Penetrating spinal injury with a wooden fragment: a case report and review of the literature

Abstract

Study design: Case description.

Objectives: To present a case of a missed diagnosis of penetrating spine injury by wood and review of the literature.

Summary of background data: Penetrating spinal injuries by wood are rare injuries. Less than 10 cases with penetrating spine injuries by a wooden fragment had been reported earlier.

Methods: A 23-year-old man had fallen from 3 m high tree and sustained a penetrating wound on his right lower back. As the direct radiographic evaluation was normal, the diagnosis of foreign body was missed. Eventually, the diagnosis was made on admission of the patient with purulent discharge from his wound, 1-week postprimary closure. Hypoesthesia of S1, S2, and S3 alone, were noted neurologically. The computed tomography and magnetic resonance imaging of patient revealed an intraspinal foreign body pierced through the S1-S2 interlaminary space. Extraction of the wooden fragment was then performed by limited S1 laminectomy and the dural defect was also repaired.

Results: With appropriate antibiotherapy, patient recovered, with no sequela.

Conclusion: Due to its density and radiologic properties, it is not unusual for wood to be overlooked, unless detailed imaging with computed tomography or magnetic resonance imaging is used.