Rostral migration of intradural bullet from lumbar to thoracic spine: Case report and review of the literature

Abstract

Migration of bullet in the canal is rare and intradural migration is even rarer. Most migration are caudal to the site of trauma. This case presents present a case of 27 years old man who sustained a bullet injury on his back at L1 with no exit site. He was having generalized tenderness on his abdomen and complete neurologic injury below the L1 level. Laparotomy was done and turned out to be negative laparotomy then a CT scan was taken to locate the bullet in T4. The patient prepared with T4 laminectomy intradural intramedullary bullet was removed under fluoroscopic guidance. The patient had no complications and was discharged. Neurosurgical management of bullet injury is controversial but there are some clear surgical indications for surgery. Complete neurologic injury has a grim prognosis as compared to patients with incomplete injury.

Keywords

• Bullet migration
• Intracanal bullet
• Spinal cord injury