Penetrating spinal cord injuries are rare in children but result in devastating impacts on long-term morbidity and mortality—with little known about the recovery capacity in this age group. We present the case of an eight-year-old child who sustained a penetrating injury through the right anterior thorax. Thoracic CT showed the arrow tip extending through the spinal canal at T6. Neurologic examination revealed no motor or sensory function below T6. The arrow was surgically removed without complications through an anterior-only approach. MRI on post-operative day (POD) 4 showed focal T2 hyperintensity at the T6 spinal cord. Patient was discharged on POD33 with an American Spinal Injury Association (ASIA)-D score and trace voluntary control over bowel and bladder function. Remarkably, four months later, he had near normal bowel and bladder function, with near-intact lower extremity strength and self-sustained ambulation. Follow-up imaging revealed hemicord formation at the level of injury. We review our case of penetrating spinal cord injury in a child and similar reports in the literature. Penetrating thoracic spinal cord trauma portends poor clinical outcomes, particularly when employing available adult prognostic spinal cord injury scoring metrics. Incomplete spinal cord injury, and often-associated spinal shock, can mimic a complete injury—as in our patient, which improved to near-complete motor and sensory restoration of function and resulted in the formation of a split hemicord. This case represents a unique penetrating spinal cord injury with remarkable neurologic recovery, which would advocate against definitive early prognostication in the pediatric population.

穿透性脊髓损伤在儿童中很少见，但会对长期发病率和死亡率造成破坏性影响——对该年龄段的恢复能力知之甚少。我们介绍了一个 8 岁儿童的案例，他的右前胸发生了穿透性损伤。胸部 CT 显示箭头尖端在 T6 处延伸穿过椎管。神经系统检查未发现 T6 以下的运动或感觉功能。箭头通过仅前路入路手术切除，没有并发症。术后第 4 天 (POD) 的 MRI 显示 T6 脊髓处的局灶性 T2 高信号。患者在 POD33 出院，美国脊髓损伤协会 (ASIA)-D 评分和跟踪对肠道和膀胱功能的自愿控制。值得注意的是，四个月后，他的肠和膀胱功能接近正常，具有近乎完整的下肢力量和自持行走能力。后续成像显示在损伤水平上形成了半脐带。我们回顾了我们的儿童穿透性脊髓损伤病例和文献中的类似报告。穿透性胸脊髓损伤预示着临床结果不佳，尤其是在使用可用的成人预后脊髓损伤评分指标时。不完全性脊髓损伤和通常伴随的脊髓休克可以模拟完全性损伤——就像我们的病人一样，它改善到近乎完全的运动和感觉功能恢复，并导致形成分裂的半球。该病例代表了一种独特的穿透性脊髓损伤，具有显着的神经功能恢复，这将反对在儿科人群中进行明确的早期预后。