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脊柱枪伤后子弹的硬膜内移位。

Intradural migration of a bullet following spinal gunshot injury.

作者信息

Kafadar A M, Kemerdere R, Isler C, Hanci M

机构信息

Department of Neurosurgery, Cerrahpasa Medical School, Istanbul University, Cerrahpasa, Istanbul, Turkey.

出版信息

Spinal Cord. 2006 May;44(5):326-9. doi: 10.1038/sj.sc.3101808.

Abstract

STUDY DESIGN

Case report.

OBJECTIVES

To report a penetrating gunshot injury at L1 with migration within the spinal canal to S2.

SETTING

Istanbul, Turkey.

METHODS

A 44-year-old man was admitted with an entrance gunshot wound on the left upper quadrant. An emergency exploratory laparotomy with left nephrectomy and transverse colon repair were performed. He had complete spinal cord injury below the level of L1. Lumbar magnetic resonance imaging (MRI) revealed hemorrhagic areas in conus medullaris and L1 corpus. The bullet was lodged at the S2 level. S1-S2 laminectomies were performed for the removal of the bullet. The antibiotic therapy was given for 17 days.

RESULTS

No meningitis or wound infection was observed after the operation. At discharge his neurological status was improved.

CONCLUSIONS

The present case presented the movement of an intraspinal bullet after a spinal gunshot injury. No signs of infection were detected postoperatively. Lumbar MRI was used safely without any change in neurological status or patient discomfort.

摘要

研究设计

病例报告。

目的

报告一例L1椎体穿透性枪伤且子弹在椎管内移行至S2椎体的病例。

地点

土耳其伊斯坦布尔。

方法

一名44岁男性因左上腹枪伤入院。行急诊剖腹探查术,同时进行左肾切除术及横结肠修补术。他在L1水平以下存在完全性脊髓损伤。腰椎磁共振成像(MRI)显示脊髓圆锥和L1椎体有出血区域。子弹嵌顿于S2椎体水平。行S1-S2椎板切除术取出子弹。给予抗生素治疗17天。

结果

术后未观察到脑膜炎或伤口感染。出院时其神经功能状态有所改善。

结论

本病例呈现了脊柱枪伤后椎管内子弹的移动情况。术后未检测到感染迹象。安全使用腰椎MRI,未引起神经功能状态改变或患者不适。

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