Case Report: Full-Endoscopic Surgery for Bullet Wounds of the Spine: A Report of Three Cases

Abstract

ObjectivesTo determine the feasibility and evaluate effectiveness of full-endoscopic surgery in gunshot wound of the spine.MethodsThree clinical cases of lumbar and thoracic spine bullet wounds made by firearms and traumatic weapons are described. Percutaneous endoscopic surgery was performed to extract bullet from the spinal canal. The results are compared to the data from literature.ResultsPercutaneous endoscopic approach to spinal canal with a possibility to extract a bullet, decompression of nerve roots, defect closure of the dura mater is demonstrated.ConclusionGood clinical outcomes allows to recommend percutaneous endoscopic surgery to manage similar lumbar and thoracic spine bullet wounds at the tertiary care level.

Full Endoscopic Surgery of Bullet Removal of the Spine: A Case Report

“…5 Sacral gunshot wounds are strongly associated with sphincter dysfunction loss and a high risk of neurologic injury. 1 The bullet removal of lumbosacral in the absence of a progressive spinal lesion is still supported by evidence. This may be due to the fact that after decompression, peripheral nerves below L1 are more responsive to recovery and have a greater capacity for regeneration.…”

“…Surgical treatment should be individualized for each patient, considering factors such as nerve damage, projectile placement, stability of the spine, resulting traumas, and hemodynamic indicators. 1,2 Percutaneous video endoscopy is the least invasive surgical technique currently employed in spinal surgery. 3 With advancements in technology required for endoscopic approaches including high-definition cameras, optical elements, high-velocity burrs, and irrigation pumping systems, various endoscopic techniques can be used to perform minimally invasive spine surgeries.…”

“…However, for most cases, percutaneous endoscopic interventions were performed limited to the degenerative-dystrophic spine diseases. 1,4 This report presents the case of a child who was injured by an air gunshot, with the bullet implanted in the right pedicle of S1 without causing neurological injury. This report describes the capabilities of percutaneous video endoscopic intervention for bullet removal from the sacrum.…”

Immune response to foreign materials in spinal fusion surgery

“…Table 1 provides a summary of examples of foreign materials used in spinal fusion procedures and their potential impact on the foreign body reaction. By carefully selecting and designing foreign materials for spinal fusion procedures [ 37 ], it may be possible to minimize the foreign body reaction and improve the long-term success of these procedures (see Table 1 ).…”

Treatment of gunshot wounds of the spine using full-endoscopic surgery: analysis of a small clinical series

“…Видеоэндоскопическая хирургия также постепенно входит в сферу лечения пациентов с огнестрельными поражениями центральной нервной системы [29]. За последние годы опубликовано несколько случаев применения данной оперативной методики при лечении пациентов с огнестрельными ранениями позвоночника [30][31][32][33][34][35][36]. В данной статье представлены три клинических случая успешного лечения пострадавших с огнестрельными слепыми осколочными ранениями позвоночника с применением методики чрескожной эндоскопии на шейном, грудном и пояснично-крестцовом уровнях.…”