Preservation of neurologic function in the setting of penetrating-knife spinal cord injury with dural involvement and concurrent lung injury.

This article focuses on the clinical management of a rare penetrating-knife spinal cord injury (PKSCI) with retained knife blade (RKB) and concurrent lung involvement in a neurologically intact adult male. It details the use of computed tomography (CT) imaging to assess the blade trajectory through the T8 vertebra and lung parenchyma, followed by surgical removal via decompressive laminectomy under direct visualization, dural repair, and chest tube placement to manage pneumothorax. The case highlights the importance of comprehensive imaging and multidisciplinary surgical intervention to preserve neurologic function despite complete dural transection and thoracic organ injury. The report also discusses current surgical approaches and cerebrospinal fluid leak management strategies in PKSCI, emphasizing that removal of RKB under direct visualization remains the preferred treatment.