Civilian gunshot wounds of the spine: A literature review

Botha, AH; Booysen, BC; Dunn, RN

doi:10.17159/2309-8309/2016/v15n3a1

Cited by 3 publications

(5 citation statements)

References 41 publications

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“…The prevalence of SGWs has increased drastically over the past decade, affecting society and the health care system 56,57. Utilization of proper current treatment modalities are effective in preventing further damage but lack in ability to considerably improve any significant neurological deficit.…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of SGWs has increased drastically over the past decade, affecting society and the health care system. 56,57 Utilization of proper current treatment modalities are effective in preventing further damage but lack in ability to considerably improve any significant neurological deficit. Despite recent improvements in understanding the pathologic mechanisms of secondary damage, no operational molecular targets exist for the treatment of SGWs.…”

Section: Discussionmentioning

confidence: 99%

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Investigational Therapies for Gunshot Wounds to the Spine

Somuncu

Gartenberg

Cho

2021

Clinical Spine Surgery: A Spine Publication

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Objective: The objective of this study was to review the standards of care and triage protocol for gunshot wounds to the spine, highlighting innovative future treatment options that may be implemented in patients with spinal cord injury (SCI). Summary of Background Data:With the increased availability of firearms among the United States population, gunshot wounds to the spine are becoming a clinically relevant and devastating issue. Such injuries result in severe and diverse complications. SCIs due to gunshot wounds are the leading cause of morbidity and mortality, as they often result in complete or incomplete paraplegia. Current standards of care focus on preventing further damage rather than total cure or treatment of SCI.Methods: A literature review was performed on the standards of care, triage protocol, associated conditions, current therapeutic options, and innovative treatment options for patients with gunshot wounds to the spine. Results:The general standards of care for spinal gunshot wounds involve maintaining or renewal of mechanical spinal steadiness and neurological activity while limiting complications of treatment. Current treatment options include management of mean arterial pressure goals, drug therapies consisting of antibiotics, and surgical approaches. With recent innovations in molecular biology and cell transplantation, potentially new and promising treatment options for patients with SCI exist. These options include cell transplantation therapies, platelet-rich plasma administration, exosomal treatments, and mitochondrial-targeted therapeutics. Stem cell transplantation is promising, as several clinical studies have been completed. However, loss-to-followup, lack of long-term evaluation, and questionable randomization has limited the use of stem cells in the standard of care practice. Although not studied on human models to a gunshot wound, exosomal and mitochondrial-based treatment options have been studied both in vitro and in animal models with SCI. Conclusion:Newly emerging molecular and cellular therapy modalities for SCI contribute to the recovery process and may be utilized in conjunction with the current modalities for better outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Investigational Therapies for Gunshot Wounds to the Spine

Somuncu

Gartenberg

Cho

2021

Clinical Spine Surgery: A Spine Publication

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“…GSW injuries to the spine with bullets retained in or around the spinal canal, with or without associated spinal cord injuries, represent another highly debated entity. Spinal fractures caused by GSW are generally stable and do not require surgical fixation [34,35,36]. Early literature recommended aggressive surgical debridement and removal of bullets in all GSW injuries to the spine [34].…”

Section: Neurovascular and Other Associated Injuriesmentioning

confidence: 99%

“…Early literature recommended aggressive surgical debridement and removal of bullets in all GSW injuries to the spine [34]. More recent publications recommend a far more conservative approach in the civilian setting [36]. There appears to be consensus that not all bullets or fragments need to be removed.…”

Section: Neurovascular and Other Associated Injuriesmentioning

confidence: 99%

“…There appears to be consensus that not all bullets or fragments need to be removed. The indications for bullet removal from the spine include deteriorating neurology, intra-canal bullets in the lower part of the spinal canal with incomplete neurology, bullets that traversed large bowel, sepsis and lead poisoning should it occur [36].…”

Section: Neurovascular and Other Associated Injuriesmentioning

confidence: 99%

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Civilian gunshot injuries in orthopaedics: a narrative review of ballistics, current concepts, and the South African experience

Laubscher

Ferreira

Birkholtz

et al. 2021

Eur J Orthop Surg Traumatol

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The incidence of civilian gunshot injuries is on the rise worldwide.Unfortunately, there is a lack of high-level evidence guiding management. The treatment of orthopaedic injuries from gunshots is complex and requires consideration of multiple aspects, including energy transfer to the tissue, severity of the wound, possible contamination, presence of fractures and associated injuries. With this narrative review we aim to discuss some of the relevant ballistics, current concepts, and controversies in the general management of civilian gunshotrelated orthopaedic injuries based on the available evidence and personal experience. Important points which will be highlighted are the initial management in the emergency room, the assessment and management of soft tissue injuries, associated injuries, use of antibiotics, indication and techniques for fracture fixation, and gunshot injuries to joints.

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Penetrating Ballistic Spinal Injury

Harrisson

2017

Ballistic Trauma

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Civilian gunshot wounds of the spine: A literature review

Cited by 3 publications

References 41 publications

Investigational Therapies for Gunshot Wounds to the Spine

Investigational Therapies for Gunshot Wounds to the Spine

Civilian gunshot injuries in orthopaedics: a narrative review of ballistics, current concepts, and the South African experience

Penetrating Ballistic Spinal Injury

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