A survey on spinal cord injuries resulting from stabbings; a case series study of 12 years' experience

Abstract

Abstract:Background:Penetrating spinal cord injuries (SCIs) are an uncommon injury and not reported very frequently. SCIs cause sensory, motor and genitourinary system problems or a combination of sensorimotor dysfunctions. These are among the most debilitating kinds of disorders and negatively affect quality of life, not only for the patient, but also for their family members. Therefore, the present study aims to evaluate complete or incomplete SCIs and the course of the injury and the prognosis for SCIs caused by stab wounds.Methods:This case-series design study was performed on 57 patients attending the emergency department of Taleqani Trauma Center (Kermanshah, Iran) due to SCIs caused by violent encounters involving sharp objects such as a knife, dagger, whittle and Bowie-knife between 1999 and 2011. An assessment of sensory and motor functions was performed as part of the neurological examination on admission, and during the treatment, using the Frankel Classification grading system, and the results were recorded.Results:The average age of patients was 27 years (SD= 7.9, Range=17 to 46 years). The results of the study showed a proportion of cervical, thoracic and lumbar injuries of 23 (40%), 24 (42%) and 10 (18%), respectively. There was no case of cerebrospinal fluid leakage (CSF) or infection at the wound site in the subjects. Regarding the extent of the SCI, the combined neurological assessment showed that several patients (43%) had a complete SCI with no sensory and motor functions in the sacral segments and the segments below the site of injury. In 32 patients (57%) incomplete injuries were observed; i.e. they showed only some degrees of sensory-motor functions that were below the neurological level.Conclusions:Both complete and incomplete SCIs are of great importance because the prognosis of SCI is directly associated with the location and extent of injury. It should be considered that partial recovery from SCIs is possible in few cases of complete injuries. Therefore, all the patients should be treated carefully and seriously.

Penetrating Spinal Injuries, Cases Registry in Sohag University Hospital

“…There was no CSF leak as the causative tool does not penetrate dura or it may act as a local compressor on the dural opening or wound infection in all patients which is not in line with other studies. The mortality rate was approximately 7%, which is similar to the study done by Saeidiborojeni et al, 10 All our patients in groups II and II showed a varied degree of improvement in their Frankel grading which is inconsistent with a study published by Venger et al, 15 In this study, a majority of the patients were dorsal and lumbar injuries which are similar when compared to other studies. Computed tomography (CT) was the option of choice in diagnosing these cases in contrast to Magnetic Resonance (MR) which was the used imaging modality in other studies.…”

Thoracic Spinal Cord Stab Injury: A Case Report and Literature Review

“…MRI is the gold standard in the absence of metal incarceration. It assesses the extent and evolution of SCI [3] [5]. CT scanning was informative enough in the reported case and allowed appropriate management of the patient.…”

“…Injuries without incarceration of foreign bodies and without neurological deficits can be managed conservatively after assessment of spinal cord lesions by MRI [4]. Nevertheless, some authors do recommend surgery in such cases because surgery has shown benefit on associated lesions which are infection, cerebrospinal fluid (CSF) leakage and arachnoiditis [2] [3]. For Li et al [2], surgery is crucial for neurological recovery no matter the initial neurological status.…”

Paraplegia in young female after stab injury: a rare injury with heavy socioeconomic burden and its impact

“…It assesses the extent and evolution of SCI. 8,10 The usefulness of magnetic resonance (MR) imaging for the detection of spinal cord abnormalities is well described, especially in the acutely injured spine. The appearance of intraspinal haemorrhage at MR image varies through several forms as the hematoma ages.…”

“…Nevertheless, some authors do recommend surgery in such cases because surgery has shown benefit on associated lesions which are infection, cerebrospinal fluid (CSF) leakage and arachnoiditis. 4,6,8 The usual clinical presentation of SCSI is incomplete paraplegia manifesting most often as Brown-Séquard syndrome. 4,7,9 Nevertheless, spinal cord stab injuries (SCSI) remain rare and their frequency diversely estimated (7)(8)(9)(10)(11).…”