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Abdulqader MN, Ismail M, Al-Khafaji AO, Al-Ageely TA, Kareem ZM, Al-Baider RA, Albairmani SS, Ayad F, Hoz SS. Brown-Sequard syndrome associated with a spinal cord injury caused by a retained screwdriver: A case report and literature review. Surg Neurol Int 2022; 13:520. [DOI: 10.25259/sni_957_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 10/27/2022] [Indexed: 11/13/2022] Open
Abstract
Background:
Nonmissile penetrating spine injury (NMPSI) represents a small percent of spinal cord injuries (SCIs), estimated at 0.8% in Western countries. Regarding the causes, an NMPSI injury caused by a screwdriver is rare. This study reports a case of a retained double-headed screwdriver in a 37-year-old man who sustained a stab injury to the back of the neck, leaving the patient with a C4 Brown-Sequard syndrome (BSS). We discuss the intricacies of the surgical management of such cases with a literature review.
Methods:
PubMed database was searched by the following combined formula of medical subjects headings, (MESH) terms, and keywords: (((SCIs [MeSH Terms]) OR (nmpsi [Other Term]) OR (nonmissile penetrating spinal injury [Other Term]) OR (nonmissile penetrating spinal injury [Other Term])) AND (BSS [MeSH Terms])) OR (BSS [MeSH Terms]).
Results:
A total of 338 results were found; 258 were case reports. After excluding nonrelated cases, 16 cases were found of BSS induced by spinal cord injury by a retained object. The male-to-female ratio in these cases is 11:5, and ages ranged from 11 to 72. The causes of spinal cord injury included screwdrivers in three cases, knives in five cases, and glass in three cases. The extracted data were analyzed.
Conclusion:
Screwdriver stabs causing cervical SCIs are extremely rare. This is the first case from Iraq where the assault device is retained in situ at the time of presentation. Such cases should be managed immediately to carefully withdraw the object under direct vision and prevent further neurological deterioration.
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Affiliation(s)
| | - Mustafa Ismail
- Department of Neurosurgery, University of Baghdad, College of Medicine, Baghdad, Iraq,
| | - Aktham O. Al-Khafaji
- Department of Neurosurgery, University of Baghdad, College of Medicine, Baghdad, Iraq,
| | - Teeba A. Al-Ageely
- Department of Neurosurgery, University of Baghdad, College of Medicine, Baghdad, Iraq,
| | - Zahraa M. Kareem
- Department of Neurosurgery, University of Baghdad, College of Medicine, Baghdad, Iraq,
| | - Ruqayah A. Al-Baider
- Department of Neurosurgery, University of Baghdad, College of Medicine, Baghdad, Iraq,
| | - Sama S. Albairmani
- Department of Neurosurgery, University of Al-Iraqia, College of Medicine, Baghdad, Iraq,
| | - Fatimah Ayad
- Department of Neurosurgery, University of Baghdad, College of Medicine, Baghdad, Iraq,
| | - Samer S. Hoz
- Department of Neurosurgery, University of Cincinnati, Cincinnati, United States
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Bhutta MA, Dunkow PD, Lang DM. A stab in the back with a screwdriver: a case report. CASES JOURNAL 2008; 1:305. [PMID: 19014454 PMCID: PMC2588581 DOI: 10.1186/1757-1626-1-305] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2008] [Accepted: 11/11/2008] [Indexed: 11/10/2022]
Abstract
Background Stabbings infrequently produce spinal injury. However, the use weapons other than blades can overcome this natural defence barrier. Case Presentation We present a spinal injury produced by a screwdriver, its management and a review of the literature. Conclusion This case highlights the need for clinical vigilance, including in those who appear stable and a senior multidisciplinary approach to each individual case.
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Affiliation(s)
- Mohammed A Bhutta
- North Western Deanery Trauma and Orthopaedics, South Manchester University Healthcare Trust, UK.
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