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  • Neurological recovery after traumatic cervical spinal cord injury is superior if surgical decompression and instrumented fusion are performed within 8 hours versus 8 to 24 hours after injury : a single center experience
    Jug, Marko, 1974- ...
    A prospective study was performed to evaluate the impact of surgical decompression (SD) and instrumented fusion within 8h versus 8-24h after injury on neurological recovery after cervical traumatic ... spinal cord injury (tSCI) in patients operated on in the UMC Ljubljana, Slovenia. Only patients with the American Spinal Injury Association (ASIA) Impairment Scale (AIS) grades of A through C and with MRI-confirmed spinal cord compression were enrolled. The primary outcome was the change in AIS grade at the 6-month follow-up. Of the 48 enrolled patients, 22 patients who underwent surgery within 8h (group 8h) and 20 patients who underwent surgery between 8 and 24h (Group 8-24h) after injury concluded the study. At admission, there was no statistically significant difference in AIS grade between the study groups. At the 6-month follow-up, an improvement of at least two AIS grades was found in 45.5% of patients in group 8h and in 10% of patients in group 8-24h (p=0.017). The median improvement in the ASIA motor score was 38.5 (10.0-61.0) motor points in group 8h and 15.0 (8.8-34.0) motor points in group 8-24h (p=0.0468). In a multivariate analysis, adjusted for the preoperative AIS grade and the degree of spinal canal compromise, the odds of an at least two-grade AIS improvement were at least 106% higher for patients in group 8h than for patients in group 8-24h (odds ratio=11.08, p=0.004). No statistically significant difference was found in the rate of perioperative complications, pneumonia, and the number of ventilator-dependent days or the mortality between the groups. Our results suggest that the patients with tSCI who undergo SD within 8h after injury have superior neurological outcomes than patients who undergo SD 8-24h after injury, without any increase in the rate of adverse effects.
    Vir: Journal of neurotrauma. - ISSN 0897-7151 (Vol. 32, iss. 18, Sep. 2015, str. 1385-1392)
    Vrsta gradiva - članek, sestavni del
    Leto - 2015
    Jezik - angleški
    COBISS.SI-ID - 32159705
    DOI

vir: Journal of neurotrauma. - ISSN 0897-7151 (Vol. 32, iss. 18, Sep. 2015, str. 1385-1392)
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