ABSTRACT
Study design: Case report.
Objective: To describe a case of spinal cord transection in a 6-year-old child.
Background information: Non-missile injury of the spinal cord is not common and its incidence varies according
to the country. In addition, to our knowledge, there are no published reports of spinal
cord injury (SCI) from a penetrating nail. Here, we report the case of a child who
developed complete SCI because of cord transection by a nail.
Methods: A detailed history and physical examination were performed along with careful review
of the patient’s medical records. In addition, a review of the literature was conducted
to assess the incidence and treatment of similar injuries.
Case description: A 6-year-old boy was admitted to the hospital after falling from a tree and landing
on a nail. His physical examination revealed an emaciated child with multiple decubitus
ulcers, lying on his side in bed. Visible was a well-healed posterior puncture wound
at the T8 vertebral level. On neurological examination, the patient had 0/5 muscle
strength in his lower extremities, symmetrical areflexia, and hypoesthesia below the
T8 level. Plain x-ray of the thoracolumbar spine was normal. Magnetic resonance imaging
revealed a transected spinal cord at the T8 vertebra, consistent with his nail puncture
wound.
Discussion: This report describes an unusual case of a complete SCI in a pediatric patient caused
by penetrating trauma from a nail. To our knowledge, this is the first case to report
on complete SCI due to trauma from a nail.
