Scheiderer B, Mild K, Gebhard F, Scola A
Abteilung für Unfall-, Hand-, Plastische und Wiederherstellungschirurgie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland.
Klinik für diagnostische und interventionelle Radiologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland.
Unfallchirurg. 2016 Mar;119(3):251-4. doi: 10.1007/s00113-015-0077-9.
This article reports the case of an 8-year-old boy with a knife stab injury to the lumbar spine without neurological deficits. The computed tomography (CT) scan revealed a longitudinal penetration of the conus medullaris at the level of the first lumbar vertebra. The knife blade was extracted and primary closure was carried out on the stab wound. The immediately postoperative magnetic resonance imaging (MRI) as well as the follow-up examinations after 1 and 6 weeks showed no evidence of compressive spinal bleeding, myelopathy or cerebrospinal fluid leakage. In addition, no secondary changes of the neurological status developed. Consequently, in cases of neurologically asymptomatic patients without concomitant injuries the surgical exploration of a stab wound does not seem to be absolutely necessary.
本文报道了一名8岁男孩腰椎被刀刺伤但无神经功能缺损的病例。计算机断层扫描(CT)显示第一腰椎水平圆锥体有纵向贯通伤。取出刀片并对刺伤伤口进行了一期缝合。术后即刻的磁共振成像(MRI)以及1周和6周后的随访检查均未发现脊髓受压出血、脊髓病或脑脊液漏的迹象。此外,神经状态也未出现继发性改变。因此,对于无伴随损伤的无症状神经功能患者,刺伤伤口的手术探查似乎并非绝对必要。