title: Retained intraspinal bullet: a rare case in a visitor to malaysia - a case report.
abstract: Firearm injuries to the spine commonly present with acute neurology caused by direct penetration or indirectly from concussive effects of bullet impact on the vertebral column. We report a case of delayed neurologic presentation of retained intra-spinal bullet in a 42 year-old African who had chronic low back pain and sciatica with a past history of gunshot injury to the spine and radiograph revealed a bullet at the L4-5 disc level. Intra-operative exploration showed a fibrous mass around the bullet compressing on the L4 existing nerve root and L5 traversing nerve root. Removal of the retained bullet resulted in a good clinical outcome with complete resolution of symptoms.
  
  
  BACKGROUND
  Intra-spinal bullet, gunshot injury.
authors.affiliation: Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur,Malaysia.
authors.forename: Mh
authors.initials: M
authors.lastname: Ariffin
authors.affiliation: Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur,Malaysia.
authors.forename: F
authors.initials: F
authors.lastname: Noreen
authors.affiliation: Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur,Malaysia.
authors.forename: Y
authors.initials: Y
authors.lastname: Nor Hamdan
authors.affiliation: Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur,Malaysia.
authors.forename: A R
authors.initials: AR
authors.lastname: Shaharuddin
authors.affiliation: Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur,Malaysia.
authors.forename: B
authors.initials: B
authors.lastname: Azmi