Document Detail

The role of routine spinal imaging and immobilisation in asymptomatic patients after gunshot wounds.
MedLine Citation:
PMID:  19375078     Owner:  NLM     Status:  In-Process    
BACKGROUND: The role of routine dedicated spinal imaging and immobilisation following gunshot wounds (GSW) to the head, neck or torso has been debated. The purpose of this study was to determine the incidence of spinal column injury requiring stabilisation in evaluable patients following gunshot injury. METHODS: A retrospective study from of a Level I trauma centre from January 1995 to December 2004. All patients with GSW to the head, neck or torso and bony spinal column injury underwent medical record review to determine injury type, presentation, presence of concomitant spinal cord injury, treatment and outcome. RESULTS: A total of 4204 patients sustaining GSW to the head, neck or torso were identified. Complete medical records were available for the 327 (7.8%) patients with bony spinal column injury. Among these patients, 173 (52.9%) sustained spinal cord injury. Two patients (0.6%) with GSW to the torso and bony spinal column injury required operative spinal intervention. The indication for operative intervention in both cases was removal of a foreign body or bony fragment for decompression of the spinal canal. None of the 4204 patients sustaining GSW to the head, neck or torso demonstrated spinal instability requiring operative intervention, and only 2/327 (0.6%) required any form of operative intervention for decompression. CONCLUSION: Spinal instability following GSW with spine injury is very rare. Routine spinal imaging and immobilisation is unwarranted in examinable patients without symptoms consistent with spinal injury following GSW to the head, neck or torso.
Joseph DuBose; Pedro G R Teixeira; Pantelis Hadjizacharia; Matt Hannon; Kenji Inaba; D G Green; David Plurad; Demetrios Demetriades; Peter Rhee
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Publication Detail:
Type:  Journal Article     Date:  2009-04-16
Journal Detail:
Title:  Injury     Volume:  40     ISSN:  1879-0267     ISO Abbreviation:  Injury     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0226040     Medline TA:  Injury     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  860-3     Citation Subset:  IM    
Division of Trauma and Critical Care at the Los Angeles County, University of Southern California Medical Center, Los Angeles, CA, USA.
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