Spinal metallosis as a complication of a lodged bullet from a firearm wound: an image-centered case

Machado, Isabela; Garcia, Daniel de Paula; Tannus, Carolina Souza; Filho, Fred Bernardes; Costa, Mauro José Brandão da; Queiroz, Rodolfo Mendes

doi:10.1590/1806-9282.64.08.676

Cited by 1 publication

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References 8 publications

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“…In previous reviews, Machado et al 9 reported a successful outcome of spinal metallosis in the lumbar spine, in that the patient presented with progressive ambulation difficulty with a history of a firearm wound in the lumbar spine, 21 years ago; which had improvement of signs and symptoms after removal of metalloma and decompression of the spinal cord. Additionally, Womack et al 10 reported a successful surgical outcome for treatment of the heterotopic bone (HO) formation of the cervical spine, after a gunshot wound.…”

Section: Discussionmentioning

confidence: 99%

“…2,6 Surgical treatment includes neurologic deterioration; in a patient with neurological deficits, mechanical instability, metallic toxicity or bullet location having high risk of migration. [7][8][9] The surgical intervention is very challenging for spinal surgeons for treatments; such as, removing the retained bullet, open decompression, adequate irrigation debridement gunshot's wound and cervical spinal fixation in unstable stability. The author presents the surgical management of patients, who initially have no neurologic deficits following a gunshot wound at the cervical spine region, but later developed progressive myelopathy and radiculopathy, secondary to metalloma, 30 years after the initial trauma.…”

Section: Introductionmentioning

confidence: 99%

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Cervical Spine Myelopathy from Metalloma Association with Chronic Retention of a Bullet

Bintachitt

Chamnan

Chaiyamongkol

et al. 2021

J Health Sci Med Res

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A Civilian gunshot wound associated with metallosis in the cervical spine region was an extremely rare case; hence, the clinician had difficulty with diagnosis and surgical treatment. A 57–year-old gentleman had a history of a gunshot wound injury going back 30 years. He presented with neck pain, progress of paresthesia of upper extremities and progressively difficult ambulation for 3 months. Radiographic and pathological diagnosis from tissue of the 7th paravertebral of the cervical spine showed foreign bodies consistent with metallosis. The patient showed improvement of symptoms after posterior cervical spine fixation and decompression. He had full recovery at 1 year follow up. Metallosis can occur in cases of chronic exposure to lead and metals. The results of this chronic process of metallosis will develop to metalloma, which then compresses the spinal cord and develops into myelopathy. The patient had a bullet, or piece of metal at the cervical spine, so surgical removal was performed to prevent further compression of the spinal cord from metalloma.

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Section: Discussionmentioning

confidence: 99%