Fig 4. Orthogonal digital radiographs of penetrating ballistic injury in a deer with caudal cervical spine shot placement.

Orthogonal digital radiographs of penetrating ballistic injury in a deer shot with the caudal cervical spine as the point of aim (A) lateral, and (B) ventrodorsal. C6-7 is the point of entry. There is circumferential trauma extending from C5-6 to the T3 and ribs. There is extensive disruption of spinal alignment with cranial displacement of the first three ribs and ventrocaudal rotation of the cranial thoracic spine. A complete distortion of the anatomic relationship between the neck and thorax is noted. There is luxation of the C5-6 articular processes and obliteration of the normal contours of C7 and the spinous processes of T1-3. Notice how the skull, cranial cervical spine and disarticulated (but intact) T1-3 vertebral bodies are preserved with the exception of a small chip fracture from the caudodorsal aspect of T1 which is likely secondary to a projectile fragment. Gas within the deep soft tissues of the neck, cranioventral mediastinum and thoracic inlet with a pneumothorax and atelectatic cranial lung field (which is partially attributed to post-mortem tissue handling). Despite the overwhelmingly destructive tissue damage, the injuries and immediate incapacitation associated with lower cervical targeting were sub-lethal, and the target remained conscious and aware. The caudal cervical impact did not result in satisfactory euthanasia.