A RARE CASE OF MINIMALLY INVASIVE REMOVAL OF A VERTEBRAL FOREIGN BODY AFTER A GUNSHOT FRAGMENT PENETRATING WOUND OF THE CHEST AND SPINE

Abstract

Objective. To demonstrate the possibilities of minimally invasive technologies in the diagnosis and treatment of gunshot wounds of the chest and spine. Methods. Patient N., 42, was wounded in the chest during mortar fire. From the diagnosis: gunshot fragment blind penetrating wound chest on the right with a gunshot fracture of the right scapula, III–V ribs on the right, damage to the right lung with the presence of a metal fragment paravertebrallyon the right at the level ThV–ThVI vertebrae, right-sided hemopneumothorax, right-sided post-traumatic pulmonitis, spinal cord injury, lower paraplegia. Results. The final is established diagnosis: gunshot fragment blind penetrating wound chest on the right with a gunshot fracture of the right scapula,III–V ribs on the right, damage to the right lung with the presence of a metal fragment paravertebrally on the right at the level ThV vertebra, right-sided hemopneumothorax. right-sided post-traumatic pneumonia, spinal cord injury, lower paraplegia. The operation was performed: video-assisted thoracoscopy on the right, revision of the pleural cavity, removal of a metal fragment from the body of the ThV vertebra, sanitation and redrainingof the right pleural cavity according to Bulau, which lasted 40 min. In the future, after 2 weeks, the stitches and signs were removed neurological deficit regressed, the wounded was sent to the military medical commission and discharged to parts. Conclusions. Gunshot wounds to the chest with spinal injuryare rare. The use of modern magnetic surgical instrument allows to remove ferromagnetic foreign bodies during vertebral injury. The use of minimally invasive operative interventions for gunshot wounds of the chest with spinal cord injury reduces operative trauma and can be applied to the third level of medical care.