Spinal Gunshot Wounds: Pattern and Associated Lesions in Civilians

Jorge Arturo Cabrera Escamilla; Jorge Álvaro González Ross; José Manuel Pérez Atanasio; Gustavo Casas Martínez; Arelhi González Cisneros; Jose Jimenez Avila

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저자정보: Jorge Arturo Cabrera Escamilla (Instituto Mexicano del Seguro Social) Jorge Álvaro González Ross (Instituto Mexicano del Seguro Social) José Manuel Pérez Atanasio (Instituto Mexicano del Seguro Social) Gustavo Casas Martínez (Instituto Mexicano del Seguro Social) Arelhi González Cisneros (Instituto Mexicano del Seguro Social) Jose Jimenez Avila (Instituto Mexicano del Seguro Social)

저널정보: 대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.12 No.4

발행연도: 2018.1

수록면: 648 - 655 (8page)

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Study Design: Retrospective, descriptive case series study. Purpose: To investigate the frequency, bone pattern, and associated lesions to the spine of gunshot wounds. Overview of Literature: Gunshot wounds are penetrating in nature and are caused by a bullet or projectile. These are becoming more common and are associated with significant sequelae, requiring long and costly multidisciplinary treatment. Associated spinal cord injuries (SCIs) in the civilian population represent 13%–17% of all spinal traumas. Spinal gunshot wounds are commonly thought to be stable; however, there is potential acute and chronic spinal instability if the bullet passes transversely, fracturing either both pedicles or both facet joints. Methods: We obtained data from the clinical files of patients with spinal gunshot wounds treated by spine surgeons. We performed a statistical analysis to obtain the pattern and frequency of the injuries. Results: We included 54 patients (48 men [89%] and six women [11%]). Eight patterns of spinal gunshot wounds were identified; 61% (33 patients) had complete SCI. The thoracic spine was most frequently affected, with 88% of patients having SCI; 75%, hemopneumothorax; 28%, pulmonary lesions; and 16%, hepatic lesions. The presence of pedicle fractures had an odds ratio of 3.64 for SCI. Conclusions: The two main bone patterns are the vertebral body and posterior arch with pedicle fractures as modifiers, given that they are at a high risk for SCI. The spinal pattern and associated lesions were related to the bullet’s path, with the vertebral body having the highest frequency of associated lesions. Vertebral body burst fracture was the main indication for instrumentation.

참고문헌 (17)

참고문헌 신청

Hernandez-Tellez IE / 2015 / Epidemiology of injuries to the spine by gun fire / Rev Sanid Milit Mex 69:265~274

Kaim Khani GM / 2015 / Pattern of bony injuries among civilian gunshot victims at tertiary care hospital in Karachi, Pakistan / Chin J Traumatol 18:161~163

Waters RL / 2003 / Spinal cord injuries from gunshot wounds to the spine / Clin Orthop Relat Res (408):120~125

Sidhu GS / 2013 / Civilian gunshot injuries of the spinal cord: a systematic review of the current literature / Clin Orthop Relat Res 471:3945~3955

Jakoi A / 2015 / Gunshot injuries of the spine / Spine J 15:2077~2085

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