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European Spine Journal

, Volume 24, Supplement 4, pp 540–543 | Cite as

Delayed presentation of deep penetrating trauma to the subaxial cervical spine

  • Julien Francisco Zaldivar-JolissaintEmail author
  • Lukas Bobinski
  • Yaelle Van Dommelen
  • Marc Levivier
  • Christian Simon
  • John Michael Duff
Case Report

Abstract

Purpose

To present a rare case of deep penetrating neck trauma in which a retained foreign body in the cervical spine (a broken knife blade) resulted in delayed radicular injury. We describe the surgical management using a retrojugular approach.

Case report

Our patient sustained a stab wound to the supraclavicular triangle from a small pocketknife. He was initially managed in a local hospital by simple primary wound closure without any radiological examinations, and was discharged home. The patient re-consulted in a delayed fashion with mild local persistent neck pain. Subsequent radiological investigations revealed a foreign body (the broken blade of a pocket knife) embedded in the left neural foramen between the C6 and C7 vertebrae penetrating the disc space. The blade was lying between the left C7 nerve root and the ipsilateral vertebral artery (VA) at the transition of V1 and V2 segments. Initial neurological evaluation was normal. Some days later, the patient developed a delayed left C7 radicular deficit. We undertook urgent exploration along the wound corridor through a retrojugular, transforaminal approach with successful removal of the blade.

Discussion

To our knowledge, this is a unique case where a retained foreign body penetrated the soft tissues of the neck, embedding deep in the vertebral column without vascular, aerodigestive or significant primary neurological injury, while causing delayed neck pain and delayed onset radicular injury. We describe our surgical management for removal of the retained blade. The retrojugular approach gives excellent access to all of the important anatomical structures of the neck from an anterolateral approach.

Keywords

Penetrating neck trauma Foreign body Delayed injury Retrojugular approach Cervical spine 

Notes

Conflict of interest

The authors declare no financial conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Julien Francisco Zaldivar-Jolissaint
    • 1
    Email author
  • Lukas Bobinski
    • 1
  • Yaelle Van Dommelen
    • 1
  • Marc Levivier
    • 1
  • Christian Simon
    • 2
  • John Michael Duff
    • 1
  1. 1.Service de NeurochirurgieCentre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne (Unil)LausanneSwitzerland
  2. 2.Service d’ORLCentre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne (Unil)LausanneSwitzerland

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