Intradural migration of a bullet following spinal gunshot injury

Study design: Case report. Objectives: To report a penetrating gunshot injury at L1 with migration within the spinal canal to S2. Setting: Istanbul, Turkey. Methods: A 44-year-old man was admitted with an entrance gunshot wound on the left upper quadrant. An emergency exploratory laparotomy with left nephrectomy and transverse colon repair were performed. He had complete spinal cord injury below the level of L1. Lumbar magnetic resonance imaging (MRI) revealed hemorrhagic areas in conus medullaris and L1 corpus. The bullet was lodged at the S2 level. S1–S2 laminectomies were performed for the removal of the bullet. The antibiotic therapy was given for 17 days. Results: No meningitis or wound infection was observed after the operation. At discharge his neurological status was improved. Conclusions: The present case presented the movement of an intraspinal bullet after a spinal gunshot injury. No signs of infection were detected postoperatively. Lumbar MRI was used safely without any change in neurological status or patient discomfort.