Gunshot wounds

Types
Gunshot wounds to the spine and spinal cord are divided into:

• Injuries to the soft tissues surrounding the spinal column,
• Impermeable,
• The penetrating blind,
• Penetrating through and through.
  
  Depending on the type of injury, the clinical picture will vary.

  Complaints are pending

  • from the type of weapon used and the type of instrument that caused the impact,
  • from the localization and extent of the damage area,
  • from the type of early canal,
  • from the presence of spinal cord injury .
    
    

    

    Clinical picture

    • Impaired or absent movement, muscle weakness (paresis, plegia) below the level of injury,
    • Loss of sensation (anesthesia) below the level of injury,
    • Central type pelvic organ dysfunction (in the form of incontinence or acute retention).
      

      Diagnostics

      • X-rays allow you to determine: the type of instrument that caused the injury, the condition of the bone structures, and the number of metal foreign bodies.
      • MSCT (multislice computed tomography) is the leading diagnostic method for gunshot wounds of the spinal cord , making it possible to determine the presence of hemorrhages and foreign bodies, assess the degree of spinal cord compression, clarify the number of foreign objects, and also allows you to determine the type of injury (soft tissue injury, penetrating wound, non-penetrating wound), and conduct dynamic observation.
      • Given that most of the striking elements are metal, MRI is contraindicated in these types of injuries. MRI can be performed only after removal of all metal fragments.
        

        Treatment
        Surgical treatment for penetrating injuries is performed under general anesthesia. In case of compression of the spinal cord by bone fragments, foreign bodies, or hematoma, the first stage of treatment is decompression (release) of the spinal cord from the factors compressing it, and all foreign objects are removed, if possible.

        In the future, if necessary, a stabilizing operation is performed.

        The neurosurgical department of the KNP KHOKL KOR performs all types of reconstructive and stabilizing operations for spinal injuries.