Epidemiology of gunshot injuries of the spine in the Kharkiv region during the war in Eastern Ukraine
Keywords:spine and spinal cord gunshot injuries, sur¬gical treatment, evacuation stages
In connection with the battle action in Eastern Ukraine in the past two years, the structure of gunshot and traumatic injuries of the spine and spinal cord has changed dramatically.
Objective: To study the structure of gunshot injuries of the spine for detecting the most common forms of this disease, the characteristics of the damage natural history and to determine the specifics of treatment tactics.
Methods: The medical records of 36 patients with gunshot spine and spinal cord injuries — 22 military officers and 14 civilians.
Results: it is determined the distribution of patients according to the type of weapon that caused the injuries — 10 people with gunshot wounds, 26 with minecomminuted injuries. Among patients with gunshot wounds 24 had penetrating damage, 11 — non-penetrating and 1 had paravertebra wound. Among all penetrating wounds there were 14 blind and 10 — penetrating. Gunshot damage to the cervical spine were found in 5 patients, thoracic spine in 16, lumbar spine in 13, sacral spine in 2. Most of patients with wounded spine (83 %) had neurological symptoms, and 66 % out of them had signs of a complete rupture of the spinal cord or cauda equina. Surgical interventions on the spine (laminectomy without stabilization or with pedicular implant stabilization ) was performed on 5–7-y day after stabilizing the patient's general state.Conclusions: in the victims of battle actions in Eastern Ukraine minecomminution injuries prevailed over the bullet wounds. Gunshot injuries of the spine and spinal cord are usually combined with the damage of neck, chest and abdomen organs. Surgical treatment of spine and spinal cord injuries should be performed in specialized hospitals, it should be differentiated depending on the overall condition of the patient and the severity of the type of damage.
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