Efficacy of Early (≤ 24 Hours), Late (25–72 Hours), and Delayed (>72 Hours) Surgery with Magnetic Resonance Imaging-Confirmed Decompression in American Spinal Injury Association Impairment Scale Grades C and D Acute Traumatic Central Cord Syndrome Caused by Spinal Stenosis
| العنوان: | Efficacy of Early (≤ 24 Hours), Late (25–72 Hours), and Delayed (>72 Hours) Surgery with Magnetic Resonance Imaging-Confirmed Decompression in American Spinal Injury Association Impairment Scale Grades C and D Acute Traumatic Central Cord Syndrome Caused by Spinal Stenosis |
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| المؤلفون: | Phelan Shea, Charles A. Sansur, Kenneth M. Crandall, Joshua Olexa, Nicole Wenger, Ashish Sharma, Riccardo Serra, Kathirkamanathan Shanmuganathan, Jason H Boulter, Abdul Kareem Ahmed, J. Marc Simard, Bizhan Aarabi, Timothy Chryssikos, Noori Akhtar-Danesh, Maureen Scarboro, Gregory Cannarsa, Gary Schwartzbauer, Aaron Wessell, Cara D Lomangino, Jeffrey Oliver |
| المصدر: | Journal of Neurotrauma |
| بيانات النشر: | Mary Ann Liebert Inc, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Male, musculoskeletal diseases, decompression, 030506 rehabilitation, medicine.medical_specialty, Decompression, Spinal stenosis, Motor Activity, Central Cord Syndrome, Time-to-Treatment, 03 medical and health sciences, Spinal Stenosis, 0302 clinical medicine, timing, medicine, Humans, Spinal cord injury, Aged, Retrospective Studies, medicine.diagnostic_test, business.industry, American Spinal Injury Association, Magnetic resonance imaging, Original Articles, Recovery of Function, Middle Aged, Decompression, Surgical, medicine.disease, Central cord syndrome, Magnetic Resonance Imaging, spinal cord injury, humanities, Surgery, body regions, trauma, Treatment Outcome, Cohort, outcome, Female, Neurology (clinical), medicine.symptom, 0305 other medical science, business, 030217 neurology & neurosurgery, Follow-Up Studies |
| الوصف: | The therapeutic significance of timing of decompression in acute traumatic central cord syndrome (ATCCS) caused by spinal stenosis remains unsettled. We retrospectively examined a homogenous cohort of patients with ATCCS and magnetic resonance imaging (MRI) evidence of post-treatment spinal cord decompression to determine whether timing of decompression played a significant role in American Spinal Injury Association (ASIA) motor score (AMS) 6 months following trauma. We used the t test, analysis of variance, Pearson correlation coefficient, and multiple regression for statistical analysis. During a 19-year period, 101 patients with ATCCS, admission ASIA Impairment Scale (AIS) grades C and D, and an admission AMS of ≤95 were surgically decompressed. Twenty-four of 101 patients had an AIS grade C injury. Eighty-two patients were males, the mean age of patients was 57.9 years, and 69 patients had had a fall. AMS at admission was 68.3 (standard deviation [SD] 23.4); upper extremities (UE) 28.6 (SD 14.7), and lower extremities (LE) 41.0 (SD 12.7). AMS at the latest follow-up was 93.1 (SD 12.8), UE 45.4 (SD 7.6), and LE 47.9 (SD 6.6). Mean number of stenotic segments was 2.8, mean canal compromise was 38.6% (SD 8.7%), and mean intramedullary lesion length (IMLL) was 23 mm (SD 11). Thirty-six of 101 patients had decompression within 24 h, 38 patients had decompression between 25 and 72 h, and 27 patients had decompression >72 h after injury. Demographics, etiology, AMS, AIS grade, morphometry, lesion length, surgical technique, steroid protocol, and follow-up AMS were not statistically different between groups treated at different times. We analyzed the effect size of timing of decompression categorically and in a continuous fashion. There was no significant effect of the timing of decompression on follow-up AMS. Only AMS at admission determined AMS at follow-up (coefficient = 0.31; 95% confidence interval [CI]:0.21; p = 0.001). We conclude that timing of decompression in ATCCS caused by spinal stenosis has little bearing on ultimate AMS at follow-up. |
| تدمد: | 1557-9042 0897-7151 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9d5399c3fe622c785329967c04e0c49dTest https://doi.org/10.1089/neu.2021.0040Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....9d5399c3fe622c785329967c04e0c49d |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15579042 08977151 |
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