent surgery might not be made early enough, often leading to worse outcomes. Our goal was to describe our experience with thoracic spinal cord injury caused by a stab wound and recognition of this clinical presentation in the Emergency Department (ED). We report a case of 32-year-old male referred for a spinal cord injury secondary to a stab wound in the midthoracic level. On admission, there was muscle weakness in his right leg. CT revealed a metallic object, consistent with a knife, passing through the right T7-T8 interspinous and interlaminer space, traversing spinal cord and corpus of the T7 vertebra and extending into the soft-tissues of the posterior mediastinum adjacent to the thoracic aorta. An urgent right T7 hemilaminectomy was performed and the metallic object was removed. Postoperative MRI revealed epidural collection and high signal intensity in the right part of the spinal cord due to injury on T2W images. Surprisingly, the patient recovered completely with no neurological deficit on follow-up. In terms of guiding the surgeon, imaging methods especially 3-D CT is very helpful in demonstration of the tract of the foreign metallic object, traumatic pneumomyelogram, hematoma and vascular injury.