Retrospective analysis of spinal missile injuries.
One hundred six patients with spinal missile injury from war zones were admitted to our department from 1994 to 2000. Functional recovery and complications in surgical and conservative treatment groups were evaluated. Sixty-five were treated surgically, of whom 55 (84%) had incomplete injuries (Frankel scores B, C, and D). In the conservative group, 28 (68%) had incomplete injuries. A total of 81 patients (53 in the surgical group, 28 in the conservative group) could be monitored for functional recovery. In the surgical group, 34 (64%) showed improvement, 15 (28%) were unchanged, and four (7%) worsened. In the conservative group, 17 (60%) improved, nine (32%) remained unchanged, and two (7%) worsened. Cerebrospinal fluid fistula was observed in ten patients, seven of them in the surgically treated group. Five of seven meningitides were seen in the surgically treated group. Surgical intervention is not essential for spinal gunshot injury; however, it may be beneficial for patients with CSF fistula, infectious and compressing foreign bodies in the injury site, instability, and rapid neurological deterioration.
Kahraman
Serdar
S
Department of Neurosurgery, School of Medicine, Gülhane Military Medical Academy, 06018 Etlik-Ankara, Turkey. skahraman@gata.edu.tr
Gonul
Engin
E
Kayali
Hakan
H
Sirin
Sait
S
Duz
Bulent
B
Beduk
Altay
A
Timurkaynak
Erdener
E
D000328:Adult; D002574:Cervical Vertebrae / Q000293:injuries / Q000503:physiopathology / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008161:Lumbosacral Region / Q000293:injuries / Q000503:physiopathology / Q000601:surgery; D008297:Male; D011183:Postoperative Complications; D020127:Recovery of Function / Q000502:physiology; D012189:Retrospective Studies; D013124:Spinal Injuries / Q000150:complications / Q000503:physiopathology* / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000293:injuries / Q000503:physiopathology / Q000601:surgery; D013997:Time Factors; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014948:Wounds, Gunshot / Q000150:complications / Q000503:physiopathology* / Q000601:surgery*