Entrapment of a metal foreign body in the cervical spinal canal during surgical procedure

A 50-year-old male presented with a one-day history of right leg weakness, numbness, and urinary retention. Weakness was present for two weeks but worsened significantly during the last 24 hours. On the right there was sensory loss in the leg and below the Th8 dermatome. On the left there was sensory loss below the Th10 dermatome and distal loss of temperature sensation. Past medical history revealed a cervical trauma 30 years ago when a glass chip lodged into the left side of the neck. The patient did not seek medical attention after removing it himself. No neurological symptoms followed the incident. No cervical manipulation or other physical trauma occurred before current symptom onset. Magnetic resonance (MR) imaging showed features consistent with myelitis at the level of C4–Th3. At the level of C6–C7, a T1 and T2 hypointense lesion was noted. On computed tomography, this lesion was hyperdense and occupied the spinal canal and the left intervertebral foramen. It was deemed to be a glass fragment. Surgical removal was withheld because the fragment was clinically silent for 30 years, the risk of surgical removal would outweigh the benefits and the patient did not prefer surgical treatment. Acute demyelinating transverse myelitis was diagnosed and treated with methylprednisolone. 10 months later MR features of myelitis resolved and the patient’s neurological condition improved. Our case shows that foreign bodies in the cervical spinal canal can remain asymptomatic for up to 30 years. In the case of a long asymptomatic retention period the need for surgical removal of a foreign body must be carefully evaluated, taking into account the probability that a foreign body is the cause of current symptoms, risk of a foreign body causing damage in the future, risk of damage to the spinal cord during removal, and probability of therapeutic success.

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Improvements in Cervical Spinal Canal Diameter and Neck Disability Following Correction of Cervical Lordosis and Cervical Spondylolistheses Using Chiropractic BioPhysics Technique: A Case Series

Journal of Radiology Case Reports ◽

10.3941/jrcr.v14i4.3890 ◽

2020 ◽

Vol 14 (4) ◽

Author(s):

Curtis Fedorchuk ◽

Douglas Frank Lightstone ◽

Robert DeVon Comer ◽

Evan Katz ◽

Justin Wilcox

Keyword(s):

Spinal Canal ◽

Case Series ◽

Cervical Lordosis ◽

Cervical Spinal Canal ◽

Canal Diameter ◽

Neck Disability

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Comparison of inter- and intra-observer reliability among the three classification systems for cervical spinal canal stenosis

European Spine Journal ◽

10.1007/s00586-017-5187-3 ◽

2017 ◽

Vol 26 (9) ◽

pp. 2290-2296 ◽

Cited By ~ 1

Author(s):

Sangbong Ko ◽

Wonkee Choi ◽

Seungbum Chae

Keyword(s):

Spinal Canal ◽

Spinal Canal Stenosis ◽

Classification Systems ◽

Observer Reliability ◽

Canal Stenosis ◽

Cervical Spinal Canal

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The Quantitative Assessment of Imaging Features for the Study of Hirayama Disease Progression

BioMed Research International ◽

10.1155/2015/803148 ◽

2015 ◽

Vol 2015 ◽

pp. 1-9 ◽

Cited By ~ 6

Author(s):

Minghao Shao ◽

Jun Yin ◽

Feizhou Lu ◽

Chaojun Zheng ◽

Hongli Wang ◽

...

Keyword(s):

Spinal Cord ◽

Cross Sections ◽

Spinal Canal ◽

Posterior Wall ◽

Transverse Diameter ◽

Imaging Features ◽

Hirayama Disease ◽

Cervical Spinal Canal ◽

Group 5 ◽

Magnetic Resonance Imaging Mri

Objective.To evaluate the forward shifting of cervical spinal cords in different segments of patients with Hirayama disease to determine whether the disease is self-limiting.Methods.This study was performed on 11 healthy subjects and 64 patients. According to the duration, the patients were divided into 5 groups (≤1 year, 1-2 years, 2-3 years, 3-4 years, and ≥4 years). Cervical magnetic resonance imaging (MRI) of flexion and conventional position was performed. The distances between the posterior edge of the spinal cord and the cervical spinal canal (X), the anterior and posterior wall of the cervical spinal canal (Y), and the anterior-posterior (A) and the transverse diameter (B) of spinal cord cross sections were measured at different cervical spinal segments (C4 to T1).Results.In cervical flexion position, a significant increase inX/Yof C4-5 segments was found in groups 2–5, the C5-6 and C6-7 segments in groups 1–5, and the C7-T1 segments in group 5 (P<0.05). The degree of the increasedX/Yand cervical flexionX/Yof C5-6 segments were different among the 5 groups (P<0.05), which was likely due to rapid increases inX/Yduring the course of Hirayama’s disease.Conclusion.TheX/Ychange progression indicates that Hirayama disease may not be self-limiting.

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Delayed Diagnosis of a Foreign Body in the Spinal Canal

Southern Medical Journal ◽

10.1097/00007611-199003000-00020 ◽

1990 ◽

Vol 83 (3) ◽

pp. 332-334 ◽

Cited By ~ 9

Author(s):

ENRIQUE CRIADO ◽

DALE OLLER ◽

JAMES FULGHUM

Keyword(s):

Foreign Body ◽

Spinal Canal ◽

Delayed Diagnosis

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Comparison of cervical spinal canal diameter between younger and elder generations of Japanese

Journal of Orthopaedic Science ◽

10.1007/s00776-009-1427-7 ◽

2010 ◽

Vol 15 (1) ◽

pp. 97-103 ◽

Cited By ~ 9

Author(s):

Shin-Ichi Goto ◽

Jutaro Umehara ◽

Toshimi Aizawa ◽

Shoichi Kokubun

Keyword(s):

Spinal Canal ◽

Cervical Spinal Canal ◽

Canal Diameter

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Operation of traumatic cataract with metal foreign body in the lens

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1104216v ◽

2011 ◽

Vol 139 (3-4) ◽

pp. 216-220

Author(s):

Dragan Veselinovic ◽

Ivan Stefanovic ◽

Milos Jovanovic ◽

Aleksandar Veselinovic ◽

Marija Trenkic-Bozinovic ◽

...

Keyword(s):

Visual Acuity ◽

Foreign Body ◽

Anterior Part ◽

Central Area ◽

Traumatic Cataract ◽

Metal Object ◽

Anterior Capsule ◽

Anterior Lens Capsule ◽

Uncorrected Visual Acuity ◽

Metal Foreign Body

Introduction. We present a patient with perforative eye injury, a metal foreign body in the lens and traumatic cataract. The paper emphasises the importance of phacoemulsification in case of patients with a traumatic cataract and the presence of a metal foreign body. Case Outline. A 41-year-old patient had a perforative wound of the cornea caused by a metal foreign body that also perforated the anterior lens capsule and remained in the paracentral anterior part of the lens. The injury, which happened upon hitting of a hammer against a metal object, showed the presence of a tangential wound of the cornea adapted edges, and a formed anterior eye chamber. The presence of a metal spear-shaped foreign body was partly inside the anterior eye chamber and partly in the central area of the lens. The visual acuity of the injured eye was 0.2. The technique of removing the foreign body out of the lens and the phacoemulsification of the lens with the implantation of intraocular lens is presented. The paracentral wound on the cornea was not sutured because of well-adapted edges. On the first postoperative day there were no inflammatory signs, and best uncorrected visual acuity of 0.8. Conclusion. Posttraumatic cataracts with a metal foreign body in the lens require operative treatment in order to remove the foreign body, phacoemulsification and implantation of artificial lens. Because of anterior capsule lesion, special care should be taken in regard to anterior capsulorhexis and appropriate hydrodisection. Ocular hypotonia and possible damage of the posterior capsule in some cases can make phacoemulsification more difficult to perform.

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