Gunshot wound to the spine without neurological loss – A case report

Abstract

The role of surgery in the treatment of penetrating spinal injury has been controversial. Neurological outcome of the gunshot wounds to the spine depends firstly on the initial traumatic neurological deficit. The extent of such injuries depends primarily on the bullet energy deposited on target. The spine injuries caused by the military high velocity bullets are of much more extensive damage comparing to the civilian injuries such are those inflicted by the handguns. The patient injured by the bullet fired from the handgun that penetrated right parasternal thoracic area and lodged into the body of the T2 vertebra is presented. There was no neurological loss from this injury. The ballistic analysis is provided. The bullet lodged in the vertebral body protruding to the spinal canal was removed from the posterior approach employing laminectomy.

Combat-Related Intradural Gunshot Wound to the Thoracic Spine: Significant Improvement and Neurologic Recovery Following Bullet Removal

“…Here, we present a rare case of a military-grade assault weapon gunshot to the thoracic spinal column, sustained in combat, with spontaneous recovery of motor function within 24-48 hours and significant, but incomplete, improvement of posterior cord syndrome, the rarest of the incomplete spinal cord syndromes, after surgical removal of the bullet fragment. There have been previous cases of significant neurological recovery after penetrating spinal injuries, although typically at the conus and cauda equina level, with lower velocity bullets and/or with different injury mechanism [ 2 , 3 , 4 ]. However, we believe that this is the first report of a high-velocity, high-caliber GSW associated with immediate complete neurological deficits, being treated with timely removal of the fragment and resulting significant neurological recovery, as well as obviation of the potential pitfalls of a retained free-floating intra-canicular foreign body.…”