Penetrating Spinal Column Injuries (pSI): An Institutional Experience with 100 Consecutive Cases in an Urban Trauma Center

World Neurosurgery
Alexis GutierrezJames M Schuster

Abstract

Gunshot wound (GSW) injuries are among the leading causes of penetrating spinal column injury (pSI). Patients with pSI often have concurrent polytrauma that complicates management. We retrospectively reviewed charts between January 2012 to June 2018 at an urban Level 1 trauma center and analyzed bracing and surgical indications, antibiotic and magnetic resonance imaging (MRI) use, and patient outcomes. We identified 100 patients with pSI with an average age of 27.2 (range, 15-58) years. Five patients had knife injuries and 95 suffered GSW. Polytrauma occurred in 90% of patients with an average of 3.39 bullets per patient (range, 1-23). Fourteen patients underwent either decompressive surgery (n = 8) or decompression and fusion (n = 6). Thirty-five patients were externally braced. A total of 43% of patients presented as American Spinal Injury Association-A compared with 26% who were intact. Although 14 patients received prophylactic antibiotics for retained bullets or durotomies, only 2 patients had postoperative wound infections and 4 had extraspinal infections from retained bullets. All inpatient mortalities (n = 5) were patients with cervical pSI. Thirteen patients with GSW obtained MRI scans without complications. Among our ...Continue Reading

Citations

Sep 3, 2020·Surgical Neurology International·Zaid Aljuboori, Emily Sieg
Feb 12, 2021·Global Spine Journal·Laurence GeAddisu Mesfin
Jul 20, 2021·Global Spine Journal·Andrew PlattEdwin Ramos

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