Gunshot Acquired Spinal Cord Injury in Civilians

Özet

AIM: To understand the differences between operative versus conservative treatment in terms of the outcome measured accordingto the American Spinal Injury Association (ASIA) impairment scale (AIS) in patients with gunshot acquired spinal cord injuries.MATERIAL and METHODS: A total of 168 patients were included in this retrospective study. The AIS score was recorded forall survivors who provided consent after emergence from spinal shock. Demographic information and level of injury were alsorecorded. Patients were categorized according to the management approach, and the outcome was measured at the 6-monthfollow-up, using the AIS score. Univariate statistics were used for data analysis.RESULTS: Most patients were male (91.6%), with a mean age of 26 ± 4.2 years. A majority of patients (73.2%) had incompletespinal cord injuries. Among the complete spinal injuries, most involved the thoracic spine (84%). Overall, the thoracic spine wasinvolved in half of the cases (51%). Twenty-six (15.4%) patients underwent surgery. The distribution of AIS score differed betweenthe operative and non-operative groups. In both groups, the AIS score on follow-up differed significantly from admission AIS score(p 0.05).CONCLUSION: None of the management approaches showed superior neurological recovery. Therefore, we conclude that outcomeimprovement in young patients depends on appropriate selection of surgical candidates.