Journal article
Nail-gun injury of the cervical spine: simple technique for removal of a barbed nail
Journal of neurosurgery. Spine, v 15(1), pp 60-63
01 Jul 2011
PMID: 21456893
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Although nail-gun injuries are a common form of penetrating low-velocity injury, impalement with barbed nails has been underreported to date. Barbed nails are designed to resist dislodgment once embedded, and any attempt at removal may splay open the barbs along the path of entry, with the potential for significant soft-tissue and neurovascular injury. A 25-year-old man sustained a nail impalement of the cervical spine from accidental discharge of a nail gun. The patient was noted to be fully conscious with no neurological deficits. Cervical Zone 2 impalement was noted, with only the head of the nail visible. Angiography revealed the nail lying just anterior to the right vertebral artery (VA), with compression of the vessel. Preoperatively, analysis of a similar nail revealed that orientation of the head determined position of the barbs. A deep neck dissection was then performed to the lateral aspect of the C-3 body, using the nail as a guide. Prior to removal, the nail was turned 180 degrees to change the position of the barbs, to prevent injury to the VA. Nail removal was uneventful. The authors present a simple technique for treatment of a nail-gun injury with a barbed nail. Prior to removal, radiographic analysis of the impaled nail must be performed to determine the presence of barbs. If possible, the surgeon should request a similar nail for analysis prior to surgery. Last, the treating surgeon must have knowledge of the barbs' position at all times during nail removal, to prevent damage to critical structures. (DOI: 10.3171/2011.3.SPINE10718)
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Details
- Title
- Nail-gun injury of the cervical spine: simple technique for removal of a barbed nail
- Creators
- Narendra Nathoo - The Ohio State UniversityAtom Sarkar - College Station Medical CenterGandhi Varma - College Station Medical CenterEhud Mendel - College Station Medical Center
- Publication Details
- Journal of neurosurgery. Spine, v 15(1), pp 60-63
- Publisher
- Amer Assoc Neurological Surgeons
- Number of pages
- 4
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology; Neurosurgery
- Web of Science ID
- WOS:000292004900014
- Scopus ID
- 2-s2.0-79959970650
- Other Identifier
- 991021960652604721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Clinical Neurology
- Surgery