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Outcome of Laminectomy for Civilian Gunshot Injuries of the Terminal Spinal Cord and Cauda Equina: Review of 88 Cases

 

作者: George Cybulski,   James Stone,   Ravi Kant,  

 

期刊: Neurosurgery  (OVID Available online 1989)
卷期: Volume 24, issue 3  

页码: 392-397

 

ISSN:0148-396X

 

年代: 1989

 

出版商: OVID

 

关键词: Cauda equina;Spinal gunshot wound;Missiles;Spinal cord injury;Spinal decompression

 

数据来源: OVID

 

摘要:

&NA;Case records of 88 patients with low‐velocity gunshot injuries of the terminal spinal cord and cauda equina treated by laminectomy at Cook County Hospital between 1969 and 1987 were reviewed. Sixty‐one patients were operated upon within 72 hours of injury, 29 of whom (47.5%) experienced neurological improvement or pain relief. Twenty‐seven patients were operated upon at a later time for associated injuries, 13 of whom (48.1%) experienced neurological improvement or pain relief. When laminectomy was delayed for more than 2 weeks, either arachnoid adhesions (15%) or occult abscesses (17%) were observed. From this review as well as from the literature, it appears that the timing of laminectomy for gunshot injuries of the thoracolumbar and lumbosacral spine is not essential to neurological recovery. It appears, however, that adequate debridement of these injuries, performed as soon as the patient is stable from any associated injuries, may help to mitigate the late sequelae of arachnoiditis, infection, and pain syndromes in the lower extremities. (Neurosurgery24:392‐397, 1989)

 

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