The bullet in the dural sac. How to catch it? A report of two cases

Bronius Špakauskas, Kazys Vytautas Ambrozaitis, Egidijus Kontautas¹

Department of Neurosurgery, ¹Department of Orthopedics and Traumatology, Kaunas University of Medicine, Lithuania

Key words: spine; spine injury; gunshot injury.

Summary. Objective. The purpose of this article is to present two cases of penetrating gunshot injuries to the lumbar spine with migration of the bullets within the dural sac and to describe the method of removal of the bullet from the dural sac.

Material and methods. Two cases of penetrating gunshot injuries to the lumbar spine with migration of the bullets within the dural sac are presented. Clinical course, diagnostic tools, and management of two patients who suffered from these injuries are illustrated. The method of removal of the bullet from the dural sac is described too.

Results. The wounds in these two cases healed without infection. The neurological status of our patients improved gradually. Radiographs taken 2 years after the injury did not demonstrate the postoperative instability of the lumbar spine.

Conclusions. The bullet in the dural sac at the level of the cauda equina must be removed. The method proposed by us can facilitate this procedure.

Correspondence to B. Špakauskas, Department of Neurosurgery, Kaunas University of Medicine, Eivenių 2, 50009 Kaunas, Lithuania. E-mail: spak@takas.lt

Received 2 June 2006, accepted 27 April 2007