Publication: Neurological Outcome of Early versus Late Surgery Following Cervical Spinal Cord Injury
Date
2022
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
There are numerous retrospective studies and a few prospective studies to determine
the neurologic outcome after early versus late surgical treatment for cervical spinal
cord injury.
Objective
To compare the neurological outcome between early (within 72 hours after injury)
and delayed (≥ 72 hours after injury) surgery in patients with cervical spinal injury.
Method
This is a retrospective analysis of the neurological outcome of early versus late
surgery following cervical spinal cord trauma. Patients meeting appropriate inclusion
criteria were divided into an early or a late surgical treatment group. The neurologic
outcomes and other complications were recorded up to six months of follow-up.
Result
Overall, there was a significant difference in neurological status at presentation and
at follow-up (p < 0.001). However, there was no statistically significant difference
between the early versus late surgery groups (p-value 0.261) in terms of neurological
outcome. Complications were found to be higher among those undergoing posterior
surgical approach (OR = 23.75; 95% CI 2.65, 212.98) than those with anterior or
combined approach (p=0.005). However, multivariate analysis of these variables
failed to show any statistically significant difference between the two groups.
Conclusion
The timing of surgery does not alter the neurological outcomes and the development
of complications significantly. The American Spinal Cord Injury Association (ASIA)
status at the time of presentation is found to be the single most important factor
correlating with the neurological outcome.
KEY WORDS
American spinal cord injury association, Cervical spine, Spinal decompression, Spinal
injury, Road traffic accident
Description
Kafle P,1 Chaudhary PK,1 Thapa J,2 Sharma MR3
1Department of Neurosurgery
Nobel Medical College and Teaching Hospital
Biratnagar, Nepal
2Patan Academy of Health Sciences
Lagankhel, Lalitpur, Nepal
3Department of Neurosurgery
Tribhuvan University Teaching Hospital
Maharajgunj, Kathmandu, Nepal
Keywords
American spinal cord injury association, Cervical spine, Spinal decompression, Spinal injury, Road traffic accident