Lumbosacral plexopathy in gunshot wounds and motor vehicle accidents - Comparison of electrophysiologic findings

Objective: To characterize the differences between injuries to the lumbosac ral (LS) plexus caused by gunshot wounds (GSW) and motor vehicle crashes (M VC) with regard to the location and extent of involvement. Design: A retrospective review of electrophysiologic data from an electromy ography laboratory of a county hospital. Nineteen patients with GSW and ten patients with MVC diagnosed by electromyography with an LS plexopathy were included in the study. Injuries were categorized by the number of anatomic quadrants of the LS plexus: upper anterior, upper posterior, lower anterio r, and lower posterior. Comparison of upper vs. lower portions and bilatera lity of LS plexus involvement was also made. Statistical analyses were perf ormed with two-tailed Fisher's exact and general association tests. Results: Lower portions of the plexus were involved more frequently in pati ents with MVC compared those observed in patients with GSW. Upper portions of the LS plexus were more involved compared with the lower portions in pat ients with GSW injuries. More sections of the plexus were involved in patie nts with MVC compared with those in patients with GSW. Conclusions: Compared with patients with MVC, patients with GSW had a great er chance of involvement of the upper portion of the plexus. The reverse wa s true for the lower portion. Hopefully this information will aid the elect romyographer and rehabilitation team in the diagnosis and treatment of trau matic plexopathies caused by different etiologies.