title: How bullet trajectory affects outcomes of civilian gunshot injury to the spine.
abstract: We analysed retrospectively the effect of missile trajectory on outcomes from civilian gunshot injury to the spine (GSIS) between 1994 and 2008. Most of the 98 patients were male (88.8%). A minority (8%) of patients had multiple column injuries and a bone or bullet fragment in the spinal canal (14%). Neurologic injury was seen in 33%; and external bracing was applied to 30% of patients. The odds of bracing among patients with multiple levels of damage were 3.4 times than for patients with a single vertebral level of damage. The odds of paralysis among black patients were 6.33 times the odds among non-black patients. The odds of paralysis among patients with a fragment in the spinal canal were 12.99 times those without. We conclude that the supero-inferior trajectory affects the number of vertebral levels involved and consequently the need for bracing. The lateral trajectory affects neurological outcomes.
authors: Department of Neurosurgery, Louisiana State University Health Sciences Center Shreveport, 1501 Kings Highway, Shreveport, LA 71130, USA.
authors: Prashant
authors: P
authors: Chittiboina
authors: Anirban Deep
authors: AD
authors: Banerjee
authors: Shihao
authors: S
authors: Zhang
authors: Gloria
authors: G
authors: Caldito
authors: Anil
authors: A
authors: Nanda
authors: Brian K
authors: BK
authors: Willis
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013124:Spinal Injuries / Q000175:diagnosis* / Q000628:therapy; D016896:Treatment Outcome; D054041:Weapons; D014948:Wounds, Gunshot / Q000175:diagnosis* / Q000628:therapy