Surgical treatment of the consequences of a gunshot wound to the lumbar spine using endoscopic techniques
- Authors: Bulyschenko G.G.1, Gayvoronsky A.I.1,2, Liev P.S.1, Kuznetsov M.V.1, Svistov D.V.1
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Affiliations:
- Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation
- Saint Petersburg State University
- Issue: Vol 23, No 2 (2021)
- Pages: 91-98
- Section: Clinical Trials
- URL: https://journals.eco-vector.com/1682-7392/article/view/70776
- DOI: https://doi.org/10.17816/brmma70776
- ID: 70776
Cite item
Abstract
A clinical case of treatment of a patient with long-term consequences of a gunshot wound to the lumbar spine with a follow-up period of fifteen years is presented. In the last year and a half, the repeatedly recurrent retroperitoneal phlegmon associated with a foreign body of the lumbar spine has prompted a decision on the issue of surgical treatment (removal of a foreign body - a bullet). The location of the foreign body and previous experience with endoscopic foreign body removal played a decisive role in the choice of surgical tactics. Removal of the wounding projectile was performed using a percutaneous transforaminal endoscopic approach. The choice of such an approach was dictated by the peculiarity of the location of the foreign body (coaxial with the endoscopic tube in the foraminal approach), as well as sufficient experience in using the technique of percutaneous endoscopic surgery. At the same time, the conversion plan was worked out in sufficient detail with both posterolateral and anterior open approaches with the involvement of appropriate specialists. So, in case of failure, it was planned to transfer endoscopic access to “open,” using the already installed working tube of the endoscope as a conductor to a foreign body. In case of inefficiency, for some reason, this version of the operation was planned for the next, third stage: wound suturing, patient turning on the back with a right-hand retroperitoneal approach to the anterior-lateral surface of LI and LII bodies. Fortunately, the purpose of the operation was achieved using the most gentle version of the allowance. The given clinical case testifies that the technique of percutaneous transforaminal endoscopic surgery is not limited in indications to the treatment of degenerative-dystrophic diseases of the spine.
Full Text
About the authors
Gennady G. Bulyschenko
Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation
Email: lievsurgeon@gmail.com
candidate of medical sciences
Russian Federation, Saint PetersburgAlexey I. Gayvoronsky
Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation; Saint Petersburg State University
Email: lievsurgeon@gmail.com
doctor of medical sciences, professor
Russian Federation, Saint PetersburgPavel S. Liev
Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation
Author for correspondence.
Email: lievsurgeon@gmail.com
ORCID iD: 0000-0003-0247-9003
listener
Russian Federation, Saint PetersburgMikhail V. Kuznetsov
Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation
Email: lievsurgeon@gmail.com
head of the department
Russian Federation, Saint PetersburgDmitry V. Svistov
Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation
Email: lievsurgeon@gmail.com
candidate of medical sciences, associate professor
Russian Federation, Saint PetersburgReferences
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- Kravtsov MN, Landik SA, Dubinin AA, et al. Full-endoscopic surgery for gunshot penetrating wound of the lumbar spine (literature review and clinical case). Neyrokhirurgiya. 2018;20 (2):66–73 (In Russ.). doi: 10.17650/1683-3295-2018-20-2-66-73.
- Henry E Aryan, MD, Arun P, et al. Gunshot Wounds to the Spine in Adolescents. Neurosurgery. 2005;57(4):748–752. doi: 10.1227/01.NEU.0000175728.93653.b1
- Mogila VV, Maksimov SA. Features of gunshot wounds of the spine and spinal cord of the lumbosacral region. Tavrichesky medico-biologichesky vestnik. 2013;16(61):123–125. (In Russ.).
- Jakoi A, Iorio J, Howell R, et al. Gunshot Injuries of the Spine. Spine J. 2015;15 (9): 2077-2085. doi: 10.1016/j.spinee.2015.06.007
- Bono CM, Heary RF. Gunshot wounds to the spine. The Spine Journal. 2004;4 (2): 230–240. doi: 10.1016/S1529-9430(03)00178-5
- Jaiswal M, Mittal RS. Concept of gunshot wound spine. Asian Spine J. 2013;7(4): 359–364. doi: 10.4184/asj.2013.7/4/359
- Farmer JC, Vaccaro A.R, Balderston R.A. The changing nature of admissions to a spinal cord injury center: violence on the rise. Journal of Spinal Disorders. 1998;11(5):400–403. PMID: 9811100
- Bumpass DB, Buchowski JM, Park A, et al. An update on civilian spinal gunshot wounds: treatment, neurological recovery, and complications. Spine. 2015;40(7):450–461. doi: 10.1097/BRS
- Apte A, Bradford K, Dente C. Lead toxicity from retained bullet fragments: a systematic review and meta-analysis. Journal of Trauma and Acute Care Surgery. 2019;87(3): 707-716. doi: 10.1097/TA.0000000000002287. PMID: 30939573
- Volkov PV, Sorokin KV. Long terms results of non-penetrative gunshot wound of lumbar spine with prevertebral abscess forming. Neyrokhirurgiya. 2011;(4):69–73 (In Russ.).
- Kosinskaya NS X-ray diagnostics gunshot wounds of the spine and spinal cord. The experience of Soviet medicine in the Great Patriotic War 1941–1945. Ed. by E.I. Smirnov. Moscow: Medgiz. 1955;138–154.
- Bulyshchenko GG, Gaivoronsky AI, Orlov VP, et al. Basic parameters of percutaneous endoscopic transforaminal approach using tessys. Rossiyskiy neyrochirurgicheskiy jurnal im. Professor Polenova. 2017;9 (1):14–19. (In Russ.).
- Crutcher CL, Wilson JM, DiGiorgioet AM, et al. Minimally invasive management of civilian gunshot wounds to the lumbar spine: a case series and technical report. Operative neurosurgery. 2020;19(3):219–225. doi: 10.1093/ons/opaa030