Microsurgical repair of severed thoracic spinal cord and clinical outcome:technical case report

作     者：Chandrasekaran Kaliaperumal 

作者机构：Department of NeurosurgeryThe Royal Infirmary of EdinburghLittle FranceEdinburgh EH164XAUK 

出 版 物：《Chinese Neurosurgical Journal》 (中华神经外科杂志（英文）)

年 卷 期：2022年第8卷第4期

页      面：300-306页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

基　　金：Intensive care team and Anaesthetists of the Royal Infirmary of Edinburgh Queen Elizabeth National Spinal Injuries Unit 

主　　题：Spinal injury Stab injury Penetrating injury to spinal cord Spinal cord repair ASIA score Brown-Séquard syndrome 

摘      要：Background:This report describes a case of successful repair of severed thoracic spine in a young man who presented with a penetrating stab injury to spine resulting in Brown-Séquard *** technique and postoperative management is *** presentation:A 34-year-old fit and well healthy man was admitted with a history of stab injury to the thoracic spine at thoracic T2/3 level with ASIA impairment score(AIS)score D with an incomplete spinal cord affecting his left lower limb with complete paralysis and right lower limb paresis with impaired sensation below T6 level to *** confirmed a penetrating knife injury traversing the T2/3 level causing hemi-section of the spinal cord confirmed *** underwent an urgent exploratory surgery of his spine and a T2/3 laminectomy was performed to aid removal of the *** dura was noted to be contused and severed spinal cord was noted to be severed with associated cord oedema.A microsurgical repair of the severed cord was performed with duroplasty followed by intense *** a 3 month follow up his AIS score is E with lower limb power is 5/5 bilaterally and he is able to mobilise independently up to 8-10 steps without any supportive aid and with crutches he is independently functional and ***:This is the first documented case of microsurgical repair of severed thoracic spinal cord secondary to traumatic knife *** the management of such scenario,apart from the removal of foreign body,repair of the cord with duroplasty should be carefully *** role of spinal neuroplasticity in healing following timely repair of the spinal cord along with intense rehabilitation remains the *** had resulted in a good clinical and functional outcome with in a 18-month follow up.