Gunshot wounds to the spine

Indications for surgery

1. injury to the cauda equina (whether complete or incomplete) if nerve root compression is demonstrated 1).

2. neurologic deterioration: suggesting the possibility of spinal epidural hematoma

3. compression of a nerve root

4. Cerebrospinal fluid fistula

5. spinal instability: very rare with isolated GSW to the spine

1)
Robertson DP, Simpson RK. Penetrating Injuries Restricted to the Cauda Equina: A Retrospective Review. Neurosurgery. 1992; 31:265–270