Sea Urchin Spines

Mike is a 57 year old professional who is a recreational free diver and is fond of both abalone and sea urchins. He was enjoying a great day of abalone diving up in Sea Ranch late October. He and a few friends were having their traditional sushi break of fresh sea urchin roe on Candy Rock (about 200 yards offshore), when one of his diving buddies "tossed" him an urchin from about 5 yards away. (He later told me that he knows, they both could win the Darwin award for that stunt.) Here he is on a better day:

This is the kind of sea urchin they were harvesting:

The patient caught the tossed urchin as a reflex but unfortunately had two of the spines penetrate his glove and break off in his hand. He presented to my office after two other physicians had tried unsuccessfully to remove the spines.

Sea urchins cannot run away like a deer (they move as fast as a starfish, an inch every 15 to 30 minutes), they cannot bite like a tiger (no teeth and no mouth, to speak of), they cannot change color and hide like a chameleon, so they have developed a defense mechanism similar to a porcupine: they have sharp spines. These spines have chemicals in them that make them hurt a lot, so that you learn to never bother a sea urchin again. This may be good for sea urchins, but unfortunately this is bad for patients!

Sea urchin spines have calcium in them, so they show up well on xray:

Mike and I discussed it. Some of his diver friends suggested to leave them in. I suggested that it was good to get the spines out, due to the toxins that were causing his pain and swelling. He agreed, and I took him to the operating room within a few days.

This is the view in the operating room. Mike has circled the two
areas of pain where the urchin spines are located.

Here is one of the spines once it was
removed: it was over half an inch!

Mike did well after the spines were removed and has since resumed his free diving. But he does not play catch with sea urchins anymore! Here is his report:

" I am happy to report the hand feels much better without the spines than with them. Your pain control regimen of Celebrex and Tylenol was very effective and there was no need for any other pain treatment following the surgery. Probably the most difficult part of the surgery was getting back to a normal exercise routine until after the effects of the anesthesia were fully out of my system (a couple of days.)

It is now several weeks after the surgery, the wound has healed nicely, you were always accessible for follow-up questions, and I'm back to playing tennis and guitar. There remains a little bit of soreness and modest loss of strength, but I expect 100% recovery within the next several weeks.

Thanks for the great care, and while I hope I never need to re-experience this clearly avoidable accident, I wouldn't hesitate to be under your care again."

Would you like to search the medical library of the National Library of Medicine for scientific papers on this topic? Just click on the Pub - Med image:

Remember the admonition from the Patient Education Links Page: the Internet has a lot of information, much of it incorrect. I have reviewed the sites that I have linked to, and have only linked to sites when I personally know the surgeon who posted it, or am a member of the organization that posted it. However, I may not agree with all that is on that site, and it may have changed since I reviewed it. If any of the information is not consistent with what I have told you, please download the material and bring it in.