SURGICAL OUTCOMES OF SPINAL GUNSHOT WOUNDS

Objective: Although gunshot injuries to the spine and spinal cord are usually not fatal, but these are associated with significant morbidities. The management of spinal gunshot wounds (SGW) is controversial. Some surgeons prefer early surgery, while others recommend late surgery, if necessary. The aim of this study was to analyse the results of patients who underwent treatment for SGW and discuss this with the current literature. Materials and Methods: A retrospective study of SGW patients treated at a single institution was conducted. The study included a total of 32 patients over a 10-year period. Preoperative and early postoperative clinical and radiological data were analysed with the surgical technique used during the management of patients. Results: Overall, 27 patients underwent surgical treatment and five patients underwent conservative management. The mean follow-up duration was 12±4 months. Eighteen patients were injured by bullet, while 14 patients were injured by shrapnels. Injury occurred at lumbar spine in 17 patients, thoracolumbar region in six, cervical spine in five, thoracic spine in three and lumbosacral region in one patient. Five patients underwent continuous lumbar drainage and cerebrospinal fluid (CSF) infection was seen in two patients. However, no patient died at the end of treatment period. Conclusion: Patients with SGW should undergo comprehensive clinical and radiological assessments for surgical treatment. The main indications for early surgical intervention are CSF fistula and progressive neurological deficits. Stabilisation surgery should be the treatment option for patients with spinal instability.

Kaynakça

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