Case report of penetrating spinal injuries from firearms
Keywords:
penetrating injuries, firearm, sublaminar instrumentation, transpedicular instrumentationAbstract
Introduction: Vertebral injuries from firearms are highly variable and require diverse management. Their neurological and psychological sequelae have significant social and economic impact.
Objective: To standardize the ordering of paraclinical studies and the appropriate course of treatment for patients with penetrating spinal injuries from firearms.
Case Report: The diagnosis, initial neurological damage, surgical treatment, and the outcome of three cases of vertebral injuries from firearms were discussed.
Conclusions: The initial physical examination should stabilize the patient. In the neurological evaluation, CT is the key complementary method for defining appropriate treatment.The choice between conservative and surgical treatment depends on several factors, including the severity of neurological damage (complete or incomplete), spinal stability, projectile location, and signs of infection. Antibiotic therapy is typically recommended, and the length of hospital stay correlates with the extent of the trauma.
Downloads
References
1. University of Alabama at Birmingham. National spinal cord injury statistical center; 2016 [acceso 01/07/2024]. Disponible en: https://sites.uab.edu/nscisc/
2. Ricciardi G, Cabrera JP, Martínez, Cabrera J, Matta J, Dávila V, Jiménez JM, et al. Heridas de bala espinal: Un estudio retrospectivo, multicéptico, de cohorte. Rev Esp Cir Ortop Traumatol. 2024:68(4):T328-35. DOI: https://doi.org/10.1016/j.recot.2024.01.022
3. Christina J, Timothy W. Management of penetrating injuries to the spine. En: Quiñones-Hinojosa, A. Schmidek & Sweet: Operative NeurosurgicaL techniques. 7 ed. Philadelphia: Editorial Elsevier; 2021. pp. 1925-33.
4. Johnson CT, Batbold A, Benson D, Herman M, Lee MJ, Ramos E, et al. Caerías balísticas civiles a la espina atlantoaxial: a single institution case series. Clin Spine Surg. 2025;38(1):E7-11. DOI: https://doi.org/10.1097/bsd.0000000000001627
5. Villarreal-García FI, Martínez-Gutiérrez OA, Reyes-Fernández PM, Saavedra-Badillo LA, Avalos RM, Acosta-Olivo CA, et al. Two-year prevalence of spinal gunshot injuries in Mexico: A single center experience. Cir Cir. 2022;90(4):467-72. DOI: https://doi.org/10.24875/ciru.21000011
6. Garrido JF, Marco L, Bertó X, Gázquez G, Hernandez L. Lesiones por arma de fuego. Serie de casos y revisión sistemática. Rev Esp Cir Osteoart. 2023;58(293). DOI: http://dx.doi.org/10.37315/SOTOCAV2023293581
7. Sajid MI, Ahmad B, Mahmood SD, Darbar A. Gunshot injury to spine: An institutional experience of management and complications from a developing country. Chin J Traumatol. 2020;23(6):324-8. DOI: https://doi.org/10.1016/j.cjtee.2020.07.005
8. Levy ML, Gans W, Wijesinghe HS, SooHoo WE, Adkins RH, Stillerman CB. Use of methylprednisolone as an adjunct in the management of patients with penetrating spinal cord injury: outcome analysis. Neurosurg. 1996;39(6):1141-8. DOI: https://doi.org/10.1097/00006123-199612000-00014
9. Morrow KD, Podet AG, Spinelli CP, Lasseigne LM, Crutcher CL, Wilson JD, et al. Una serie de casos de trauma espinal penetrante: comparaciones con traumatismo contundente, indicaciones quirúrgicas y resultados. Neurosurg Focus. 2019;46(3):E4. DOI: https://doi.org/10.3171/2018.12.focus18577
10. Sidhu GS, Ghag A, Prokuski V, Vaccaro AR, Radcliff KE. Civilian gunshot injuries of the spinal cord: a systematic review of the current literature. Clin Orthop Relat Res. 2013;471(12):3945-55. DOI: https://doi.org/10.1007/s11999-013-2901-2
11. McCoy E, Eftekhary N, Nwosu K, Fukunaga D, Liu C, Rolfe K. American Spinal Injury Association A (sensorosa y motor completa) no es diferente de la American Spinal Injury Association B (sensoriado incompleto, motor completo) en lesión de la médula espinal relacionada con el disparo. Spine J. 2017;17(12):1846-9. DOI: https://doi.org/10.1016/j.spinee.2017.06.016
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Litzarys Caridad Cuba Rodriguez
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
