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Órgano Oficial de Difusión Científica de la Federación Mexicana de Colegios de Ortopedia y Traumatología, A.C. (FEMECOT)

2011, Number 3-4

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Ortho-tips 2011; 7 (3-4)

Heridas de arma de fuego en la columna vertebral

Tejeda-Barreras M

Language: Spanish
References: 14
Page: 155-161
PDF size: 69.02 Kb.


ABSTRACT

Gunshots wound in spine are very complex injuries, involving most of times some other organs, so that is its management must be multidisciplinary. In this kind of injuries, we must set priorities to safeguard life, and next, once the patient is stabilized, we must request appropriate imaging studies in order to take proper management decisions about spine injuries. The application of broad spectrum antibiotics is mandatory, and must be kept for at least two weeks. Steroids have not proved to be useful in these wounds. Surgical treatment of spine is indicated when there is neurological damage consistent with evidence of compression al the level of injury; due to instability of the spine; or because of proximity of the bullet into neurological duct. We must consider decompression and removal of a bullet in T12 and lumbar levels, due to neurological damage, and motor improvement may occur. In some cases of cervical injuries, it might be neurological improvement in cases of incomplete spinal cord injuries. The worst neurological functional outcome is in thoracic spine injuries. Regarding the optimal time to perform a decompression surgery, so far we do not have enough evidence to do so urgently (within 72 hours) in order to obtain a better result, or less complications.


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