Spinal gunshot wounds: A retrospective, multicenter, cohort study.

Area of Science:

• Neurosurgery
• Trauma Surgery
• Public Health

Background:

• Spinal gunshot wounds (SGSW) present unique challenges in trauma management.
• Understanding treatment patterns is crucial for improving outcomes in affected populations.

Purpose of the Study:

• To characterize the demographics, clinical presentation, and treatment strategies for patients with spinal gunshot wounds in Latin America.
• To identify factors influencing surgical versus non-surgical management.

Main Methods:

• A retrospective, multicenter cohort study involving 12 institutions across Latin America from January 2015 to January 2022.
• Data collected included patient demographics, injury characteristics, neurological status, and treatment received.

Main Results:

• 423 patients with spinal gunshot injuries were analyzed, predominantly male civilians with low-energy firearm injuries affecting the thoracic and lumbar spine.
• Neurological injury was present in 76% of patients, with spinal cord injury in 63%.
• The majority (79%) received conservative treatment, with surgical intervention in 21%, primarily via posterior midline approaches.

Conclusions:

• Despite high rates of neurological compromise, most spinal gunshot wound patients in Latin America are managed non-surgically.
• Factors like canal compromise and retained fragments significantly influenced surgical decisions.