Title

Neurogenic claudication and radiculopathy as delayed presentations of retained spinal bullet.

Document Type

Article

Department

Neurosurgery

Abstract

Background Context: Firearm injuries to the spine may cause injury to the neurological structures and/or to the spine, including ligaments and bones. Purpose: Patients usually present with symptoms immediately after injury. However, only a few cases have been reported where a Patient is neurologically intact after the initial injury but develops deficits several months or years later. Almost all these cases develop delayed neurological deficit because of bullet migration. Study Design: Case report.

Methods:

A discussion, with a relevant review of the literature, the clinical histories, and radiological findings of two Patients who experienced delayed neurological symptoms after gunshot wounds to the spine.

Results:

One Patient presented after 14 years and the other after 5 months from the day of injury. Both cases are unique in that the delayed symptoms appeared because of formation of a reactive mass around the site of bullet impact. Lack of serial imaging studies is a barrier to the exclusion of bullet migration as an alternate cause of delayed symptoms.

Conclusion:

These cases illustrate that retained intraspinal bullets can present with delayed neurological findings secondary to reactive changes around the bullet.

Publication

The Spine Journal : official Journal of the North American Spine Society