Leon Kong, Victor Kong, Jonathan Ko, Howard Wain, Jim Wang, Jonah Qi, John Bruce, Grant Laing, Damian Clarke
ABSTRACT 
Objective
This study reviews our experience with penetrating neck injury (PNI) secondary to a stab wound (SW) to clarify the incidence of cervical spinal injury (CSI) and to interrogate the role of cervical spinal motion with cervical collar in these patients.
Methods
A retrospective review of a prospectively captured data set was conducted at the Pietermaritzburg Metropolitan Trauma Service in South Africa from December 2012 to December 2022. All patients who presented with a PNI due to a SW were included.
Results
There were 1249 cases of PNI over the 10 year study period. 1028 were due to a SW and 90% were male. The mean age 30 years. The zonal distribution of the external wounds was were 329 (32%) in zone 1, 469 (46%) in zone 2, 164 (16%) zone 3 and 162 (16%) in the posterior triangle of the neck. In eighty two (8%) cases a CSI was sustained. In none of these cases was the CSI unstable. Twenty two (22) patients sustained a spinal cord injury and presented with a neurological deficit.
Conclusions
While there is a significant incidence of spinal cord injury after a cervical SW, there is a very low incidence of cervical spine instability requiring spinal fixation. The routine application of cervical collar following a SW to the neck is unnecessary.
