Injury
Volume 40, Issue 8 , Pages 860-863 , August 2009

The role of routine spinal imaging and immobilisation in asymptomatic patients after gunshot wounds

  • Joseph DuBose

      Affiliations

    • Division of Trauma and Critical Care at the Los Angeles County, University of Southern California Medical Center, Los Angeles, CA, United States
    • ,
  • Pedro G.R. Teixeira

      Affiliations

    • Division of Trauma and Critical Care at the Los Angeles County, University of Southern California Medical Center, Los Angeles, CA, United States
    • ,
  • Pantelis Hadjizacharia

      Affiliations

    • Division of Trauma and Critical Care at the Los Angeles County, University of Southern California Medical Center, Los Angeles, CA, United States
    • ,
  • Matt Hannon

      Affiliations

    • Division of Trauma and Critical Care at the Los Angeles County, University of Southern California Medical Center, Los Angeles, CA, United States
    • ,
  • Kenji Inaba

      Affiliations

    • Division of Trauma and Critical Care at the Los Angeles County, University of Southern California Medical Center, Los Angeles, CA, United States
    • ,
  • D.G. Green

      Affiliations

    • Division of Trauma and Critical Care at the Los Angeles County, University of Southern California Medical Center, Los Angeles, CA, United States
    • ,
  • David Plurad

      Affiliations

    • Division of Trauma and Critical Care at the Los Angeles County, University of Southern California Medical Center, Los Angeles, CA, United States
    • ,
  • Demetrios Demetriades

      Affiliations

    • Division of Trauma and Critical Care at the Los Angeles County, University of Southern California Medical Center, Los Angeles, CA, United States
    • ,
  • Peter Rhee

      Affiliations

    • Division of Trauma, Critical Care and Emergency Surgery, University of Arizona, Tucson, AZ, United States
    • Corresponding Author InformationCorresponding author at: Division of Trauma, Critical Care and Emergency Surgery, University of Arizona, PO Box 245063, Tucson, AZ 85724, United States.

,Accepted 7 November 2008.

References 

  1. Arishita GI, Vayer JS, Bellamy RF. Cervical spine immobilization of penetrating neck wounds in a hostile environment. J Trauma. 1989;29(3):332–337
  2. Aryan HE, Amar AP, Ozgur BM, et al. Gunshot wounds to the spine in adolescents. Neurosurgery. 2005;57(4):748–752discussion 748–52
  3. Barkana Y, Stein M, Scope A, et al. Prehospital stabilization of the cervical spine for penetrating injuries of the neck—is it necessary?. Injury. 2000;31(5):305–309
  4. Connell RA, Graham CA, Munro PT. Is spinal immobilisation necessary for all patients sustaining isolated penetrating trauma?. Injury. 2003;34(12):912–914
  5. Cornwell EE, Chang DC, Bonar JP, et al. Thoracolumbar immobilization for trauma patients with torso gunshot wounds: is it necessary?. Arch Surg. 2001;136(3):324–327
  6. Farmer JC, Vaccaro AR, Balderston RA, et al. The changing nature of admissions to a spinal cord injury center: violence on the rise. J Spinal Disord. 1998;11(5):400–403
  7. Hoffman JR, Mower WR, Wolfson AB, et al. Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma. National Emergency X-Radiography Utilization Study Group. N Engl J Med. 2000;343(2):94–99
  8. Isiklar ZU, Lindsey RW. Gunshot wounds to the spine. Injury. 1998;29(Suppl 1):SA7-12
  9. Kaups KL, Davis JW. Patients with gunshot wounds to the head do not require cervical spine immobilization and evaluation. J Trauma. 1998;44(5):865–867
  10. Kennedy FR, Gonzalez P, Beitler A, et al. Incidence of cervical spine injury in patients with gunshot wounds to the head. South Med J. 1994;87(6):621–623
  11. Kihtir T, Ivatury RR, Simon R, et al. Management of transperitoneal gunshot wounds of the spine. J Trauma. 1991;31(12):1579–1583
  12. Klein Y, Cohn SM, Soffer D, et al. Spine injuries are common among asymptomatic patients after gunshot wounds. J Trauma. 2005;58(4):833–836
  13. Kupcha PC, An HS, Cotler JM. Gunshot wounds to the cervical spine. Spine. 1990;15(10):1058–1063
  14. le Roux JC, Dunn RN. Gunshot injuries of the spine—a review of 49 cases managed at the Groote Schuur Acute Spinal Cord Injury Unit. S Afr J Surg. 2005;43(4):165–168
  15. Lin SS, Vaccaro AR, Reisch S, et al. Low-velocity gunshot wounds to the spine with an associated transperitoneal injury. J Spinal Disord. 1995;8(2):136–144
  16. Medzon R, Rothenhaus T, Bono CM, et al. Stability of cervical spine fractures after gunshot wounds to the head and neck. Spine. 2005;30(20):2274–2279
  17. Mirovsky Y, Shalmon E, Blankstein A, et al. Complete paraplegia following gunshot injury without direct trauma to the cord. Spine. 2005;30(21):2436–2438
  18. Peleg K, Aharonson-Daniel L, Stein M, et al. Gunshot and explosion injuries: characteristics, outcomes, and implications for care of terror-related injuries in Israel. Ann Surg. 2004;239(3):311–318
  19. Rhee P, Kuncir EJ, Johnson L, et al. Cervical spine injury is highly dependent on the mechanism of injury following blunt and penetrating assault. J Trauma. 2006;61(5):1166–1170
  20. Rhee P, Martin M, Dave P, et al. Spine injuries following isolated truncal, head, or neck gunshots. J Trauma. 2005;59(4):1033–1034
  21. Roye WP, Dunn EL, Moody JA. Cervical spinal cord injury—a public catastrophe. J Trauma. 1988;28(8):1260–1264
  22. Stauffer ES, Wood RW, Kelly EG. Gunshot wounds of the spine: the effects of laminectomy. J Bone Joint Surg Am. 1979;61(3):389–392
  23. Waters RL, Sie IH. Spinal cord injuries from gunshot wounds to the spine. Clin Orthop Relat Res 2003;408(408):120–5.
  24. Waters RL, Adkins RH. Firearm versus motor vehicle related spinal cord injury: preinjury factors, injury characteristics, and initial outcome comparisons among ethnically diverse groups. Arch Phys Med Rehabil. 1997;78(2):150–155
  25. Yoshida GM, Garland D, Waters RL. Gunshot wounds to the spine. Orthop Clin N Am. 1995;26(1):109–116

PII: S0020-1383(08)00519-6

doi: 10.1016/j.injury.2008.11.005

Injury
Volume 40, Issue 8 , Pages 860-863 , August 2009

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