Bullet Fragment of the Lumbar Spine: The Decision Is More Important Than the Incision

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Study Design

Case report.


Treatment of gunshot wounds to the spine is a topic of continued discussion and controversy. The following case study provides a description of a patient with a gunshot wound to the lumbar spine with a retained bullet in the intrathecal space.


Immediately after gunshot injury, a patient developed lumbar and radicular pain, as well as neurologic deficits. He was taken for surgery to remove the retained bullet.


Following surgery, pain and neurologic function improved. The operative techniques and the postoperative clinical management are discussed in this report.


In our opinion, it was necessary to remove the bullet to avoid migration and possible worsening of neurologic function. However, surgical intervention is not appropriate in every case, and ultimately decisions should be based on patient presentation, symptomology, and imaging.

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