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Case Reports
. 2020 Apr 23:27:100301.
doi: 10.1016/j.tcr.2020.100301. eCollection 2020 Jun.

Unusual case of a migrating spinal bullet: An opportunity for reflection

Nolitha Morare  1 , Maeyane Stephens Moeng  1
Affiliations
Case Reports

Unusual case of a migrating spinal bullet: An opportunity for reflection

Nolitha Morare et al. Trauma Case Rep. .

Erratum in

Abstract

The following case report documents the presentation of a 28 year old male who presented to the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) trauma unit following a single gunshot wound to the spine. He presented walking, with no neurological dysfunction. On further investigation he was found to have a retained bullet at the L3 level of the spinal canal, which migrated within the canal from its initial point of entry. He was subsequently taken for a laminectomy and bullet removal under fluoroscopic guidance. Post operatively he was noted to have reduced proprioception bilaterally.

Keywords: Bullet; Gunshot wound; Intrathecal; Spine.

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Conflict of interest statement

Nil to declare.

Figures

Fig. 1
Fig. 1
Anteroposterior and Lateral views of plain film X-rays demonstrating a bullet at the level of the L3 Vertebra.
Fig. 2
Fig. 2
Sagittal and Coronal Views of CT scan of the abdomen and pelvis demonstrating bullet at L3 vertebral level within the spinal canal. Associated right Sacral Alar Fracture noted on coronal film with bone fragments in spinal canal. No other intra-abdominal injuries noted.
Fig. 3
Fig. 3
Axial views of CT of the pelvis on a bone window, showing fracture traversing the right iliac blade towards the sacral alar.
Fig. 4
Fig. 4
Axial views of CT of the pelvis on a bone window, showing right Sacral Alar fracture, with bone fragments in the spinal canal.
Fig. 5
Fig. 5
Axial view of CT of the Lumbar spine showing intact L5 vertebra with no fracture or bullet fragments (left) and L3 Vertebra with bullet lodged in the spinal canal with associated scatter (right).
Fig. 6
Fig. 6
Fluoroscopic Images taken intraoperatively demonstrating localization of bullet at L3 vertebral level.
See this image and copyright information in PMC

References

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