Screw driver: an unusual cause of cervical spinal cord injury

Rabiu, Taopheeq Bamidele; Aremu, Abayomi Adeniran; Amao, Olusegun Adetunji; Awoleke, Jacob Olumuyiwa

doi:10.1136/bcr.06.2011.4309

Cited by 5 publications

(13 citation statements)

References 16 publications

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“…Gunshot or stab wounds are common causes of penetrating injuries to the vertebral column. In addition, bizarre penetrating objects as seen in our case are reported to cause spinal cord injuries (2,5) . Peacock et al (6) reported a study on 450 patients with stab wounds of spinal cord.…”

Section: Dıscussıonsupporting

confidence: 49%

“…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) .…”

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confidence: 99%

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A rare lumbar spinal column injury: glass injury

Toker¹,

Atilla²,

Kılıç³

et al. 2016

Terh

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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

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Section: Dıscussıonsupporting

confidence: 49%

mentioning

confidence: 99%

A rare lumbar spinal column injury: glass injury

Toker¹,

Atilla²,

Kılıç³

et al. 2016

Terh

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“…is is manifested as ipsilateral spastic paralysis and loss of proprioception and touch sensation, with contralateral loss of pain and temperature sensation. [31] BSS commonly arises in cases involving the thoracic spine (75%) followed by the cervical (17%) and lumbar spine (8%). [6] Screwdriver impaling in the context of NMPSI is particularly dangerous due to the concentrated force applied to a small area and the forceful stem penetrating the bone deeply.…”

Section: Discussionmentioning

confidence: 99%

Brown-Sequard syndrome associated with a spinal cord injury caused by a retained screwdriver: A case report and literature review

Abdulqader

Ismail

Al-Khafaji

et al. 2022

Surgical Neurology International

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Background: Nonmissile penetrating spine injury (NMPSI) represents a small percent of spinal cord injuries (SCIs), estimated at 0.8% in Western countries. Regarding the causes, an NMPSI injury caused by a screwdriver is rare. This study reports a case of a retained double-headed screwdriver in a 37-year-old man who sustained a stab injury to the back of the neck, leaving the patient with a C4 Brown-Sequard syndrome (BSS). We discuss the intricacies of the surgical management of such cases with a literature review. Methods: PubMed database was searched by the following combined formula of medical subjects headings, (MESH) terms, and keywords: (((SCIs [MeSH Terms]) OR (nmpsi [Other Term]) OR (nonmissile penetrating spinal injury [Other Term]) OR (nonmissile penetrating spinal injury [Other Term])) AND (BSS [MeSH Terms])) OR (BSS [MeSH Terms]). Results: A total of 338 results were found; 258 were case reports. After excluding nonrelated cases, 16 cases were found of BSS induced by spinal cord injury by a retained object. The male-to-female ratio in these cases is 11:5, and ages ranged from 11 to 72. The causes of spinal cord injury included screwdrivers in three cases, knives in five cases, and glass in three cases. The extracted data were analyzed. Conclusion: Screwdriver stabs causing cervical SCIs are extremely rare. This is the first case from Iraq where the assault device is retained in situ at the time of presentation. Such cases should be managed immediately to carefully withdraw the object under direct vision and prevent further neurological deterioration.

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“…Um ponto importante a ser destacado em casos de TRM por arma branca e de fundamental importância para o prognóstico do caso é referente ao manejo pré-hospitalar, imobilização da coluna vertebral e transporte desse paciente até o centro de referência 7,10,11,27 . Tal cuidado deve ser praticado com o intuito de não agravar mais a lesão e nenhuma tentativa deve ser feita no sentido de retirar a ferramenta que não seja em ambiente cirúrgico por profissional capacitado, sob pena de piora de déficit neurológico, permanência de corpo estranho, infecção, hemorragia ou derrame de liquido cefalorraquidiano (LCR) 10,11, 36,39 .…”

Section: Discussionunclassified

“…A lesão traumática da coluna vertebral por arma branca tem sido descrita como rara na literatura médica 1,10,17 . Representa 1,5% de todas as lesões traumática da coluna vertebral 3,6,12,16,17,27 . Acomete mais o sexo masculino, numa proporção de 4:1 feminino, e nas idades entre 15 e 40 anos 6,13,16,18 .…”

Section: Introductionunclassified

Traumatismo Raquimedular por Arma Branca

Pereira¹,

Barbosa²,

Dezena³

et al. 2018

jbnc

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Introdução: Traumatismo raquimedular (TRM) por arma branca é pouco relatado na literatura médica. Seu tratamento é controverso. Os autores apresentam uma série de casos, discutem seu tratamento e prognóstico. Métodos: No período de janeiro de 2009 a dezembro de 2013, foram analisados doze pacientes vítimas de TRM por arma branca, quanto ao gênero, idade, localização anatômica da lesão, quadro neurológico, exames de imagem, tratamento e sequelas. Resultados: Quanto ao gênero, foram dez vítimas do sexo masculino e duas do sexo feminino. As idades variaram entre 16 e 54 anos, com média de 28 anos. Houve predomínio da localização cervical com cinco casos, seguido de dorsal com quatro e lombar com três. A tomografia computadorizada foi o exame de eleição. Oito pacientes apresentavam déficit motor e os demais eram assintomáticos. Cinco pacientes foram submetidos à intervenção cirúrgica, sendo três para retirada do corpo estranho e em dois para correção da dura-máter. Cinco pacientes apresentaram sequelas: paresia em membros inferiores em três e de membros superiores em dois. Não houve óbitos. Conclusão: TRM por arma branca é menos frequente que por arma de fogo e a literatura relata melhor prognóstico naqueles casos, fato evidenciado em nossos pacientes. Antibioticoterapia sistêmica profilática e fisioterapia motora têm sido preconizadas de rotina com resultados excelentes.

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Screw driver: an unusual cause of cervical spinal cord injury

Cited by 5 publications

References 16 publications

A rare lumbar spinal column injury: glass injury

A rare lumbar spinal column injury: glass injury

Brown-Sequard syndrome associated with a spinal cord injury caused by a retained screwdriver: A case report and literature review

Traumatismo Raquimedular por Arma Branca

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