Articles

Extraction of gunshot corpus allienum in upper cervical spine with transoral approach: A case report

Novan Krisno Adji , Muhammad Yuda Nugraha

Novan Krisno Adji
Neurosurgery Department, dr. Soebandi Regional Hospital, Jember, Indonesia ; Faculty of Medicine, University of Jember, Indonesia. Email: soebandi@pdpersi.co.id

Muhammad Yuda Nugraha
Faculty of Medicine, University of Jember, Indonesia
Online First: April 23, 2021 | Cite this Article
Adji, N., Nugraha, M. 2021. Extraction of gunshot corpus allienum in upper cervical spine with transoral approach: A case report. Indonesian Journal of Neurosurgery 4(1). DOI:10.15562/ijn.v4i1.129


Introduction: Penetrating trauma that caused by gunshot injuries have been reported about 17–21% of all spinal cord injuries. Transoral approach may facilitate accessing the lumens and sites such as upper cervical spine with minimally invasive surgical exposure. Here, we present an interesting case of removal a bullet in the cervical spine with new method.

Case Presentation: A 53-year-old man who underwent a gunshot in the maxillary region of the face. A CT scan of head and neck showed that a metallic foreign body located in corpus vertebrae as high as  C1-C2. The bullets in this patient were removed under the minimal invasive surgery through transoral approach. The patients were discharged without neurological deficit.

Conclusion: The presented transoral approach can be used as minimal invasive surgery method to extract corpus allienum in upper cervical spinal region without spinal cord tissue damage. 

Keywords: Cervical spine, Corpus allienum, Gunshot injury, Transoral approach

 

References

Amps J, Steinmetz MP, Krishnaney AA et al. Surgical Treatment of Penetrating Wound of the Spine. Neurosurgical Operative Atlas: Spine and Peripheral Nerves, 3rd edition, Tiemes, 2016. ISBN: 9781604068986.

Chen Y, Tang Y, Vogel LC, Devivo MJ. Causes of spinal cord injury. Top Spinal Cord Inj Rehabil. 2013 Winter;19(1):1-8. DOI: 10.1310/sci1901-1

Patil R, Jaiswal G, Gupta TK. Gunshot wound causing complete spinal cord injury without mechanical violation of spinal axis: Case report with review of literature. J Craniovertebr Junction Spine. 2015 Oct-Dec; 6(4): 149–57. DOI: 10.4103/0974-8237.167855

Torretti JA, Sengupta DK. Cervical spine trauma. Indian J Orthop. 2007 Oct;41(4):255-67. DOI: 10.4103/0019-5413.36985

Snell, R.S. The spinal cord and the ascending and descending tracts. Clinical Neuroanatomy. Lippincott Williams & Wilkins. 2010. ISBN 978-0-7817-9427-5.

Sidhu GS, Ghag A, Prokuski V et al. Civilian gunshot injuries of the spinal cord: A systematic review of the current literature. Clin Orthop Relat Res. 2013; 471: 3945–55. DOI: 10.1007/s11999-013-2901-2

Brasel S, Karen S, Ronald M et al. Advanced Trauma Life Support for Doctors. American College of Surgeons, Chicago. 1997. p27

Azevedo-Filho HR, Martins C, Carneiro-Filho GS et al. Gunshot wounds to the spine: Study of 246 patients. Neurosurg Q. 2001; 267: 14–21. DOI: 10.1590/S0004-282X2001000400034

Kupcha PC, An HS, Cotler JM. Gunshot wounds to the cervical spine. Spine 1990;1510:1058–63. DOI: 10.1097/00007632-199015100-00014

Velmahos G, Demetriades D. Gunshot wounds of the spine: should retained bullets be removed to prevent infection?. Ann R Coll Surg Engl 1994;762:85–7. PMCID: PMC2502214

Wang J, Ye CY, Zhu MY, et al. Gunshot-caused facial injury combined with lower cervical spine injury: a case report. West Indian Med J 2014;634:378–81. DOI: 10.7727/wimj.2013.260

Walter T, Schwabe P, Schaser KD, et al. Positive outcome after a small-caliber gunshot fracture of the upper cervical spine without neurovascular damage. Polish J Radiol 2016;81:134–7. DOI: 10.12659/PJR.895529

Secer M, Ulutas M, Yayla E, et al. Upper cervical spinal cord gunshot injury without bone destruction. Int J Surg Case Rep 2014;53:149–51. DOI: 10.1016/j.ijscr.2014.01.009

Li Q, Jiang Z, Zhuo X, Zhang X. Endoscopic removal of bullets from the cranial ridge junction region via transoral and transnasal approaches. Medicine 2016; 95:24. DOI: 10.1097/MD.0000000000003918

Shriver MF, Kshettry VR, Sindwani R, et al. Transoral and transnasal odontoidectomy complications: a systematic review and meta-analysis. Clin Neurol Neurosurg 2016;148:121–9. DOI: 10.1016/j.clineuro.2016.07.019


No Supplementary Material available for this article.
Article Views      : 96
PDF Downloads : 30