@article{ref1,
title="Nonmissile penetrating spinal injuries: mechanisms, expectations, and management",
journal="Surgical neurology international",
year="2020",
author="Fiani, Brian and Figueras, Ryan Arthur and Stefano, Frank De and Gautam, Neha and Khan, Asif and Soula, Marisol",
volume="11",
number="",
pages="e406-e406",
abstract="BACKGROUND: Nonmissile penetrating spinal injury (NMPSI) is an uncommon form of  traumatic injury to the spine. Here, we present a comprehensive and contemporary  literature review that provides insight into NMPSI-type injuries, their mechanisms,  clinical practice, management, and expectations. <br><br>METHODS: An extensive review of the  published literature was conducted in PubMed, OVID Medline, and EMBASE journals for  studies of nonmissile penetrating spine injuries. Terms for search included NMPSI  and nonmissile penetrating spinal cord injury. No date restrictions were used. <br><br>RESULTS: The search yielded only 17 related articles. Cross-checking of articles was  conducted to exclude duplicate articles. The 17 articles were screened for their  full text and English language availability. We finalized those articles pertaining  to the topic. <br><br>CONCLUSION: The mechanism of injury in NMPSI occurs in two different  stages. Immediate injury is caused by direct damage to the neurological structures. The delayed injury response is caused by damage to the spinal vasculature and  activated immune response pathways. Computed tomography (CT) angiograms or formal  diagnostic angiograms are indicated to identify vascular injury or development of  pseudoaneurysm and can be performed both preoperatively and postoperatively. Surgically, decompressive procedures include laminectomies and hemilaminectomies. Dural exploration may be indicated if a cerebrospinal fluid leak with fistula  develops from dural puncture. Further research and technologies are being developed  to provide patients who have suffered NMPSI with more resources for a better quality  of life.<p /> <p>Language: en</p>",
language="en",
issn="2229-5097",
doi="10.25259/SNI_596_2020",
url="http://dx.doi.org/10.25259/SNI_596_2020"
}