Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai, China.
Spine (Phila Pa 1976). 2012 Jul 1;37(15):E931-4. doi: 10.1097/BRS.0b013e31824e477f.
Case report and literature review.
To report the case of a young patient who sustained a penetrating wound with a knife tip retained in his cervical vertebrae and to review the literature.
Stab wound with foreign body retained, associated with spinal cord injury and vertebral artery injury, is not commonly reported. The timing and approach of surgical intervention are still controversial.
A 17-year-old boy with a wound in the neck presented with diminishing feeling and dysfunction of the left leg and arm. Radiographs demonstrated a foreign body at the C4 level, and possible spinal cord and vertebral artery injuries were detected by computed tomography. Digital subtracted angiography showed a small lateral opening of the injured artery, which was successfully embolized. The knife tip was removed from the original wound without severe cerebrospinal fluid leakage or bleeding,
The patient achieved immediate improvement after the operation.
Cases of simultaneous spinal cord injury and vertebral artery injury in which the foreign body is retained are uncommonly reported. Digital subtracted angiography is necessary for cervical penetrating wounds and surgical approach should be individualized.
病例报告和文献回顾。
报告一例年轻患者颈椎内残留刀尖刺伤的病例，并复习文献。
带异物残留的刺伤，伴有脊髓损伤和椎动脉损伤，并不常见。手术干预的时机和方法仍存在争议。
一名 17 岁男孩颈部有伤口，出现左侧肢体感觉和功能减退。X 线片显示 C4 水平有异物，CT 显示可能存在脊髓和椎动脉损伤。数字减影血管造影显示损伤动脉有一个小的侧支开口，成功进行了栓塞。在没有严重脑脊液漏或出血的情况下，从原伤口取出了刀尖。
患者术后即刻改善。
同时存在脊髓损伤和椎动脉损伤且异物残留的病例很少见。对于颈椎穿透伤，数字减影血管造影是必要的，手术方法应个体化。
