PMC7591970_01
Axial slice of the patient's preoperative chest CT showing three-column fracture at T1 and T2 levels. The hypodense diagonal path bisecting the vertebra illustrates shattering of the vertebral body and posterior elements, presumably from the bullet's impact and trajectory.
CRIA2020-8835292.001.jpg
PMC7591970_01_CRIA2020-8835292.001.jpg
fig1
Chest CT (computed tomography) scan showed T1 and T2 fractures and spinal cord transection (Figure 1).
Average daily NRS pain scores before, during, and after ketamine. Day number -3 corresponds to 3 days preceding ketamine initiation, and day number 1 is the first day of the ketamine treatment. Of note, the patient's spinal surgery occurred on day -1, and day 1 also represents postoperative day 1 (POD1). Day numbers +1 to +3 refer to the days following ketamine discontinuation. The graph shows a downtrend in average pain scores.
CRIA2020-8835292.002.jpg
PMC7591970_01_CRIA2020-8835292.002.jpg
fig2
The allodynia subsequently improved such that he no longer required doses of hydromorphone (Figure 2).
Total daily dose of hydromorphone in milligrams. Day number -3 corresponds to 3 days preceding ketamine initiation, and day number 1 is the first day of the ketamine treatment. Of note, the patient's spinal surgery occurred on day -1, and day 1 also represents postoperative day 1 (POD1). Day numbers +1 to +3 refer to the days following ketamine discontinuation. The graph shows a downtrend in daily hydromorphone dose. From ketamine day number 4, the patient did not receive any hydromorphone.
CRIA2020-8835292.003.jpg
PMC7591970_01_CRIA2020-8835292.003.jpg
fig3
Total daily hydromorphone requirements steadily decreased (Figure 3).