GUNSHOT WOUNDS OF THE SPINE - EFFECTS OF LAMINECTOMY

In a review of 185 patients with gunshot wounds of the spine from low-velocity missiles, 106 were found to have a complete lesion and seventy-nine, an incomplete lesion. Fifty-six patients with complete lesions underwent laminectomy and only one had a partial (sensory) return of function. The fifty patients with complete lesions who had no laminectomy also had no spontaneous improvement. There were forty-five patients with incomplete lesions who had laminectomy and thirty-two (71%) of them showed measurable improvement. For comparison, thirty-four patients with incomplete lesions had no operative treatment and in twenty-six (76.5%) there was some spontaneous return of neural function. Four wound infections and six spinal fistulae developed in the operative group (a complication rate of 10%). Spinal instability developed in six patients because of the laminectomies.