Egyptian Spine Journal (Apr 2016)
Penetrating Spinal Injuries, Cases Registry in Sohag University Hospital
Abstract
Background Data: Penetrating spinal cord injuries caused by missile or stab wound injuries are uncommon. The harm may be due to the direct injurious effect or may be due to the resulting vascular insult either in the form of an intra- or extradural hemorrhage or spinal infarction or a late infection at the site of injury. Penetrating injuries may cause a neurological motor, sensory or an autonomic deficits or a combination of them. Both the conservative and the surgical treatments are widely practiced among the neurosurgeons. Such injuries not only affect the patient’s lifestyle but also influence the whole patient’s family. Purpose: To Evaluate the penetrating spinal injuries and describe the multiteam management and report both clinical and radiological characteristics of the patients. Also, we would assess the course and the prognosis in both complete and incomplete spinal cord injuries. Study Design: A cohort study conducted to patients with penetrating injuries Patients and Methods: A case series retrospective study of 28 patients presented to the emergency department at Sohag university hospital between March 2012 and March 2015 with penetrating spinal injuries caused by knives, dagger, and missile and nail gun injuries. A full history was taken. Complete general and neurological examination including motor power, sensory examination using Frankel grading classification. Results: The average age was 28.36±5.96 (range 19-37) years. Twelve injuries were in lumbar spine, 12 in the dorsal spine, and 4 in the cervical spine. None of the cases shows an infection or a cerebrospinal fluid leak. Spinal cord injuries were as follow; 16 cases (57.1%) showed no spinal cord injuries, 8 patients (28.6%) showed incomplete spinal cord injuries and 4 patients (14.3%) had complete spinal cord injury with no motor or sensory functions below the level of the injury. The incomplete spinal injuries due to firearm improved markedly according to Frankel grading system. Conclusion: Missile injuries have the most detrimental effect among the penetrating spinal injuries. Complete spinal cord injuries have the worst prognosis. Most of the incomplete spinal cord injuries had improved with varying degrees. The prognosis of the penetrating spinal injury is proportional to the extent and to the level of the injury. (2016ESJ110)
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