Penetrating Stab Wounds of the Spine: Two Cases and Review of the Literature

Abstract

Penetrating wounds of the spine caused by edged weapons are on the increase due to the growing insecurity, violence, availability and accessibility of these weapons, which are generally objects of everyday use (knife, axe, machete, screwdriver, bicycle spoke, scissors, garden fork, sickle and sharpened broom handle, etc.). These objects may be the cause of penetrating wounds responsible for neurological deficits with breaches of the dura mater, or they may be without neurological deficits due to the level of the weapon in the spine. We present two clinical cases of patients with penetrating knife wounds of the spine. One at cervical level with pneumorrhagic emphysema, spinal cord compression and pneunemoencephaly, with neurological deficit who had a surgical intervention followed by physiotherapy and a progressive recovery, the other with a penetrating wound at L5 crossing the blade to the vertebral body without neurological deficit in whom the knife was extracted at the emergency department without secondary deficit. Penetrating wounds of the spine are caused by stab wounds, including knives. In particular, emphysema, diffuse pneumorrhagia and pneumoencephalus are extremely rare in the same patient, this being due to the knife extraction technique. These lesions, associated with neurological deficit and cerebrospinal fluid (CSF) leakage, constitute a neurosurgical emergency.