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Thorn in My Spine: A case of a retained intradural extramedullary foreign body

      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.

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