Gunshot wounds to the spine: comparative analysis of two retrospective cohorts

The objective of this study is to compare two cohorts of patients affected by this disease in different periods and evaluate specifically the role of decompressed laminectomy. Analysis of 246 and 127 patients with gunshot wounds to the spine admitted to the Hospital da Restauração, Recife, Brazil, between January 1981 and June 1998, and January 2005 to December 2008. The general comparative features were: an experience of 17.5 and 3 years, 95.8 % and 85.8% men and a mean age of 26.6 and 25 years. The neurologic condition at admission was Frankel/ASIA/IMSOP grade A (59.8% and 38.6%); B (2.4% and 30.7%); C (20.8% and 29.9%); D (14.2% and 0.8%) and E (2.8% and 0%). Hospital stay mean were 28 and 30 days. Follow-up mean 76.3 days. Conservative management was three times higher than surgical treatment in period 2005-2008, 14.2% and 12.6% patients died respectively. We concluded that the decompressive laminectomies continued to be associated with a higher level of complications and did not improve patient’s outcome.