Acute penetrating injury of the spinal cord by a wooden spike with delayed surgery:a case report  

作　　者：James D.Guest Zhuojing Luo Yansheng Liu Hongkun Gao Dianchun Wang Xiao-Ming Xu Hui Zhu 

机构地区：[1]Neurological Surgery,and the Miami Project to Cure Paralysis,Miller School of Medicine,University of Miami,Miami,FL,USA [2]Kunming International Spine,and Spinal Cord Injury Treatment Center,Kunming Tongren Hospital,Kunming,Yunnan Province,China [3]Department of Orthopedic Spinal Surgery,Xijing Hospital,The Fourth Military Medical University,Xi’an,Shaanxi Province,China [4]Department of Neurosurgery,Kunming Tongren Hospital,Kunming,Yunnan Province,China [5]Indiana University School of Medicine,Stark Neurosciences Research Institute,Indianapolis,IN,USA

出　　处：《Neural Regeneration Research》2023年第12期2781-2784,共4页中国神经再生研究（英文版）

摘　　要：Rarely,penetrating injuries to the spinal cord result from wooden objects,creating unique challenges to mitigate neurological injury and high rates of infection and foreign body reactions.We report a man who sustained a penetrating cervical spinal cord injury from a sharpened stick.While initially tetraparetic,he rapidly recovered function.The risks of neurological deterioration during surgical removal made the patient reluctant to consent to surgery despite the impalement of the spinal cord.A repeat MRI on day 3 showed an extension of edema indicating progressive inflammation.On the 7~(th)day after injury,fever and paresthesias occurred with a large increase in serum inflammatory indicators,and the patient agreed to undergo surgical removal of the wooden object.We discuss the management nuances related to wood,the longitudinal evolution of MRI findings,infection risk,surgical risk mitigation and technique,an inflammatory marker profile,long-term recovery,and the surprisingly minimal neurological deficits associated with low-velocity midline spinal cord injuries.The patient had an excellent clinical outcome.The main lessons are that a wooden penetrating central nervous system injury has a high risk for infection,and that surgical removal from the spinal cord should be performed soon after injury and under direct visualization.

关 键 词：case report INTERLEUKIN-6 magnetic resonance imaging PENETRATING spinal cord injury wood 

分 类 号：R651.2[医药卫生—外科学]