Download PDF
CC BY-NC-ND 4.0 · Indian Journal of Neurosurgery 2021; 10(01): 074-076
DOI: 10.1055/s-0040-1717822
Techniques in Neurosurgery

A Pencil in Spinal Canal-penetrating Injury–Endoscopic Management

Vivek Agrawal
1   Department of Neuroscience, Sir H N Reliance Foundation hospital and Research Centre, Mumbai, Maharashtra, India
,
Kailash Rathod
2   Department of Anaesthesia, Jankalyan Hospital, Kalyan, Thane, Maharashtra, India
,
Ranjit Rangnekar
1   Department of Neuroscience, Sir H N Reliance Foundation hospital and Research Centre, Mumbai, Maharashtra, India
› Author Affiliations
› Further Information
   Permissions and Reprints

Abstract

Penetrating spinal trauma is a rare event and mostly occurs as a result of assault or accident. There is no specific management protocol about such injuries. We are reporting a case of spinal trauma in a child of 6 years, who encountered a penetrating injury to the lower back when he fell over a sharp pencil. It resulted in a penetrating wound in the lower back with half of the broken pencil fragment lodged deep into the wound. There was a watery discharge from the wound with severe backache and radiating pain in both lower limbs. On clinical examination, motor power of both lower limbs was 5/5 (Medical Research Council [MRC] grade) with intact sensation and severely restricted straight leg raise (SLR). Imaging revealed a large fragment of pencil lodged in the spinal canal at L4 vertebral level. Surgical removal of foreign bodies and dura repair was done with endoscope and without laminectomy. The backache and lower limb pain relieved completely with healing of puncture site. In this case, the endoscopic technique enabled us to direct visualize penetration tract, injured structures, removal of foreign bodies and hematoma with repair of dura and without doing a destabilizing bone cutting and tissue damage.

Keywords

penetrating injury - endoscope - spinal canal


Publication History

Article published online:
12 November 2020

© 2020. Neurological Surgeons’ Society of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • Reference

  • 1 Long ZS, Nie XY, Zhang YW. Treatment of penetrating trauma to the buttock assisted by spinal endoscopy. J Int Med Res 2020; 48 (01) 300060519887303
    CrossrefPubMedGoogle Scholar
  • 2 Velmahos GC, Degiannis E, Hart K, Souter I, Saadia R. Changing profiles in spinal cord injuries and risk factors influencing recovery after penetrating injuries. J Trauma 1995; 38 (03) 334-337
    CrossrefPubMedGoogle Scholar
  • 3 Simpson Jr RK, Venger BH, Narayan RK. Treatment of acute penetrating injuries of the spine: a retrospective analysis. J Trauma 1989; 29 (01) 42-46
    PubMedGoogle Scholar
  • 4 Rall JM, Gebremariam FA, Joubert G. Imaging findings of penetrating spinal cord injuries secondary to stab wounds on magnetic resonance imaging in a tertiary trauma unit, South Africa. SA J Radiol 2019; 23 (01) 1761
    Google Scholar
  • 5 Manzone P, Domenech V, Forlino D. Stab injury of the spinal cord surgically treated. J Spinal Disord 2001; 14 (03) 264-267
    CrossrefPubMedGoogle Scholar
  • 6 Kulkarni AV, Bhandari M, Stiver S, Reddy K. Delayed presentation of spinal stab wound: case report and review of the literature. J Emerg Med 2000; 18 (02) 209-213
    CrossrefPubMedGoogle Scholar