Gunshot wounds of the spine: the effects of laminectomy.

In a review of 185 patients with gunshot wounds of the spine from low-velocity missiles, 106 were found to have a complete lesion and seventy-nine, an incomplete lesion. Fifty-six patients with complete lesions underwent laminectomy and only one had a partial (sensory) return of function. The fifty patients with complete lesions who had no laminectomy also had no spontaneous improvement. There were forty-five patients with incomplete lesions who had laminectomy and thirty-two (71 per cent) of them showed measurable improvement. For comparison, thirty-four patients with incomplete lesions had no operative treatment and in twenty-six (76.5 per cent) there was some spontaneous return of neural function. Four wound infections and six spinal fistulae developed in the operative group (a complication rate of 10 per cent). Spinal instability developed in six patients because of the laminectomies.