Long-term clinical manifestations of retained bullet fragments within the intervertebral disk space

Gaetano J. Scuderi, Alexander R. Vaccaro, Laurence N. Fitzhenry, Steven Greenberg, Frank Eismont

Research output: Contribution to journalArticle

36 Scopus citations

Abstract

A retrospective review of 12 patients who were victims of penetrating trauma with a bullet or bullet fragments lodged within the intervertebral disk space was conducted. The objective of the review was to evaluate the potential systemic effects of lead resorption at long-term follow-up. Literature regarding the potential for lead toxicity due to retained bullet fragments within the intervertebral disk space is lacking. Between January 1969 and June 1993, a total of 238 patients with a gunshot wound to the spine were identified. Twelve of the 238 were found to have a bullet or bullet fragments within the intervertebral disk space. All patients were fully screened for evidence of plumbism. The average age at time of gunshot injury was 35.8 years; the average time for follow-up was 7.8 years. One of the 12 patients showed clinical evidence of plumbism. The patient subsequently underwent a partial laminectomy and diskectomy with excision of the bullet fragments. The patient's complaints, specific for plumbism, resolved 2 months postoperatively. We conclude that patients with retained lead-based bullet fragments in the intervertebral disk should be educated about the rare potential for plumbism due to partial bullet fragment resorption and that long-term observation for this disorder is recommended.

Original languageEnglish (US)
Pages (from-to)108-111
Number of pages4
JournalJournal of Spinal Disorders
Volume17
Issue number2
DOIs
StatePublished - Apr 2004

Keywords

  • Intervertebral disk space
  • Plumbism
  • Retained bullet fragments

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Orthopedics and Sports Medicine

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