Stability of the Subaxial Spine after Penetrating Trauma: Do Classification Systems Apply?
Joint Authors
Theiss, Steven
Staggers, Jackson Rucker
Niemeier, Thomas Elliot
Neway, William E.
Source
Issue
Vol. 2018, Issue 2018 (31 Dec. 2018), pp.1-6, 6 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2018-10-09
Country of Publication
Egypt
No. of Pages
6
Main Subjects
Abstract EN
Objective.
Blunt spinal trauma classification systems are well established and provide reliable treatment algorithms.
To date, stability of the spine after civilian gunshot wounds (CGSWS) is poorly understood.
Herein, we investigate the validity of trauma classification systems including the Thoracolumbar Injury Classification and Severity Score (TLICS), Subaxial Cervical Spine Injury Classification and Severity Score (SLIC), and Denis’ three-column model when applied to spinal penetrating trauma from gunshots, while secondarily evaluating stability of these injuries.
Methods.
Gunshot injuries to the spine were identified from an institutional database from ICD-nine codes.
Trauma scorings systems were applied using traditional criteria.
Neurologic compromise and spinal stability were evaluated using follow-up clinic notes and radiographs.
Results.
Thirty-one patients with CSGSW were evaluated.
There was an equal distribution of injuries amongst the spinal levels and spinal columns.
Twenty patients had neurological deficits at presentation.
Eight patient had a TLICS score >4.
Three patients had a SLIC score >4.
One patient had surgical treatment.
Nonoperative treatment did not lead to spinal instability or adverse outcomes in any cases.
The posterior column had a high correlation with neurologic compromise, though not statistically significant (p=.118).
Conclusions.
The TLICS, SLIC, and three-column classification systems cannot be applied to CSGSW to quantify injury severity, predict outcomes, or guide treatment decision-making.
Despite significant neurologic injuries and disruption of multiple spinal columns, CSGSW do not appear to result in unstable injuries requiring operative intervention.
Further research is needed to identify the rare spinal gunshot injury that would benefit from immediate surgical intervention.
American Psychological Association (APA)
Staggers, Jackson Rucker& Niemeier, Thomas Elliot& Neway, William E.& Theiss, Steven. 2018. Stability of the Subaxial Spine after Penetrating Trauma: Do Classification Systems Apply?. Advances in Orthopedics،Vol. 2018, no. 2018, pp.1-6.
https://search.emarefa.net/detail/BIM-1122630
Modern Language Association (MLA)
Staggers, Jackson Rucker…[et al.]. Stability of the Subaxial Spine after Penetrating Trauma: Do Classification Systems Apply?. Advances in Orthopedics No. 2018 (2018), pp.1-6.
https://search.emarefa.net/detail/BIM-1122630
American Medical Association (AMA)
Staggers, Jackson Rucker& Niemeier, Thomas Elliot& Neway, William E.& Theiss, Steven. Stability of the Subaxial Spine after Penetrating Trauma: Do Classification Systems Apply?. Advances in Orthopedics. 2018. Vol. 2018, no. 2018, pp.1-6.
https://search.emarefa.net/detail/BIM-1122630
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1122630