Gunshot wounds of the spine and spinal cord in a local wars (literature review and analysis of own observations)

Abstract

The character of gunshot injuries of the spine and spinal cord with modern weapons in local fighting was analyzed, the sequencing and features of tactics in these patients were determined.Observation and surgical treatment was performed in 16 patients with gunshot injuries of the spine and spinal cord.In all cases identified multiple injuries of the chest and/or abdomen were revealed, in 2 — pelvic organs. Bullet wounds dominated in places not protected by body armor. Life-saving surgery was performed in acute period in health facilities close to the fighting zone, as well as in general hospitals that allowed to save lives of 15 wounded persons. 15 injured persons were operated on for gunshot wounds of the spine and spinal cord. One patient with wounded liver, stomach, spine and spinal cord (Frankel A) died after surgery on abdominal organs in a result of multiple organ failure and disseminated intravascular coagulation.In local fighting spine wounds in most cases were characterized by multiple injuries of the chest and/or abdomen, surgery was performed in the first hours after injury in general hospitals. Surgery on the spine was performed after patients’ state stabilization: liquorrhea elimination, decompression of spinal cord and it’s roots, and spine stabilization as indicated.