Thoracic spine stab injury with a retained knife

Area of Science:

• Trauma Surgery
• Neurosurgery
• Radiology

Background:

• Penetrating spinal injuries are rare but can have devastating consequences.
• Prompt and accurate diagnosis is crucial for effective management.

Observation:

• A female patient presented with an isolated thoracic spine stab injury from a retained knife.
• CT imaging revealed the knife blade near the spinal cord, aorta, and inferior vena cava.
• The patient was hemodynamically stable with no initial neurological deficits.

Findings:

• A multidisciplinary team planned and executed the safe removal of the knife under sedation and local anesthesia in a prone position.
• Post-operative neurological examination was normal.
• MRI confirmed no spinal cord injury.

Implications:

• This case highlights the importance of detailed preoperative imaging and multidisciplinary collaboration in managing penetrating spinal trauma.
• Safe knife removal techniques, even with airway challenges in prone positioning, are essential.
• Successful outcomes are achievable with meticulous planning and execution.