Penetrating Trauma Of The Spine With Cutter And Surgical Management

Penetrating trauma of the spine can be rarely seen. A 28 year old male patient admitted to our emergency clinic with cutter injury. A two-centimeter skin incision was determined at the patient’s lumbar region. Neurological examination was with in the normal range. A metallic cutter tip was seen at the lumbar tomography and lumbar plain radiograph at the level of L1 corpus and L1-2 disc space. The patient operated at emergency settings. Under general anesthesia the patient was taken into left side lateral decubitus position. Previous skin incision enlarged to the anterolateral direction. Surgical dissection was advanced to the anterolateral direction from posterior aspect. Left L1 and L2 processus transversus was reached. Then the cutter tip was seen at the L1 corpus and L1-2 disc space just lateral from the nevre root. The cutter tip was withdrawn slowly without laminectomy. The main goal of the surgical treatment for neurologically intact patients with penetrating injuries is to remove the foreign object with minimal damage to the patient in the light of radiological studies. The foreign object should be removed from the spine because late neurological deficits can be seen in these patients.