Highlights
- •Patient with long-term back pain developed acute neurologic symptoms without recent penetrating spinal injury.
- •Initial thoracic spine MRI demonstrated enhancing intradural extramedullary lesion concerning for aggressive neoplasm.
- •Surgical resection demonstrated a retained foreign body with surrounding inflammatory changes.
- •Similar cases and MRI imaging characteristics of penetrating foreign bodies are reviewed.
Abstract
Foreign bodies in the spine are most commonly traumatic and managed in an acute setting.
A few case reports describe foreign bodies resulting in delayed neurologic dysfunction,
most commonly iatrogenic or from penetrating injury. We present a 30-year old man
with lower extremity weakness from an intradural extramedullary foreign body granuloma
secondary to a thorn, which was initially thought to represent an aggressive malignant
process with intra and extramedullary involvement on MR. Postoperatively, the patient
endorsed a causative trauma several years prior. We also present a review of the few
similar published cases as well as the described prototypical imaging features and
pathologic process.
Keywords
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References
- Epidemiology of traumatic spinal cord injury: trends and future implications.Spinal Cord. 2012; 50: 365-372
- Spinal cord injury caused by stab wounds: incidence, natural history, and relevance for future research.J Neurotrauma. 2016; https://doi.org/10.1089/neu.2015.4375
- Nonmissile penetrating spinal injury. Case report and review of the literature.J Neurosurg Spine. 2006; 4: 400-408
- Glass foreign body in the spinal canal of a child: case report and review of the literature.Pediatr Emerg Care. 2004; 20: 468-472
- A glass foreign body migrating into the lumbar spinal canal: a case report.J Orthop Surg (Hong Kong). 2012; 20: 257-259
- Delayed myelopathy secondary to retained intraspinal metallic fragment. Case report.J Neurosurg. 1981; 55: 979-982
- Delayed effects from retained foreign bodies in the spine and spinal cord.Surg Neurol. 1986; 25: 214-218
- Delayed myelopathy after a stab wound with a retained intraspinal foreign body: case report.J Trauma. 1992; 32: 539-541
- Delayed presentation of spinal stab wound: case report and review of the literature.J Emerg Med. 2000; 18: 209-213
- Delayed myelopathy secondary to stab wound with a retained blade tip within the laminae: case report.Int J Clin Exp Med. 2015; 8: 16787-16792
- A review of 450 stabwounds of the spinal cord.S Afr Med J. 1977; 51: 961-964
- Penetrating spinal injury with wooden fragments causing cauda equina syndrome: case report and literature review.Eur Spine J. 2006; 15: 574-577
- Spectrum of complex non-missile penetrating spinal injury: a series of four cases with review of literature.ResearchGate. 2014; 5: 25-34
- On the AJR viewbox: terminal spine of agave plant extracted from patient's spinal cord.AJR Am J Roentgenol. 2003; : 1155-1156
- Textiloma: a case of foreign body mimicking a spinal mass.Eur Spine J. 2006; 15: 626-629
- Spinal textiloma (gossypiboma): a report of three cases misdiagnosed as tumour.Balkan Med J. 2013; 30: 422-428
- Retained surgical sponge in differential diagnosis of paraspinal soft-tissue mass after posterior spinal surgery: report of eight cases.Neurol India. 2009; 57: 320-323
- A 13-year-old textiloma (gossypiboma) after discectomy for lumbar disc herniation: a case report and review of the literature.Spine J. 2007; 7: 618-621
- Foreign body granuloma simulating solid neoplasm on MR.Clin Imaging. 1997; 21: 269-272
- MR imaging findings of paravertebral gossypiboma.AJNR Am J Neuroradiol. 2007; 28: 709-713
- Magnetic resonance imaging in lumbar gunshot wounds: an absolute contraindication?.Neurosurg Focus. 2014; 37E13
- MR of the spine in the presence of metallic bullet fragments: is the benefit worth the risk?.AJNR Am J Neuroradiol. 1999; 20: 354-356
- Uncommon intraspinal space occupying lesion (foreign-body granuloma) in the lumbosacral region.Neuroradiology. 1985; 27: 354-356
- Use of methylprednisolone as an adjunct in the management of patients with penetrating spinal cord injury: outcome analysis.Neurosurgery. 1996; 39: 1141-1149
- Civilian gunshot injuries of the spinal cord: a systematic review of the current literature.Clin Orthop. 2013; 471: 3945-3955
- Global prevalence and incidence of traumatic spinal cord injury.Clin Epidemiol. 2014; 6: 309-331
- Spinal cord injury facts and figures at a glance.J Spinal Cord Med. 2012; 35
Article info
Publication history
Published online: May 17, 2017
Accepted:
May 9,
2017
Received in revised form:
April 24,
2017
Received:
January 20,
2017
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
