Question

J.S. is a 21-year-old male who was brought into the emergency room via ambulance after suffering a gunshot wound to the spine. At the accident scene, the paramedics noted J.S. had some movement of all his fingers and only his left leg. J.S. was not able to move his right foot.

Based upon the above situation:

J.S.'s parents are present and ask you if he will every gain control of legs and feet.

4. Do you expect J.S. to eventually gain control of his legs and feet?

5. How would you explain primary and secondary injury in terms the parents will understand?
6. Compare and contrast cervical, thoracic, and sacral lesions.

Answer 1

Answer:Gun shot injury may be caused by compression and stretch and by the shock wave,heat from the friction when the bullet penetrates the tissue,and direct complete or incomplete transection of the nerve trunks. Spinal cord injury is one of the potentially catastrophic consequences of gunshot wounds.The severity of the spinal cord injury is classified into two- Complete or Incomplete.

• In complete,if all feelings ( sensory) and all ability to control movement ( motor function) are lost below the spinal cord injury,is called complete spinal cord injury
• In incomplete the patient have some motor or sensory functions below the affected area,the injury is called incomplete spinal cord injury.

4) J.S is suffering with incomplete injury as J.S was not able to move his right foot and he is able to move his left leg and fing.People with incomplete injuries will often regain some functions.However,making a full recovery is rare.The majority of recovery occurs within the first six months after injury.Any remaining loss of function present after 12 months is much more likely to become permanen

5)Primary gunshot wound is physical trauma caused by a bullet from a firearm.Damage may include bleeding,broken bones,organ damage,infection of the wound,or loss of the ability to move part of the body. In secondary spinal cord injury with gunshot wounds due to retention of bullet fragments in the spinal canal.

6)Injuries in the cervical spine are frequently associated with airway lesions and vascular lesions that may require emergency intubation or tracheotomy with or without neck exploitation.Cervical gunshot wounds most likely result in complete rather than the incomplete neurological deficit.

In thoracic spine gunshot injuries to solid organs,hollow visceral organs are at risk.Abdominal lesions and hemopneumothorax are the most prevalent associated injury and that transfixing lesions are the most common.

Most Patients with gunshot wound in the spine have complete spinal cord injury which is classified into three  I: transfixing ( when small fragments are found inside the canal) typeIi: intracanal( when the whole projectile is inside the canal) or type III: intervertebral lesions ( when the bullet is inside the intervertebral disc space). The main concern lumbosacral spine gunshot wound in acute phase should be bleeding,some times life threatening,requires prompt treatment with tamponade,exploration or embolization.