Authors: Anish Sen, Shankar Gopinath

Authors Affiliations: Department of Neurosurgery, Baylor College of Medicine, Houston, TX, U.S.A

Address of correspondence:  Anish Neeraj Sen, M.D., 7200 Cambridge Street, Suite 9A, Houston, TX  77030  U.S.A.


Abstract                                                                                                                 

Background – Gunshot wounds (GSW) to the spine represent a significant component of neurosurgical trauma patients in large metropolitan areas.  In this study, we examined the presenting characteristics and outcomes of patients presenting with GSW injuries to any portion of the spine.

Material & Methods:  A retrospective analysis was performed on all patients presenting to our trauma center who underwent neurosurgical evaluation for spinal GSW injury. Fifty patients were reviewed from 2011 to 2014.  Demographics, presenting neurological examination, toxicology screen results, and imaging were reviewed upon admission.  Need for surgical interventions were documented, as well as follow up neurological examinations and any complications. Neurologic function was assessed using the ASIA impairment scale.

Results: The average age of presentation was 28.6 years, ranging from 16 to 54 years old.  Males composed most patients (88%).  Twenty-six percent presented with complete spinal cord injuries (ASIA A), with ASIA B, 14%; ASIA C & D, 34%; ASIA E, 24%.  Most patients had thoraco-lumbar neurologic levels (56%), with eight with cervical levels and one sacral level.  Fifty-two percent of patients underwent admission toxicology evaluation, 65% of whom were positive.  The most common positive findings were cannabinoids and cocaine.  Eight patients underwent surgery (16%). In follow up, two patients progressed to ASIA A disabilities, three improved to ASIA D, and one improved to ASIA E.  The most common complications on follow up included pressure ulcers, depression, and neuropathic pain.

Conclusion:  GSW to the spine occur mostly in young male patients, many of whom who use drugs.  Most patients with spinal GSWs do not require surgical intervention.  Stabilization, decompression, and repair of CSF fistulas are the primary indications for intervention. Most patients do not have changes in their ASIA disability scores from presentation to post-hospitalization follow up.

How to Cite this Abstract
Sen A. Gunshot Wounds to the Spine: A Single Center Retrospective Review. International Journal of Conference Proceedings. March 2015;(2015):19.