Gunshot injuries in the spine.
METHODS
Review article.


OBJECTIVE
To review the literature regarding treatment approaches in cases of gunshot wounds (GSWs) affecting the spine.


METHODS
Brazil.


METHODS
Narrative review of medical literature.


RESULTS
GSWs are an increasing cause of morbidity and mortality. Most patients with spinal GSW have complete neurological deficit. The injury is more common in young men and is frequently immobilizing. The initial approach should follow advanced trauma life support, and broad-spectrum antibiotic therapy should be initiated immediately, especially in patients with perforation of the gastrointestinal tract. The indications for surgery in spinal GSW are deterioration of the neurologic condition in a patient with incomplete neurological deficit, the presence of liquor fistula, spinal instability, intoxication by the metal from the bullet or risk of bullet migration.


CONCLUSIONS
Surgical treatment is associated with a higher complication rate than conservative treatment. Therefore, the surgeon must know the treatment limitations and recognize patients who would truly benefit from surgery.
Department of Orthopaedics and Traumatology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
T E P
TE
de Barros Filho
Division of Spine Surgery, Department of Orthopaedics and Traumatology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
A F
AF
Cristante
Division of Spine Surgery, Department of Orthopaedics and Traumatology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
R M
RM
Marcon
Division of Spine Surgery, Department of Orthopaedics and Traumatology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
A
A
Ono
1] Division of Spine Surgery, Department of Orthopaedics and Traumatology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil [2] Department of Orthopaedics and Traumatology, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
R
R
Bilhar
D006801:Humans; D013119:Spinal Cord Injuries / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D014948:Wounds, Gunshot / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*