Stab Wound With Lodged Knife Tip Causing Spinal Cord and Vertebral Artery Injuries Case Report and Literature Review

Study Design. Case report and literature review. Objective. To report the case of a young patient who sustained a penetrating wound with a knife tip retained in his cervical vertebrae and to review the literature. Summary of Background Data. Stab wound with foreign body retained, associated with spinal cord injury and vertebral artery injury, is not commonly reported. The timing and approach of surgical intervention are still controversial. Methods. A 17-year-old boy with a wound in the neck presented with diminishing feeling and dysfunction of the left leg and arm. Radiographs demonstrated a foreign body at the C4 level, and possible spinal cord and vertebral artery injuries were detected by computed tomography. Digital subtracted angiography showed a small lateral opening of the injured artery, which was successfully embolized. The knife tip was removed from the original wound without severe cerebrospinal fluid leakage or bleeding, Results. The patient achieved immediate improvement after the operation. Conclusion. Cases of simultaneous spinal cord injury and vertebral artery injury in which the foreign body is retained are uncommonly reported. Digital subtracted angiography is necessary for cervical penetrating wounds and surgical approach should be individualized.