Impalement injuries involving the spinal canal.

Two cases of impalement injury involving the spinal canal are presented. In the first patient septic bacteria were carried into the spinal canal along the track of the impaling rod. This patient died of sepsis. In the second patient a steel rod penetrated the patient's trunk on the right side, traversing his body obliquely, impaling the L1 vertebral body and coming to lie in the left retroperitoneal space. This injury was not complicated by infection and the patient recovered without any neurological deficit. The principles of managing these injuries and factors influencing their outcomes are discussed.