medigraphic.com
ISSN 2992-7749 (Electronic)
ISSN 2992-7897 (Print)
Órgano Oficial de difusión científica de la Asociación Mexicana de Cirujanos de Columna A. C.

2024, Number 3

<< Back Next >>

Cir Columna 2024; 2 (3)

Neurosurgical approach to thoracic trauma with complete spinal cord injury due to a firearm projectile. Case report and literature review

Gutiérrez-Albavera RR, Martínez-Tapia AG, Paredes-Herrera FJ, Vega-Rosas GA

Language: Spanish
References: 15
Page: 175-179
PDF size: 744.84 Kb.


ABSTRACT

Introduction: firearm injuries (FI) are a public health problem that predominantly affects young men, with a poor prognosis when they injure the spinal cord, with the thoracic spine being the most affected level. The goals in the dneurosurgical approach to FI in the spine are the maintenance or renewal of mechanical stability, as well as neurological functionality to avoid as many neurological sequelae as possible. Case presentation: 23-year-old male who came to the emergency room with a gunshot wound that resulted in a burst fracture of T5 and T6 Gustillo-Anderson IIIA, fracture of the right pedicles of T6 and T7, spinal cord trauma Frankel A, ASIA A and fracture of the costovertebral joint of costal arches 8 and 9, after experiencing violence on public roads. He received posterior thoracic instrumentation with hemilaminectomy and physical rehabilitation, achieving satisfactory progress and functionality. Conclusions: the surgical approach to FI in the thoracic spine should be considered when they are the best option to recover functionality and reduce neurological sequelae, highlighting the role of physical rehabilitation and support network.


REFERENCES

  1. Weigend Vargas E, Perez Ricart C. Non-fatal gunshot injuries during criminal acts in Mexico, 2013-2019. Inj Prev. 2022; 28: 238-242. doi: 10.1136/injuryprev-2021-044411.

  2. Mahmassani D, Bachir R, El Sayed M. Patterns and predictors of firearm-related spinal cord injuries in adult trauma patients. West J Emerg Med. 2021; 22: 270-277.

  3. Loder RT, Mishra A, Atoa B, Young A. Spinal injury associated with firearm use. Cureus. 2021; 13: e13918.

  4. Sajid MI, Ahmad B, Mahmood SD, Darbar A. Gunshot injury to spine: an institutional experience of management and complications from a developing country. Chin J Traumatol. 2020; 23: 324-328.

  5. Ricciardi G, Martinez O, Cabrera J, Matta J, Davila V, Jimenez JM, Vilchis H, et al. Spinal gunshot wounds: A retrospective, multicenter, cohort study. Rev Esp Cir Ortop Traumatol. 2023: S1888-4415(23)00165-0.

  6. Platt A, Dafrawy MHE, Lee MJ, Herman MH, Ramos E. Gunshot wounds to the lumbosacral spine: systematic review and meta-analysis. Global Spine J. 2022; 12: 1247-1253.

  7. Somuncu D, Gartenberg A, Cho W. Investigational therapies for gunshot wounds to the spine: a narrative review. Clin Spine Surg. 2022; 35: 233-240.

  8. Goh BC, Striano BM, Crawford AM, Tobert DG, Fogel HA, Cha TD, et al. Surgical intervention is associated with improvements in the ASIA impairment scale in gunshot-induced spinal injuries of the thoracic and lumbar spine. Clin Spine Surg. 2022; 35: 323-327.

  9. Cantú-Alejo DR, Reyna-Sepúlveda F, García-Hernández S, Sinsel-Ayala J, Hernández-Guedea M, Rodríguez EP, et al. Presentation, management and evolution of patients with abdominal gunshot wound. A decade of violence in Mexico. Cir Cir. 2021; 89: 39-45.

  10. Sherrod BA, Young JB, Wilkerson CG, Bisson EF, Dailey AT, Mazur MD. Epidemiology of gunshot-related spinal injuries and related risk factors for in-hospital mortality in the United States from 2015-2019: a national trauma data bank analysis. J Neurotrauma. 2023.

  11. Hauser BM, McNulty J, Zaki MM, Gupta S, Cote DJ, Bernstock JD, et al. Predictors of thoracic and lumbar spine injuries in patients with TBI: a nationwide analysis. Injury. 2022; 53: 1087-1093.

  12. Li J, Shan Y, Zhao X, Shan G, Wei PH, Liu L, et al. Structural and functional changes in the brain after chronic complete thoracic spinal cord injury. Brain Res. 2024; 1823: 148680.

  13. Nandakumar B, Blumenthal GH, Disse GD, Desmond PC, Ebinu JO, Ricard J, et al. Exercise therapy guides cortical reorganization after midthoracic spinal contusion to enhance control of lower thoracic muscles, supporting functional recovery. Exp Neurol. 2023; 364: 114394.

  14. Prieto A, Martins Almeida Ayupe K, Nemetala Gomes L, Saúde AC, Gutierres Filho P. Effects of equine-assisted therapy on the functionality of individuals with disabilities: systematic review and meta-analysis. Physiother Theory Pract. 2022; 38: 1091-1106.

  15. Mendonca T, Bienboire-Frosini C, Menuge F, Leclercq J, Lafont-Lecuelle C, Arroub S, et al. The impact of equine-assisted therapy on equine behavioral and physiological responses. Animals (Basel). 2019; 9: 409. Published 2019.




2020     |     www.medigraphic.com