Cervical Spine Myelopathy from Metalloma Association with Chronic Retention of a Bullet
Abstract
A Civilian gunshot wound associated with metallosis in the cervical spine region was an extremely rare case; hence, the clinician had difficulty with diagnosis and surgical treatment.
A 57–year-old gentleman had a history of a gunshot wound injury going back 30 years. He presented with neck pain, progress of paresthesia of upper extremities and progressively difficult ambulation for 3 months. Radiographic and pathological diagnosis from tissue of the 7th paravertebral of the cervical spine showed foreign bodies consistent with metallosis. The patient showed improvement of symptoms after posterior cervical spine fixation and decompression. He had full recovery at 1 year follow up.
Metallosis can occur in cases of chronic exposure to lead and metals. The results of this chronic process of metallosis will develop to metalloma, which then compresses the spinal cord and develops into myelopathy. The patient had a bullet, or piece of metal at the cervical spine, so surgical removal was performed to prevent further compression of the spinal cord from metalloma.
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Farmer JC, Vaccaro AR, Balderston RA, Albert TJ, Cotler J. The changing nature of admissions to a spinal cord injury center: violence on the rise. J Spinal Disord 1998;11:400–3.
Chittiboina P, Banerjee AD, Zhang S, Caldito G, Nanda A, Willis BK. How bullet trajectory affects outcomes of civilian gunshot injury to the spine. J Clin Neurosci J Neurosurg Soc Australas 2011;18:1630-3.
Lin SS, Vaccaro AR, Reisch S, Devine M, Cotler JM, Reich SM. Low-velocity gunshot wounds to the spine with an associated transperitoneal injury. J Spinal Disord 1995;8:136-44.
Tezer M, Kuzgun U, Hamzaoglu A. Intraspinal metalloma resulting in late paraparesis. Arch Orthop Trauma Surg 2005;125:417-21.
Goldenberg Y, Tee JW, Salinas-La Rosa CM, Murphy M. Spinal metallosis: a systematic review. Eur Spine J 2016;25:1467-73.
Sidhu GS, Ghag A, Prokuski V, Vaccaro AR, Radcliff KE. Civilian gunshot injuries of the spinal cord: a systematic review of the current literature. Clin Orthop 2013;12:3945-55.
Waters RL, Sie IH. Spinal cord injuries from gunshot wounds to the spine. Clin Orthop 2003;3:120-5.
Cristante AF, de Souza FI, Barros Filho TEP, Oliveira RP, Marcon RM. Lead poisoning by intradiscal firearm bullet: a case report. Spine 2010;2:140-3.
Machado I, Gracia DP, Tannus CS, Tanaka K. Spinal metallosis as a complication of a lodgues bullet from a firearmwound: an image-centered case. Rev Assoc Med Bras (1992) 2018;64: 676-9.
Womack R, Luther E, Perez-Roman RJ, Manzano GR. Heterotopic bone formation 20 years after gunshot wound to the cervical spine: a rare cause of progressive cervical myelopathy in a previously asymptomatic patient. World Neurosurg 2019: 132:197-201
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