Penetrating Stab Injury of Spine; Diagnostic Value of Thin-Section Multislice Computed Tomography

Abstract

Penetrating stab injuries of the spinal cord (PSISC) are extremely rare and typically associated with immediate neurological damages. However, some patients may represent with atypical and indistinct symptoms. Herein we report a case of atypical presentation of spinal canal penetration which was not detected in thorax computerized tomography (CT) scans performed in emergency room, but subsequently was revealed in thoracal CT and magnetic resonance imaging (MRI) scans. Initial neurological examination was normal except for the hypoesthesia in the right lower extremity. Surgical treatment was not performed since any foreign body or effusion consistent with hematoma and/or dural leak, or extrinsic cord compression was present. After administering a prophylactic tetanus shot and initiating a broad-spectrum antibiotic prophylaxis, patient was discharged with recommendations. On follow-up, he described that hypoesthesia was decreased, but still present at end of the first month of injury. To conclude, it is very important to scan the affected region with thin slice thickness-multislice CT or with MRI for proper diagnosis in patients with stab wounds presented with neurological symptoms.