The majority of penetrating spinal cord lesions are caused by gunshot wounds. These wounds may be localized to the spine or may involve transperitoneal trajectories. The spinal cord may be injured by direct contact with the bullet, by bony fragments, or from concussive forces.14 Most gunshot wounds result in stable vertebral injuries, although cord lesions are often complete. Stabbing injuries are much less common. These may be inflicted by a variety of implements including knives, axes, icepicks, screwdrivers, and glass fragments. The majority of stab wounds involve incomplete Brown-Sequard lesions of the thoracic cord. These have the best prognosis of incomplete spinal injuries. The prognosis for patients with stab injuries to the spine and incomplete paralysis is significantly better than that for patients with gunshot wounds to the spine and a similar extent of paralysis.
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