医学
脊髓损伤
外科
前瞻性队列研究
减压
脊髓
脊柱减压
回顾性队列研究
中枢神经系统疾病
绳索
麻醉
精神科
作者
Alexander R. Vaccaro,Reza Daugherty,Terrence P. Sheehan,Stephen J. Dante,Jerome M. Cotler,Richard A. Balderston,Gerald J. Herbison,Bruce E. Northrup
出处
期刊:Spine
[Ovid Technologies (Wolters Kluwer)]
日期:1997-11-01
卷期号:22 (22): 2609-2613
被引量:279
标识
DOI:10.1097/00007632-199711150-00006
摘要
A prospective analysis evaluating neurologic outcome after early versus late surgery for cervical spinal cord trauma.The study was conducted to determine whether neurologic and functional outcome is improved in traumatic cervical spinal cord-injured patients (C3-T1, American Spinal Injury Association grades A-D) who had early surgery (<72 hours after spinal cord injury) compared with those patients who had late surgery (>5 days after spinal cord injury).There is considerable controversy as to the appropriate timing of surgical decompression and stabilization for cervical spinal cord trauma. There have been numerous retrospective studies, but no prospective studies, to determine whether neurologic outcome is best after early versus late surgical treatment for cervical spinal cord injury.Patients meeting appropriate inclusion criteria were randomized to an early (<72 hours after spinal cord injury) or late (>5 days after spinal cord injury) surgical treatment protocol. The neurologic and functional outcomes were recorded from the acute hospital admission to the most recent follow-up.Comparison of the two groups showed no significant difference in length of acute postoperative intensive care stay, length of inpatient rehabilitation, or improvement in American Spinal Injury Association grade or motor score between early (mean, 1.8 days) versus late (mean, 16.8 days) surgery.The results of this study reveal no significant neurologic benefit when cervical spinal cord decompression after trauma is performed less than 72 hours after injury (mean, 1.8 days) as opposed to waiting longer than 5 days (mean, 16.8 days).
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