title: Stab wound to the intramedullary spinal cord: Presurgical and surgical management options for a retained blade to optimize neurological preservation.
abstract: BACKGROUND
  We present a rare case of an intraparenchymal nonmissile penetrating spinal injury (NMPSI) occurring at the T11 level in a patient presenting without neurological deficit.
  
  
  METHODS
  The patient sustained a knife wound that penetrated the lamina without incurring bony injury and entered the spinal cord at the T11 level. During surgery, the intramedullary penetration of the cord was confirmed, and following surgical removal of the knife, the patient fully recovered without losing any neurological function.
  
  
  CONCLUSIONS
  The surgical management of NMPSI in patients who are neurologically intact is controversial. Here, we report surgical excision of a knife that penetrated the spinal cord at the T11 level, without the patient incurring further neurological deterioration.
authors.affiliation: Department of Neurological Surgery, Surgical Critical Care, and Emergency Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Prateek
authors.initials: P
authors.lastname: Agarwal
authors.affiliation: Department of Neurological Surgery, Surgical Critical Care, and Emergency Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: John F
authors.initials: JF
authors.lastname: Burke
authors.affiliation: Department of Neurological Surgery, Surgical Critical Care, and Emergency Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Kalil G
authors.initials: KG
authors.lastname: Abdullah
authors.affiliation: Department of Neurological Surgery, Surgical Critical Care, and Emergency Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Piazza
authors.affiliation: Department of Traumatology, Surgical Critical Care, and Emergency Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Brian P
authors.initials: BP
authors.lastname: Smith
authors.affiliation: Department of Neurological Surgery, Surgical Critical Care, and Emergency Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Jayesh P
authors.initials: JP
authors.lastname: Thawani
authors.affiliation: Department of Neurological Surgery, Surgical Critical Care, and Emergency Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Neil R
authors.initials: NR
authors.lastname: Malhotra
keywords: Nonmissile penetrating spinal injury; penetrating spinal trauma; spinal cord injury; stab wounds