Journal Information
Vol. 34. Issue 1.
Pages 44-47 (January - February 2023)
Download PDF
More article options
Vol. 34. Issue 1.
Pages 44-47 (January - February 2023)
Case Report
Minimally invasive retrieval of a bullet settling into the thoracic spinal canal in a pediatric patient: A case report
Recuperación mínimamente invasiva de una bala que se asienta en el canal espinal torácico en un paciente pediátrico: reporte de un caso
Rami Darwazeha, Mazhar Darwazeha,
Corresponding author
, Mohammed Awad Elzainb, Rasha Al-Kanashc
a Department of Neurosurgery, Arab Women's Union Hospital, Nablus, Palestine
b Department of Neurosurgery, King Abdullah Hospital, Bisha, Saudi Arabia
c Endoscopic Spine Department, Razi Spine Clinic, Amman, Jordan
This item has received
Article information
Full Text
Download PDF
Figures (2)

A 10-year-old boy presented to neurosurgery department after a gunshot wound to the upper thoracic spine. The bullet entered through the right deltoid muscle and lodged inside the spinal canal at T1 level. The patient arrived conscious and obeying commands; however, he experienced a loss of sensation below T3 level, loss of reflexes below the injured T1 level, loss of anal sphincter tone and paraplegia in the lower limbs (American Spinal Injury Association grade-A). Imaging studies revealed an intra-canalicular metallic bullet at the T1 level. The patient underwent urgent operation using a tubular retractor system and the microscope. Subsequently, the bullet was successfully retrieved. Postoperatively, the patient made a significant recovery and by the end of the 6th month, he was able to walk independently despite some gait instability. A minimally invasive approach for intra-canalicular bullet removal in the thoracic region is a safe and effective technique in pediatric patients.

Case report
Minimally invasive

Un niño de 10 años se presentó al departamento de neurocirugía después de una herida de bala en la columna torácica superior. La bala entró por el músculo deltoides derecho y se alojó dentro del canal espinal a nivel T1. El paciente llegó consciente y obedeciendo órdenes; sin embargo, experimentó una pérdida de sensibilidad por debajo del nivel T3, pérdida de reflejos por debajo del nivel T1 lesionado, pérdida del tono del esfínter anal y paraplejía en las extremidades inferiores (American Spinal Injury Association grado-A). Los estudios de imagen revelaron una bala metálica intracanalicular a nivel T1. El paciente fue intervenido de urgencia mediante un sistema retractor tubular y el microscopio. Posteriormente, la bala se recuperó con éxito. En el postoperatorio, el paciente se recuperó significativamente y, al final del sexto mes, podía caminar de forma independiente a pesar de cierta inestabilidad en la marcha. Un enfoque mínimamente invasivo para la extracción de balas intracanaliculares en la región torácica es una técnica segura y eficaz en pacientes pediátricos.

Palabras clave:
Reporte de caso
Mínimamente invasivo


These are the options to access the full texts of the publication Neurocirugía (English edition)
Member of the Sociedad Española de Neurocirugía

If it is the first time you have accessed you can obtain your credentials by contacting Elsevier Spain in or by calling our Customer Service at902 88 87 40 if you are calling from Spain or at +34 932 418 800 (from 9 to 18h., GMT + 1) if you are calling outside of Spain.

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option ¿I have forgotten my password¿.


If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe to

Neurocirugía (English edition)

Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
Neurocirugía (English edition)
Article options
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?