Direct withdrawal of a retained foreign body bisecting the thoracic spinal canal in a neurologically intact pediatric patient: illustrative case.

Details

Serval ID
serval:BIB_F0DF476CAF2E
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Direct withdrawal of a retained foreign body bisecting the thoracic spinal canal in a neurologically intact pediatric patient: illustrative case.
Journal
Journal of neurosurgery. Case lessons
Author(s)
Peters D.R., VanHorn T., Karimian B., Pruden B., Wait S.D., Daniel R.T., Tuleasca C.
ISSN
2694-1902 (Electronic)
ISSN-L
2694-1902
Publication state
Published
Issued date
19/06/2023
Peer-reviewed
Oui
Volume
5
Number
25
Pages
2363
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Nonmissile penetrating spinal cord injury (NMPSCI) with a retained foreign body (RFB) is rare and usually results in permanent neurological deficits. In extremely rare cases, patients can present without significant neurological deficits despite an RFB that traverses the spinal canal. Given the rarity of these cases, a consensus has not yet been reached on optimal management. In a patient with an RFB and a neurologically normal clinical examination, the risk of open surgical exploration may outweigh the benefit and direct withdrawal may be a better option.
A 10-year-old female suffered an NMPSCI to the thoracic spine with an RFB that bisected the spinal canal but remained neurologically intact. Direct withdrawal of the RFB was chosen instead of open surgical exploration, leading to an excellent clinical outcome. The literature was reviewed to find other examples of thoracic NMPSCI with RFB and neurologically normal examinations. Management strategies were compared.
For NMPSCI with RFB and without significant neurological deficits, direct withdrawal is a viable and possibly the best treatment option. The use of fast-acting anesthesia without intubation minimizes patient manipulation, speeds up recovery, and allows early assessment of neurological status after removal.
Keywords
direct withdrawal, penetrating spinal cord injury, penetrating trauma, retained foreign body, spinal stab wound
Pubmed
Open Access
Yes
Create date
29/06/2023 14:03
Last modification date
14/07/2023 5:55
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