Journal of Trauma and Injury

Case Reports

Detection of pharyngeal perforation during fiberoptic endoscopic evaluation of swallowing in a person with cervical spinal cord injury in the intensive care unit: a case report: Min Soo Choi, Sang Hun Han, Yong Beom Shin, Myung Hun Jang; J Trauma Inj. 2022;35(Suppl 1):S40-S45. Published online July 22, 2022; DOI: https://doi.org/10.20408/jti.2022.0016

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Abstract PDF: Endotracheal tube insertion and mechanical ventilation are indicated in spinal cord injury patients; however, dysphagia can occur after extubation. The resultant complications of dysphagia may increase the length of hospital stay and mortality. Therefore, dysphagia should be evaluated after extubation. This case report introduces a rare case of finding pharyngeal perforation during the fiberoptic endoscopic evaluation of swallowing (FEES) in patients with cervical spine injuries in the intensive care unit. A 71-year-old male patient met with a road traffic accident. The patient underwent C3–4 posterior fusion and C3–4 anterior cervical discectomy and fusion. After successful extubation, the patient underwent FEES to assess swallowing function. During FEES, the metallic plate was found to be exposed through mucosal erosion, and swelling was observed at the surgical site at the hypopharynx. The nasogastric tube was removed to prevent secondary damage and infection at the operation site and the patient was received conservative therapy. The FEES endoscope machine is portable so it can be easily applied at the bedside to intensive care unit patients. In addition, FEES allows the identification of anatomical abnormalities of the oropharynx and abnormalities of vocal cord. Thus, it is recommended to do FEES to check anatomical abnormalities as well as dysphagia in patients in the intensive care unit.; Summary

Bilateral foot drop caused by T12 infectious spondylitis after vertebroplasty: a case report: Dong Hwan Kim, Yong Beom Shin, Mahnjeong Ha, Byung Chul Kim, In Ho Han, Kyoung Hyup Nam; J Trauma Inj. 2022;35(1):56-60. Published online March 21, 2022; DOI: https://doi.org/10.20408/jti.2021.0083

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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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Evaluating Acute Bilateral Foot Drop: A Case Report
Arsh N Patel, Colby Kihara, Carter Gay, Katie Oakley, P.J. Reddy
Cureus.2022;[Epub] CrossRef

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