Penetrating thoracolumbar spine injuries

Purpose of review: As violent crime in the US continues to rise, unfortunately so does the incidence of gunshot wounds and other penetrating injuries to the spine increase. As well, our understanding of the mechanisms of injury and the body's response to injury develops, and consequently, treatment algorithms evolve. The purpose of this review is to discuss the current recommendations for these types of injuries. Recent findings: In the past year, there has been little advancement in the management of penetrating thoracolumbar spine injuries. Certainly our understanding of these injuries continues to evolve, but the treatment algorithms remains static at this point. With the continued research into the secondary mechanisms of spinal cord injury, and advanced pharmacologic management, these algorithms will certainly evolve. Summary: To date, indications for acute surgical management of penetrating spine injuries have not changed, and are currently limited to progressive neurologic deficits, spinal column instability, intradural copper fragmentation, and perhaps cerebrospinal fluid fistula. As other management strategies evolve, our management will also evolve.