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Anterior approach for a stab wound with penetrating rebar injury causing incomplete cauda equina syndrome in lumbosacral spine lesion: a case report and literature review – Lumbar Spinal Stenosis

This article discusses a rare case of incomplete cauda equina syndrome (CES) caused by a penetrating rebar injury in the perineal region with a retro-pulsed fragment. The patient, a 26-year-old male, presented with CES due to the spinal injury. Computed tomography revealed a bony fragment compressing into the spinal canal. The patient underwent a surgical procedure involving partial corpectomy, decompression, and interbody fusion. The anterior approach was chosen to effectively perform decompression and minimize iatrogenic damages. The patient experienced significant recovery and had no clinical complications during the 2-year follow-up period. This case highlights the challenge of determining the optimal surgical approach for penetrating spinal injuries with foreign bodies. The anterior approach is suggested as a suitable option in such cases

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most specialised day surgery spinal centre on Harley Street UK

Published article

CONCLUSION: It is challenging to determine the optimal strategy of surgical treatment for penetrating spinal injuries with retained foreign bodies, here we suggest an anterior approach situation that has the advantage of being able to effectively perform decompression and prevent iatrogenic damages of thecal sac and nerve rootlets.

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Eur Spine J. 2024 Jan 29. doi: 10.1007/s00586-023-08125-1. Online ahead of print.ABSTRACTPURPOSE: To report a unique case of incomplete CES following a rebar penetrating injury in perineal region with retro-pulsed fragment, which was treated with anterior approach and discuss suitable surgical approach.METHODS: Incomplete cauda equina syndrome caused by non-missile penetrating injury is extremely rare. A,

Eur Spine J. 2024 Jan 29. doi: 10.1007/s00586-023-08125-1. Online ahead of print.

ABSTRACT

PURPOSE: To report a unique case of incomplete CES following a rebar penetrating injury in perineal region with retro-pulsed fragment, which was treated with anterior approach and discuss suitable surgical approach.

METHODS: Incomplete cauda equina syndrome caused by non-missile penetrating injury is extremely rare. A 26-year-old male patient presented incomplete cauda equina syndrome due to a penetrating rebar wound from his perineal region to the lumbosacral spine. Computed tomography demonstrated a bony fragment broken from S1 body compressing into the spinal canal.

RESULTS: By anterior approach, we performed partial corpectomy of L5, decompression by retrieving the bony fragment and L5-S1 interbody fusion. The patient had a significant recovery, and no clinical complication was found after over 2-year follow-up.

CONCLUSION: It is challenging to determine the optimal strategy of surgical treatment for penetrating spinal injuries with retained foreign bodies, here we suggest an anterior approach situation that has the advantage of being able to effectively perform decompression and prevent iatrogenic damages of thecal sac and nerve rootlets.

PMID:38286907 | DOI:10.1007/s00586-023-08125-1

The London Spine Unit : most specialised day surgery spinal centre on Harley Street UK

Read the original publication:

Anterior approach for a stab wound with penetrating rebar injury causing incomplete cauda equina syndrome in lumbosacral spine lesion: a case report and literature review

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Eur Spine J. 2024 Jan 29. doi: 10.1007/s00586-023-08125-1. Online ahead of print.ABSTRACTPURPOSE: To report a unique case of incomplete CES following a rebar penetrating injury in perineal region with retro-pulsed fragment, which was treated with anterior approach and discuss suitable surgical approach.METHODS: Incomplete cauda equina syndrome caused by non-missile penetrating injury is extremely rare. A

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