Tan Hao, Guo Qing-Shan, Zhang Lian-Yang, Sun Shi-Jin, Yao Yuan-Zhang, Huang Xiao-Ying
State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing 400042, China.
Chin J Traumatol. 2012;15(4):241-3.
Penetrating injury to the rectum, vertebral body and spinal cord by a steel rod is a rare condition. Treatment of this kind of injury is very challenging. Rectal injury requires repair and fecal diversion, while debridement of the spine is difficult, especially when the injury site is very long. Here we report a case of penetrating injury of rectum and sacral vertebra by a steel rod after falling onto the ground from 1 m height. The abscess cavity was irrigated with 3% hydrogen peroxide and physio-logical saline repeatedly. The bony canal was carefully debrided, curetted and bony fragments were removed. Spinal irrigation and drainage lasted for 2 months and sensitive antibiotic (amikacin sulfate) was given 7 days after surgery, but abscess was still formed in the vertebral canal. At 6-month follow-up, the patient was paralyzed without any neurological improvement, and the pain in low back and lower limb still continued.
钢棒穿透直肠、椎体和脊髓是一种罕见的情况。这类损伤的治疗极具挑战性。直肠损伤需要修复和粪便转流，而脊柱清创困难，尤其是损伤部位很长时。在此我们报告一例从1米高处坠落后钢棒穿透直肠和骶椎的病例。用3%过氧化氢和生理盐水反复冲洗脓肿腔。仔细清创骨管，刮除并清除骨碎片。脊柱冲洗引流持续2个月，术后7天给予敏感抗生素（硫酸阿米卡星），但椎管内仍形成脓肿。在6个月的随访中，患者仍瘫痪，神经功能无任何改善，腰背部和下肢疼痛仍持续。
