Impalement with spinal cord injury requiring intraoperative division of a reinforced steel bar

Impalement injuries result when a rigid object penetrates and remains lodged within the body. While these injuries are rare, and many patients die at the scene, they often produce complex surgical problems. Few case reports describe complete spinal cord transection due to impalement. No case reports have described intrathoracic division of a reinforcing steel bar to assist the removal. The authors report a case of impalement by a steel bar resulting in immediate spinal cord transection requiring intraoperative division of the bar with a pneumatic drill for removal. They also present a literature review on thoracic impalement and discuss the general management of these injuries.