Prognostic factor analysis after surgical decompression and stabilization for cervical spinal-cord injury.

Abstract

INTRODUCTION:

Several studies have demonstrated the role of decompression surgery in preventing secondary injury and improving the neurological outcome after spinal cord injury (SCI). We retrospectively analyzed the prognostic factors affecting the outcomes of decompression surgery in patients with SCI.

METHODS:

We performed one-level decompression and fusion surgery on 73 patients with cervical SCI. We classified all patients based on their interval to decompression, sex, age, surgical level, presence of high signal intensity, American Spinal Injury Association Impairment scale (AIS) before surgery, blood pressure at admission, the amount of cord compression, surgical time, estimated blood loss during surgery, and steroid use. We considered an improvement to have occurred if the patient showed an AIS improvement of ≥1 grade.

RESULTS:

Among the 73 patients with SCI we analyzed, 27 and 35 showed ≥1 grade of AIS improvement immediately and 3 months after surgery, respectively. Using multivariate analysis, the mean arterial blood pressure (MAP) was a significant prognostic factor affecting recovery in the SCI patients during the immediate post-operative period. In the late recovery period at 3 months after surgery, the AIS before surgery and the MAP were significant prognostic factors affecting recovery.

CONCLUSIONS:

Prognostic factors for AIS improvement include the initial neurological status before surgery and hemodynamic MAP at admission. The interval between decompression surgery and trauma does not affect the neurological outcome.

• Authors: Jin Hoon Park, Jeoung Hee Kim, Sung Woo Roh, Seung Chul Rhim, Sang Ryong Jeon
• Journal: British journal of neurosurgery (Br J Neurosurg) Vol. 31 Issue 2 Pg. 194-198 (Apr 2017) ISSN: 1360-046X [Electronic] England
• PMID: 27802777 (Publication Type: Journal Article)

Chemical References

• Steroids

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Arterial Pressure
• Blood Loss, Surgical
• Cervical Vertebrae (diagnostic imaging, surgery)
• Decompression, Surgical (methods)
• Female
• Humans
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Orthopedic Procedures (methods)
• Prognosis
• Retrospective Studies
• Spinal Cord Compression (surgery)
• Spinal Cord Injuries (diagnostic imaging, surgery)
• Spinal Fusion
• Steroids (therapeutic use)
• Treatment Outcome
• Young Adult