{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T23:48:50Z","timestamp":1776728930265,"version":"3.51.2"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,20]]},"DOI":"10.7759\/cureus.107416","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T23:31:56Z","timestamp":1776727916000},"source":"Crossref","is-referenced-by-count":0,"title":["American Spinal Injury Association (ASIA) Impairment Scale Motor Grade Outcomes Among Patients With Ballistic Neurologic Injuries Managed Expectantly: A 13-Year Single Institution Retrospective Review and Narrative Review of the Literature"],"prefix":"10.7759","author":[{"given":"Tyler X","family":"Giles","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas R","family":"Hemphill","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas P","family":"Derrico","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebekah","family":"Kimball","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Carroll","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine E","family":"Baker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evan C","family":"Bowen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Wilkinson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory R","family":"Vance","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zachary S","family":"Smalley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chad W","family":"Washington","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jared J","family":"Marks","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.9393","article-title":"Analysis of firearm violence during the COVID-19 pandemic in the US","volume":"5","author":"Sun S","year":"2022","unstructured":"Sun S, Cao W, Ge Y, Siegel M, Wellenius GA. Analysis of firearm violence during the COVID-19 pandemic in the US. JAMA Netw Open. 2022, 5:e229393. 10.1001\/jamanetworkopen.2022.9393","journal-title":"JAMA Netw Open"},{"key":"ref2","unstructured":"U.S. surgeon general issues advisory on the public health crisis of firearm violence in the United States. (2024). Accessed. June 25, 2024: https:\/\/www.hhs.gov\/about\/news\/2024\/06\/25\/us-surgeon-general-issues-advisory-public-health-crisis-firearm-violence-un...."},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2023.09.026","article-title":"Costs of fatal and nonfatal firearm injuries in the U.S., 2019 and 2020","volume":"66","author":"Miller GF","year":"2024","unstructured":"Miller GF, Barnett SB, Florence CS, McDavid Harrison K, Dahlberg LL, Mercy JA. Costs of fatal and nonfatal firearm injuries in the U.S., 2019 and 2020. Am J Prev Med. 2024, 66:195-204. 10.1016\/j.amepre.2023.09.026","journal-title":"Am J Prev Med"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2022.09.007","article-title":"The economic impact of acute firearm injuries at a trauma center in New Orleans","volume":"64","author":"Marrero CE","year":"2023","unstructured":"Marrero CE, Petrie JK, Bonvillain K 2nd, Leonardi C, Stinger BA. The economic impact of acute firearm injuries at a trauma center in New Orleans. Am J Prev Med. 2023, 64:221-6. 10.1016\/j.amepre.2022.09.007","journal-title":"Am J Prev Med"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199502000-00029","article-title":"Hospital costs of firearm injuries","volume":"38","author":"Ordog GJ","year":"1995","unstructured":"Ordog GJ, Wasserberger J, Ackroyd G. Hospital costs of firearm injuries. J Trauma. 1995, 38:291-8. 10.1097\/00005373-199502000-00029","journal-title":"J Trauma"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1136\/tsaco-2021-000854","article-title":"A decade of hospital costs for firearm injuries in the United States by region, 2005-2015: government healthcare costs and firearm policies","volume":"7","author":"Spitzer SA","year":"2022","unstructured":"Spitzer SA, Forrester JD, Tennakoon L, Spain DA, Weiser TG. A decade of hospital costs for firearm injuries in the United States by region, 2005-2015: government healthcare costs and firearm policies. Trauma Surg Acute Care Open. 2022, 7:e000854. 10.1136\/tsaco-2021-000854","journal-title":"Trauma Surg Acute Care Open"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.3171\/2010.2.FOCUS1036","article-title":"Can surgery improve neurological function in penetrating spinal injury? A review of the military and civilian literature and treatment recommendations for military neurosurgeons","volume":"28","author":"Klimo P Jr","year":"2010","unstructured":"Klimo P Jr, Ragel BT, Rosner M, Gluf W, McCafferty R. Can surgery improve neurological function in penetrating spinal injury? A review of the military and civilian literature and treatment recommendations for military neurosurgeons. Neurosurg Focus. 2010, 28:E4. 10.3171\/2010.2.FOCUS1036","journal-title":"Neurosurg Focus"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000001716","article-title":"Surgical management of civilian gunshot-induced spinal cord injury: is it overutilized?","volume":"42","author":"Nwosu K","year":"2017","unstructured":"Nwosu K, Eftekhary N, McCoy E, Bhalla A, Fukunaga D, Rolfe K. Surgical management of civilian gunshot-induced spinal cord injury: is it overutilized?. Spine (Phila Pa 1976). 2017, 42:E117-24. 10.1097\/BRS.0000000000001716","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-013-2901-2","article-title":"Civilian gunshot injuries of the spinal cord: a systematic review of the current literature","volume":"471","author":"Sidhu GS","year":"2013","unstructured":"Sidhu GS, Ghag A, Prokuski V, Vaccaro AR, Radcliff KE. Civilian gunshot injuries of the spinal cord: a systematic review of the current literature. Clin Orthop Relat Res. 2013, 471:3945-55. 10.1007\/s11999-013-2901-2","journal-title":"Clin Orthop Relat Res"},{"key":"ref10","article-title":"Treatment of asymptomatic gunshot injuries to the spine","volume":"55","author":"Wigle RL","year":"1989","unstructured":"Wigle RL. Treatment of asymptomatic gunshot injuries to the spine. Am Surg. 1989, 55:591-5.","journal-title":"Am Surg"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.4184\/asj.2013.7.4.359","article-title":"Concept of gunshot wound spine","volume":"7","author":"Jaiswal M","year":"2013","unstructured":"Jaiswal M, Mittal RS. Concept of gunshot wound spine. Asian Spine J. 2013, 7:359-64. 10.4184\/asj.2013.7.4.359","journal-title":"Asian Spine J"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1038\/sc.2014.56","article-title":"Gunshot injuries in the spine","volume":"52","author":"de Barros Filho TE","year":"2014","unstructured":"de Barros Filho TE, Cristante AF, Marcon RM, Ono A, Bilhar R. Gunshot injuries in the spine. Spinal Cord. 2014, 52:504-10. 10.1038\/sc.2014.56","journal-title":"Spinal Cord"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.31616\/asj.2018.12.4.648","article-title":"Spinal gunshot wounds: pattern and associated lesions in civilians","volume":"12","author":"Escamilla JA","year":"2018","unstructured":"Escamilla JA, Ross J\u00c1G, Atanasio JM, Mart\u00ednez GC, Cisneros AG, Avila JJ. Spinal gunshot wounds: pattern and associated lesions in civilians. Asian Spine J. 2018, 12:648-55. 10.31616\/asj.2018.12.4.648","journal-title":"Asian Spine J"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.4103\/0974-8237.100052","article-title":"Penetrating spinal injuries and their management","volume":"2","author":"Kumar A","year":"2011","unstructured":"Kumar A, Pandey PN, Ghani A, Jaiswal G. Penetrating spinal injuries and their management. J Craniovertebr Junction Spine. 2011, 2:57-61. 10.4103\/0974-8237.100052","journal-title":"J Craniovertebr Junction Spine"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1177\/2192568221991802","article-title":"Civilian gun shot wounds associated with spinal injuries","volume":"12","author":"Ge L","year":"2022","unstructured":"Ge L, Jubril A, Mesfin A. Civilian gun shot wounds associated with spinal injuries. Global Spine J. 2022, 12:1428-33. 10.1177\/2192568221991802","journal-title":"Global Spine J"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1177\/21925682211030873","article-title":"Gunshot wounds to the lumbosacral spine: systematic review and meta-analysis","volume":"12","author":"Platt A","year":"2022","unstructured":"Platt A, Dafrawy MH, Lee MJ, Herman MH, Ramos E. Gunshot wounds to the lumbosacral spine: systematic review and meta-analysis. Global Spine J. 2022, 12:1247-53. 10.1177\/21925682211030873","journal-title":"Global Spine J"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1097\/BSD.0000000000001308","article-title":"Surgical intervention is associated with improvements in the ASIA impairment scale in gunshot-induced spinal injuries of the thoracic and lumbar spine","volume":"35","author":"Goh BC","year":"2022","unstructured":"Goh BC, Striano BM, Crawford AM, et al.. Surgical intervention is associated with improvements in the ASIA impairment scale in gunshot-induced spinal injuries of the thoracic and lumbar spine. Clin Spine Surg. 2022, 35:323-7. 10.1097\/BSD.0000000000001308","journal-title":"Clin Spine Surg"},{"key":"ref18","article-title":"Treatment of acute penetrating injuries of the spine: a retrospective analysis","volume":"29","author":"Simpson RK Jr","year":"1989","unstructured":"Simpson RK Jr, Venger BH, Narayan RK. Treatment of acute penetrating injuries of the spine: a retrospective analysis. J Trauma. 1989, 29:42-6.","journal-title":"J Trauma"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1097\/01.ta.0000195472.99198.71","article-title":"The role of debridement and antibiotics in gunshot wounds to the spine","volume":"60","author":"Quigley KJ","year":"2006","unstructured":"Quigley KJ, Place HM. The role of debridement and antibiotics in gunshot wounds to the spine. J Trauma. 2006, 60:814-9; discussion 819-20. 10.1097\/01.ta.0000195472.99198.71","journal-title":"J Trauma"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199603010-00015","article-title":"Validation of the American Spinal Injury Association (ASIA) motor score and the National Acute Spinal Cord Injury Study (NASCIS) motor score","volume":"21","author":"El Masry WS","year":"1996","unstructured":"El Masry WS, Tsubo M, Katoh S, El Miligui YH, Khan A. Validation of the American Spinal Injury Association (ASIA) motor score and the National Acute Spinal Cord Injury Study (NASCIS) motor score. Spine (Phila Pa 1976). 1996, 21:614-9. 10.1097\/00007632-199603010-00015","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3102044","article-title":"Inter-rater reliability of motor and sensory examinations performed according to American Spinal Injury Association standards","volume":"45","author":"Savic G","year":"2007","unstructured":"Savic G, Bergstr\u00f6m EM, Frankel HL, Jamous MA, Jones PW. Inter-rater reliability of motor and sensory examinations performed according to American Spinal Injury Association standards. Spinal Cord. 2007, 45:444-51. 10.1038\/sj.sc.3102044","journal-title":"Spinal Cord"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-016-5133-4","article-title":"Classifications in brief: American Spinal Injury Association (ASIA) Impairment Scale","volume":"475","author":"Roberts TT","year":"2017","unstructured":"Roberts TT, Leonard GR, Cepela DJ. Classifications in brief: American Spinal Injury Association (ASIA) Impairment Scale. Clin Orthop Relat Res. 2017, 475:1499-504. 10.1007\/s11999-016-5133-4","journal-title":"Clin Orthop Relat Res"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1097\/PHM.0000000000001006","article-title":"Relationships between specific functional abilities and health-related quality of life in chronic traumatic spinal cord injury","volume":"98","author":"Goulet J","year":"2019","unstructured":"Goulet J, Richard-Denis A, Thompson C, Mac-Thiong JM. Relationships between specific functional abilities and health-related quality of life in chronic traumatic spinal cord injury. Am J Phys Med Rehabil. 2019, 98:14-9. 10.1097\/PHM.0000000000001006","journal-title":"Am J Phys Med Rehabil"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2024.10.006","article-title":"Civilian ballistic spinal cord injuries versus blunt trauma: comparative analysis of clinical characteristics, management, and outcomes","volume":"25","author":"Jacob A","year":"2025","unstructured":"Jacob A, Loibl M, Kruger S, et al.. Civilian ballistic spinal cord injuries versus blunt trauma: comparative analysis of clinical characteristics, management, and outcomes. Spine J. 2025, 25:568-80. 10.1016\/j.spinee.2024.10.006","journal-title":"Spine J"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.21608\/esj.2021.55152.1160","article-title":"Injuries of the spine: the outcome assessment of series of twenty-one patients","volume":"36","author":"Nagy M","year":"2020","unstructured":"Nagy M, Elgaidi M. Injuries of the spine: the outcome assessment of series of twenty-one patients. Adv Spine J. 2020, 36:10.21608\/esj.2021.55152.1160","journal-title":"Adv Spine J"},{"key":"ref26","article-title":"Particularities of ballistic spinal injuries and management in an African context (Chad): study of 27 cases","volume":"35","author":"Kessely YK","year":"2020","unstructured":"Kessely YK, Oryon AB, Njesada NS, et al.. Particularities of ballistic spinal injuries and management in an African context (Chad): study of 27 cases. Adv Spine J. 2020, 35:101860-2214.","journal-title":"Adv Spine J"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-198702000-00014","article-title":"Civilian gunshot wounds to the spinal cord and cauda equina","volume":"20","author":"Benzel EC","year":"1987","unstructured":"Benzel EC, Hadden TA, Coleman JE. Civilian gunshot wounds to the spinal cord and cauda equina. Neurosurgery. 1987, 20:281-5. 10.1227\/00006123-198702000-00014","journal-title":"Neurosurgery"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199112000-00002","article-title":"Management of transperitoneal gunshot wounds of the spine","volume":"31","author":"Kihtir T","year":"1991","unstructured":"Kihtir T, Ivatury RR, Simon R, et al.. Management of transperitoneal gunshot wounds of the spine. J Trauma. 1991, 31:1579-83. 10.1097\/00005373-199112000-00002","journal-title":"J Trauma"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199015100-00014","article-title":"Gunshot wounds to the cervical spine","volume":"15","author":"Kupcha PC","year":"1990","unstructured":"Kupcha PC, An HS, Cotler JM. Gunshot wounds to the cervical spine. Spine. 1990, 15:1058-63. 10.1097\/00007632-199015100-00014","journal-title":"Spine"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2008.11.005","article-title":"The role of routine spinal imaging and immobilisation in asymptomatic patients after gunshot wounds","volume":"40","author":"DuBose J","year":"2009","unstructured":"DuBose J, Teixeira PG, Hadjizacharia P, et al.. The role of routine spinal imaging and immobilisation in asymptomatic patients after gunshot wounds. Injury. 2009, 40:860-3. 10.1016\/j.injury.2008.11.005","journal-title":"Injury"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3181e7576e","article-title":"Unstable cervical spine fracture after penetrating neck injury: a rare entity in an analysis of 1,069 patients","volume":"70","author":"Lustenberger T","year":"2011","unstructured":"Lustenberger T, Talving P, Lam L, et al.. Unstable cervical spine fracture after penetrating neck injury: a rare entity in an analysis of 1,069 patients. J Trauma. 2011, 70:870-2. 10.1097\/TA.0b013e3181e7576e","journal-title":"J Trauma"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.17161\/kjm.vol1413772","article-title":"Demographics and incident location of gunshot wounds at a single level I trauma center","volume":"14","author":"Benton B","year":"2021","unstructured":"Benton B, Watson D, Ablah E, et al.. Demographics and incident location of gunshot wounds at a single level I trauma center. Kans J Med. 2021, 14:31-7. 10.17161\/kjm.vol1413772","journal-title":"Kans J Med"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1136\/tsaco-2023-001199","article-title":"Improved follow-up care for gun violence survivors in the Trauma Quality of Life Clinic","volume":"9","author":"Brandolino A","year":"2024","unstructured":"Brandolino A, deRoon-Cassini TA, Biesboer EA, et al.. Improved follow-up care for gun violence survivors in the Trauma Quality of Life Clinic. Trauma Surg Acute Care Open. 2024, 9:e001199. 10.1136\/tsaco-2023-001199","journal-title":"Trauma Surg Acute Care Open"},{"key":"ref34","article-title":"Outcomes following low-energy civilian gunshot wound trauma to the lower extremities: results of a standard protocol at an urban trauma center","volume":"35","author":"Abghari M","year":"2015","unstructured":"Abghari M, Monroy A, Schubl S, Davidovitch R, Egol K. Outcomes following low-energy civilian gunshot wound trauma to the lower extremities: results of a standard protocol at an urban trauma center. Iowa Orthop J. 2015, 35:65-9.","journal-title":"Iowa Orthop J"}],"container-title":["Cureus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cureus.com\/articles\/480211-american-spinal-injury-association-asia-impairment-scale-motor-grade-outcomes-among-patients-with-ballistic-neurologic-injuries-managed-expectantly-a-13-year-single-institution-retrospective-review-and-narrative-review-of-the-literature","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T23:32:01Z","timestamp":1776727921000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cureus.com\/articles\/480211-american-spinal-injury-association-asia-impairment-scale-motor-grade-outcomes-among-patients-with-ballistic-neurologic-injuries-managed-expectantly-a-13-year-single-institution-retrospective-review-and-narrative-review-of-the-literature"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,20]]},"references-count":34,"URL":"https:\/\/doi.org\/10.7759\/cureus.107416","relation":{},"ISSN":["2168-8184"],"issn-type":[{"value":"2168-8184","type":"print"}],"subject":[],"published":{"date-parts":[[2026,4,20]]}}}