Spontaneous Bullet Migration from Cervical to Lumbosacral Spine: Case Report
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Abstract
The spontaneous migration of projectiles in the spinal canal due to gunshot wound are a rare entity, and may be associated with multiple complications in the evolution.
Given the low prevalence, there are no large series registered, so there is no standardized therapeutic protocol.
We made a review of the subject on purpose and presented the case of a 22-year-old patient who suffered a HAF in the cervical spine lodging the projectile at the level of C6-C7, installing a quadriplegia, and in the evolution we observed how the projectile migrated at the lumbosacral level L5-S.
The diagnosis, clinical and surgical treatment performed were evaluated.
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References
I. Spakauskas, B., Ambrozaitis, K. V., & Kontautas, E. (2007). The bullet in the dural sac. How to catch it? A report of two cases. Medicina (Kaunas, Lithuania), 43(6), 478–481. https://doi.org/10.3390/medicina43060059
II. Siddiqui, M. I., Hawksworth, S. A., & Sun, D. Y. (2019). Removal of Migrating Lumbar Spine Bullet: Case Report and Surgical Video. World Neurosurgery, 131, 62–64. https://doi.org/10.1016/j.wneu.2019.07.151
III. de los Cobos, D., Powers, A., Behrens, J. P., Mattei, T. A., & Salari, P. (2021). Surgical removal of a migrating intraspinal bullet: illustrative case. Journal of Neurosurgery: Case Lessons, 1(22), 2–6. https://doi.org/10.3171/case21132
IV. Farrugia, A., Raul, J. S., Géraut, A., & Ludes, B. (2010). Ricochet of a bullet in the spinal canal: A case report and review of the literature on bullet migration. Journal of Forensic Sciences, 55(5), 1371–1374. https://doi.org/10.1111/j.1556-4029.2010.01439.x
V. 5-Öktem, I. S., Selçuklu, A., Kurtsoy, A., Kavuncu, I. A., & Paşaoǧlu, A. (1995). Migration of bullet in the spinal canal: A case report. Surgical Neurology, 44(6), 548–550. https://doi.org/10.1016/0090-3019(95)00212-X
VI. Rowlinson, S., & Capper, S. (2007). Descent of a bullet in the spinal canal. Emergency Medicine Journal, 24(7), 519. https://doi.org/10.1136/emj.2006.038711
VII. Baldawa, S., & Shivpuje, V. (2017). Migratory low velocity intradural lumbosacral spinal bullet causing cauda equina syndrome: Report of a case and review of literature. European Spine Journal, 26, S128–S135. https://doi.org/10.1007/s00586-016-4913-6
VIII. Avci SB, Acikgoz B, Gundogdu S. Delayed neurological symptoms from the spontaneous migration of a bullet in the lumbosacral spinal canal. Case report. Paraplegia 1995;33(9):541–2.
IX. Kulcheski, Á. L., Graells, X. S. I., Sebben, A. L., Benato, M. L., & del Santoro, P. G. (2021). Management of spinal gunshot wound injuries. Coluna/ Columna, 20(3), 217–223. https://doi.org/10.1590/S1808-185120212003242926
X. Ben-Galim, P., & Reitman, C. A. (2008). Intrathecal migratory foreign body without neurological deficit after a gunshot wound. Spine Journal, 8(2), 404–407. https://doi.org/10.1016/j.spinee.2006.10.025
XI. Bellabarba, C. (2013). Expert’s comment concerning grand rounds case entitled “lead toxicity and management of gunshot wounds in the lumbar spine” (by B. Rentfrow, R. Vaidya, C. Elia, A. Sethi doi:10.1007/s00586-013-2805-6). European Spine Journal, 22(11), 2358–2359. https://doi.org/10.1007/s00586-013-2807-4