Penetrating injury of the spinal cord treated surgically.

Abstract

A 44-year-old man reported acute neck pain, hyperalgesia, and mild paraplegia caused by a wire-penetrating injury of the neck and was hospitalized. The foreign body was located at the C6 level. Pre- and postoperative physical examination and imaging studies were performed to assess the degree of injury. Emergent surgery was performed 30 minutes after admission to prevent the patient from potential severe neurological impairment and infection. The patient's postoperative recovery was significant. Only hyperalgesia at the ulnar side of the forearm remained, with no other positive signs of neurologic loss. Motor strength of the upper and lower extremities returned to normal. The postoperative degree of the spinal cord injury was assessed as American Spinal Injury Association grade E. Surgical removal of foreign bodies retained in the spinal canal may prevent infection, myelopathy, and delayed neurologic loss. Removal of retained intraspinal metallic fragments can improve neurologic outcome.