• Jong-Hyun Ko, Seong-Woo Chong, Vinh-Lac Nguyen, and Dong-Hun Ham.
• Department of Orthopedic Surgery, Jeonbuk National University Hospital, Jeonju, Jeonbuk, Republic of Korea.
• Eur Spine J. 2024 Jul 1; 33 (7): 287028772870-2877.

PurposeTo report a unique case of incomplete CES following a rebar penetrating injury in perineal region with retro-pulsed fragment, which was treated with anterior approach and discuss suitable surgical approach.MethodsIncomplete cauda equina syndrome caused by non-missile penetrating injury is extremely rare. A 26-year-old male patient presented incomplete cauda equina syndrome due to a penetrating rebar wound from his perineal region to the lumbosacral spine. Computed tomography demonstrated a bony fragment broken from S1 body compressing into the spinal canal.ResultsBy anterior approach, we performed partial corpectomy of L5, decompression by retrieving the bony fragment and L5-S1 interbody fusion. The patient had a significant recovery, and no clinical complication was found after over 2-year follow-up.ConclusionIt is challenging to determine the optimal strategy of surgical treatment for penetrating spinal injuries with retained foreign bodies, here we suggest an anterior approach situation that has the advantage of being able to effectively perform decompression and prevent iatrogenic damages of thecal sac and nerve rootlets.© 2024. The Author(s).

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