SPINAL-CORD MISSILE INJURIES DURING THE LEBANESE CIVIL-WAR

BACKGROUND Spinal cord injuries due to penetrating wounds are not unco mmon. The management of these injuries remains controversial especiall y with regard to the effect of laminectomy on the neurological outcome . METHODS Between 1980 and 1989, 64 patients injured by bullets and sh ell fragments to the spinal cord were reviewed. There were 58 males an d 6 females: 24 injuries (37.5%) involved the cervical spine, 37 (57.8 %) the dorsal spine, and 3 (4.7%) the lumbar spine. One group (group 1 ) consisted of 47 patients (73.4%) who had immediate and complete sens orimotor loss of function. Another group (group II) contained 13 patie nts (20.3%) who presented with incomplete and nonprogressive spinal co rd deficit. One patient (1.6%) (group III) had progressive spinal cord deficit. Three patients (4.7%) (group IV) had injuries to the cauda e quina. RESULTS The results were analyzed using a chi-squared test when possible. In group I, 20 patients (42.5%) underwent laminectomy with no recovery, and 27 (57.5%) were treated conservatively, with 1 patien t (3.7%) achieving marked improvement (p > 0.05). In group II, 3 patie nts (23.1%) underwent laminectomy with the 3 (100%) improved, and 10 p atients (76.9%) were treated conservatively, with 8 (80%) recovering ( p > 0.05). CONCLUSIONS Our data in groups I and II agree with previous ly published literature that shows no significant advantage of perform ing laminectomies following penetrating spinal cord injuries. Moreover , group I patients had a poor prognosis whether laminectomy was done o r not, and group II patients had a good prognosis whether laminectomy was done or not.