George Derek David, Houk Clifton, Pieters Thomas Allyn, Towner James E, Stone Jonathan J
Department of Neurosurgery, University of Rochester, Rochester, New York, United States.
Surg Neurol Int. 2022 Jul 15;13:308. doi: 10.25259/SNI_390_2022. eCollection 2022.
Penetrating spinal cord injury (PSCI) represents an average of 5.5% of all SCIs among civilians in the United States. The formation of a cerebrospinal fluid (CSF) fistula following PSCI occurs in approximately 9% of cases. Intra-abdominal CSF fistulae are rarely reported.
We present the case of a 28-year-old Caucasian female who suffered a single gunshot wound to the abdomen with a missile fragment lodged within the left L2 pedicle and transverse process without obvious canal compromise. The patient developed bacterial meningitis 13 days after the initial injury, treated with IV antibiotics. CT myelogram demonstrated intra-abdominal ventral CSF fistula from the left L2-L3 neuroforamen. The patient was successfully treated with fluoroscopy-guided dorsal autologous blood patch graft.
This case highlights a rare complication of PSCI successfully managed with the use of a blood patch graft.
在美国，穿透性脊髓损伤（PSCI）占所有平民脊髓损伤病例的5.5%。PSCI后脑脊液（CSF）瘘的形成约占病例的9%。腹腔内脑脊液瘘很少有报道。
我们报告一例28岁的白种女性，她腹部遭受单一枪伤，一枚导弹碎片嵌顿在左侧L2椎弓根和横突内，椎管无明显损伤。患者在初次受伤13天后发生细菌性脑膜炎，接受静脉抗生素治疗。CT脊髓造影显示左侧L2-L3神经孔有腹腔内腹侧脑脊液瘘。患者通过透视引导下的自体血补丁移植成功治愈。
本病例突出了PSCI一种罕见并发症，通过血补丁移植成功治疗。
