Back “pane” secondary to glass coffee table mishap: case illustration

View More View Less
  • Division of Neurosurgery, Royal University Hospital, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
Free access

A 47-year-old male patient presented with a severe laceration of the right thoracolumbar junction after he fell backward onto a tempered glass coffee table. He had no neurologic symptoms or signs. A CT scan showed a wedge-shaped piece of glass that measured almost 7 cm penetrating the spinal canal at the T11–12 level, causing a rightward deviation of the spinal cord (Fig. 1).

FIG. 1.
FIG. 1.

Sagittal (upper) and axial (lower) CT scans showing penetrating glass through the spinal canal at the T11–12 level.

The patient was taken to the operating room urgently for a T11–12 laminectomy under microscopic visualization performed with motor-evoked potential monitoring. The glass fragment was removed gently along its original trajectory path. A durotomy due to the fragment was found to the left of midline just alongside the pedicle and was repaired with duraplasty.

This case demonstrates a very rare injury pattern, as the vast majority of intradural penetrating injuries result in complete or incomplete spinal cord injury due to a narrow subarachnoid space at the thoracic level.1,4 This patient remained neurologically intact postoperatively.

To our knowledge, this is the first case reported in the literature that describes a patient with an intradural thoracic glass injury without significant neurological deficits. The outcome in this case supports the already-existing evidence for successful management of a penetrating spine injury using microscopic techniques, intraoperative neurophysiologic monitoring, and dural repair.2,3

Disclosures

The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

Author Contributions

Conception and design: Mercure-Cyr. Acquisition of data: Mercure-Cyr. Drafting the article: Mercure-Cyr. Critically revising the article: Fourney. Reviewed submitted version of manuscript: Fourney. Approved the final version of the manuscript on behalf of both authors: Fourney. Administrative/technical/material support: Mercure-Cyr.

Supplemental Information

Previous Presentations

This case has been previously presented in poster format at the 54th Canadian Neurological Sciences Federation, Montreal, Quebec, Canada, June 16–19, 2019.

References

  • 1

    Komarowska M, Debek W, Wojnar JA, Hermanowicz A, Rogalski M: Brown-Séquard syndrome in a 11-year-old girl due to penetrating glass injury to the thoracic spine. Eur J Orthop Surg Traumatol 23 (Suppl 1):S141S143, 2013

    • Search Google Scholar
    • Export Citation
  • 2

    Kumar A, Pandey PN, Ghani A, Jaiswal G: Penetrating spinal injuries and their management. J Craniovertebr Junction Spine 2:5761, 2011

    • Search Google Scholar
    • Export Citation
  • 3

    Morrow KD, Podet AG, Spinelli CP, Lasseigne LM, Crutcher CL, Wilson JD, : A case series of penetrating spinal trauma: comparisons to blunt trauma, surgical indications, and outcomes. Neurosurg Focus 46(3):E4, 2019

    • Search Google Scholar
    • Export Citation
  • 4

    Müller H, Brock M, Pöll W, Fischer T: Injury to the thoracic spinal cord by glass fragments. Case report. Spine (Phila Pa 1976) 10:475477, 1985

    • Search Google Scholar
    • Export Citation

If the inline PDF is not rendering correctly, you can download the PDF file here.

Contributor Notes

CORRESPONDENCE Daryl R. Fourney: University of Saskatchewan, Royal University Hospital, Saskatoon, SK, Canada. daryl.fourney@usask.ca.

INCLUDE WHEN CITING Published online December 13, 2019; DOI: 10.3171/2019.10.SPINE191208.

Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

  • View in gallery

    Sagittal (upper) and axial (lower) CT scans showing penetrating glass through the spinal canal at the T11–12 level.

  • 1

    Komarowska M, Debek W, Wojnar JA, Hermanowicz A, Rogalski M: Brown-Séquard syndrome in a 11-year-old girl due to penetrating glass injury to the thoracic spine. Eur J Orthop Surg Traumatol 23 (Suppl 1):S141S143, 2013

    • Search Google Scholar
    • Export Citation
  • 2

    Kumar A, Pandey PN, Ghani A, Jaiswal G: Penetrating spinal injuries and their management. J Craniovertebr Junction Spine 2:5761, 2011

    • Search Google Scholar
    • Export Citation
  • 3

    Morrow KD, Podet AG, Spinelli CP, Lasseigne LM, Crutcher CL, Wilson JD, : A case series of penetrating spinal trauma: comparisons to blunt trauma, surgical indications, and outcomes. Neurosurg Focus 46(3):E4, 2019

    • Search Google Scholar
    • Export Citation
  • 4

    Müller H, Brock M, Pöll W, Fischer T: Injury to the thoracic spinal cord by glass fragments. Case report. Spine (Phila Pa 1976) 10:475477, 1985

    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 171 171 0
Full Text Views 60 60 8
PDF Downloads 43 43 3
EPUB Downloads 0 0 0