Penetrating Vertebral-Medullary Wound by Ballistic Weapon: A Clinical Cases and Literature Reviewer

Abstract

Introduction: Penetrating trauma by vertebromedullary ballistic weapon is a rare pathology in Cameroon, it may be related to the existence of armed conflict zones, it may be responsible for CSF leakage, spinal instability and/or partial or complete neurological deficits. The controversial question is when to operate on penetrating ballistic spinal injury with complete neurological deficit. Clinical Case: We report the clinical case of a patient victim of a close range shooting of a real ball gun, in the paraspinal region opposite D8, by confusion of his status to the enemy in armed conflict zone in Cameroon. Followed Fränkel A paraplegia of D8 level of cerebrospinal fluid with CT scan of spine, stability of spine and insertion of Ball under upper plateau of D8. He was operated on to close the gap and remove the ball. The situation of the ball destroying the posterior 2/3 of the vertebral body of D8 and located in the anterior 1/3 of the body of D8 motivated the stabilization of the spine by the osteosynthesis material, the operative follow-up was marked by the absence of infection, but without any recovery of the neurological deficit. Conclusion: Penetrating gunshot wounds of the spine are rare in Cameroon, CSF leakage and spinal instability are emergency surgical indications, extraction of the bullet in a patient with a complete neurological deficit remains controversial, but the bullet should be extracted when there is an operative indication, in case of high risk of spinal instability, the patient should benefit from a spondylodesis.