Work

Comparison of Direct Penetrating Versus Blast Injuries Following Gunshot Wounds to the Spine

Year: 2024

Type: article

Abstract: Spinal cord injury (SCI) is a major cause of morbidity and disability in the United States. While most SCI is caused by blunt trauma, penetrating spine injuries can be particularly devastating. Our aim is to compare management strategies, surgical intervention, imaging findings, and neurological outcomes in patients sustaining SCI due to direct spinal cord penetration versus indirect spinal cord or blast injury following gunshot wounds (GSWs). This study is a retrospective chart review of patients presenting to Highland Hospital with GSWs to the spine between January 2013 and June 2020. Baseline demographics and outcome parameters were analyzed, and multiple regression analysis was performed to identify predictor variables. A p value of ≤0.05 was considered statistically significant. A total of 111 patients were included in our analysis. Sixty-nine patients sustained blast injuries whereas 42 sustained direct penetrating injuries to the spinal cord. More patients in the blast injury group were classified as American Spinal Injury Association (ASIA) E whereas more patients in the direct penetrating group were classified as ASIA A (p = 0.000). There was no statistically significant difference in treatment modalities utilized between groups. Multiple regression analysis demonstrated that the use of mean arterial pressure (MAP) augmentation was predictive of a change in ASIA class in both groups. Patients with penetrating injuries to the spinal cord had more severe neurological deficits than those with blast injuries. In our study, MAP augmentation was predictive of neurological improvement in both groups; however, larger sample sizes are needed to identify effective management strategies for patients with penetrating and blast SCIs following GSWs to the spine.

Source: Neurotrauma Reports

DOI: 10.1089/neur.2024.0154

Authors: Zoe Robinow, Liesl Close, Margaret Riordan

Institutions: University of North Carolina at Chapel Hill, University of California, San Francisco, Highland Hospital

Language: English

Topic: Spinal Cord Injury Research

Subfield: Pathology and Forensic Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,750