An unusual case of penetrating injury to the spine resulting in cauda equina syndrome: Case presentation and a review of the literature

STUDY DESIGN. Case study. OBJECTIVE. We present an unusual case of cauda equina syndrome due to a penetrating injury in which the brake caliper of a motorcycle lodged in the lumbar canal of the operator of the vehicle after a road accident and provide a review of the literature on penetrating injury to the spine. SUMMARY OF BACKGROUND DATA. While the large majority of penetrating spinal injuries are due to gunshot wounds, penetrating injury to the spine causing cauda equina syndrome is rare. METHODS. We report the case of a 42-year-old man involved in a motorcycle accident in which the brake caliper penetrated the lumbar region and entered the lumbar canal through the interlaminar space between L2 and L3. He had a complete motor and sensory deficit in the lower extremities with absent rectal tone. The patient was taken urgently to the operating room and underwent removal of the foreign object and repair of a dural laceration. He was treated with a course of intravenous antibiotics. RESULTS. The wound healed without evidence for cerebrospinal fluid leakage or infection. The patient made a good neurologic recovery, becoming ambulatory with bowel and bladder continence at 5 months following the injury. CONCLUSIONS. Surgical removal of foreign object resulted in resolution of cauda equina syndrome injury.