A sewing needle in contact with the cervical dura mater and vertebral artery

Abstract Rationale: Although cervical foreign bodies have been previously reported, the report of a needle in the cervical spinal cord is rare. Herein, we report a rare case of a sewing needle in contact with the cervical dura mater and vertebral artery. Patients concerns: A 47-year-old man presented with discomfort in the posterior region of his neck. Approximately 2 years before admission, he suffered a stiff neck and had stabbed the posterior region of his neck with a sewing needle. The sewing needle had deeply entered his neck, and he left it alone because it could not be identified or removed. On examination, the patient had a full range of neck motion, but was experiencing discomfort. Cervical spine radiographs revealed a metal foreign body oriented from between the C2 and C3 spinous processes to the anterior cervical spine. Diagnosis: Computed tomography (CT) myelogram and CT angiogram revealed that the sewing needle was penetrating into the foramen transversarium and was in contact with the cervical dura mater and the right vertebral artery. Interventions: The sewing needle was removed under general anesthesia. Outcomes: Cerebrospinal fluid leakage occurred immediately after removal of the needle. Symptoms of discomfort disappeared without any complications. Lessons: This is the first report of a sewing needle that entered the cervical spinal canal while avoiding the cervical spine and the vertebral artery. Although no symptoms occurred for nearly 2 years, surgical removal of a foreign body near the cervical spinal cord and vertebral artery should be performed as soon as possible, before the occurrence of symptoms.