- Penetrating sacral injury with a metallic pipe: a case report and literature review
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Mahnjeong Ha, Kyoung Hyup Nam, Jae Hun Kim, In Ho Han
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J Trauma Inj. 2022;35(2):131-138. Published online May 11, 2022
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DOI: https://doi.org/10.20408/jti.2021.0063
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Abstract
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- Other than gunshot injuries, sacral penetrating injuries with a foreign body exiting to the other side are extremely rare. We encountered a case of sacral injury in which a long metallic pipe penetrated from the anus into the lower back of a patient. Since the pelvis contains various organs, management of a penetrating injury requires multidisciplinary treatment involving several medical specialties. Due to the infrequency of this type of injury, there are no definitive guidelines for effective management. We described our experience surgically treating a sacral penetrating injury and conducted a literature review. On this basis, we suggest a surgical strategy for treating this type of injury.
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Summary
- Bilateral foot drop caused by T12 infectious spondylitis after vertebroplasty: a case report
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Dong Hwan Kim, Yong Beom Shin, Mahnjeong Ha, Byung Chul Kim, In Ho Han, Kyoung Hyup Nam
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J Trauma Inj. 2022;35(1):56-60. Published online March 21, 2022
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DOI: https://doi.org/10.20408/jti.2021.0083
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Abstract
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- The most common cause of foot drop is lumbar degenerative disc herniation, particularly at L4/5. We present a rare case of spinal cord injury accompanied by a thoracolumbar lesion that presented with bilateral foot drop. A 69-year-old male patient presented with sudden-onset severe bilateral leg pain and bilateral foot drop. Radiologic findings revealed T12 spondylitis compressing the conus medullaris. He had undergone vertebroplasty for a T12 compression fracture after a fall 6 months before. A physical examination showed bilateral foot drop, paresthesia of both L5 dermatomes, increased deep tendon reflex, and a positive Babinski sign. An acute bilateral L5 root lesion and a conus medullaris lesion were suspected based on electromyography. A surgical procedure was done for decompression and reconstruction. After the operation, bilateral lower extremity muscle strength recovered to a good grade from the trace grade, and the patient could walk without a cane. The current case is a very rare report of bilateral foot drop associated with T12 infectious spondylitis after vertebroplasty. It is essential to keep in mind that lesions of the thoracolumbar junction can cause atypical neurological symptoms. Furthermore, understanding the conus medullaris and nerve root anatomy at the T12–L1 level will be helpful for treating patients with atypical neurological symptoms.
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Summary
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Citations
Citations to this article as recorded by
- Evaluating Acute Bilateral Foot Drop: A Case Report
Arsh N Patel, Colby Kihara, Carter Gay, Katie Oakley, P.J. Reddy Cureus.2022;[Epub] CrossRef
- Associated Injuries in Spine Trauma Patients: A Single-Center Experience
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Seunghan Yu, Hyuk Jin Choi, Jung Hwan Lee, Byung Chul Kim, Mahnjeong Ha, In Ho Han
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J Trauma Inj. 2020;33(4):242-247. Published online December 31, 2020
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DOI: https://doi.org/10.20408/jti.2020.0071
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Abstract
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Purpose
The purpose of this study was to determine the incidence and characteristics of associated injuries in patients with spine trauma.
Methods
Data of 3,920 consecutive patients admitted to a regional trauma center during a 3-year period were analyzed retrospectively.
Results
Of the 3,920 patients who were admitted to the trauma center during the 3-year study period, 389 (9.9%) had major spinal injuries. Among these 389 patients, 303 (77.9%) had associated injuries outside the spine. The most common body region of associated injuries was the extremities or pelvis (194 cases, 49.4%), followed by the chest (154 cases, 39.6%) and face (127 cases, 32.6%). Of these 303 patients, 149 (64%) had associated injuries that required surgical treatment such as laparotomy or internal fixation. Associated injuries were more common in patients with lumbar injuries (93.3%) or multiple spinal injuries (100%) than in those with lower cervical injuries (67.4%). There was a significant correlation between the location of the spinal injury and the body region of the associated injury. However, distant associated injuries were also common.
Conclusions
Associated injuries were very common in spinal injury patients. Based on demographic groups, the trauma mechanism, and the location of spinal injury, an associated injury should be suspected until proven otherwise. Using a multidisciplinary and integrated approach to treat trauma victims is of the paramount importance.
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