Yoshida G M, Garland D, Waters R L
Spinal Cord Injury Service, Rancho Los Amigos Medical Center, Downey, California.
Orthop Clin North Am. 1995 Jan;26(1):109-16.
Gunshot wounds to the spine are becoming more prevalent, especially in urban areas. Neurologic injury can occur even if the projectile does not penetrate the spinal canal. Initial treatment should consist of stabilizing the patient's medical condition followed by a careful neurologic examination. Spinal stability can be determined from plain radiographs and CT scan, with the overwhelming majority of injuries being stable. Retained bullets rarely cause problems of delayed infection, late neurologic decline, or lead toxicity, eliminating the need for prophylactic bullet removal; however, in the thoracolumbar spine, removal of bullet fragments lodged within the spinal canal has been shown to significantly improve neurologic recovery.
脊柱枪伤正变得越来越普遍，尤其是在城市地区。即使子弹未穿透椎管，也可能发生神经损伤。初始治疗应包括稳定患者的病情，随后进行仔细的神经学检查。脊柱稳定性可通过X线平片和CT扫描确定，绝大多数损伤是稳定的。留存的子弹很少会引起延迟感染、晚期神经功能衰退或铅中毒问题，因此无需预防性取出子弹；然而，在胸腰椎，已证明取出位于椎管内的子弹碎片可显著改善神经功能恢复。
