Comprative evaluation of outcomes for early and late decompressive surgery in patients with traumatic injuries of the spinal cord, in thoracic and throvacolumbar regions

Document Type : Research Paper

Authors

1 Associate Professor of Neurosurgery / Department of Neurosurgery , Faculty of medicine ,Mashhad university of medical sciences

2 Associate Professor of Neurosurgery / Department of Neurosurgery, Faculty of medicine, Mashhad University of medical sciences.

3 Resident of Neurosurgery / Department of Neurosurgery, Faculty of medicine, Mashhad University of medical sciences.

Abstract

Background: Nowadays, traumatic injuries of the spinal cord affect young population and impose an enormous burden on both the patient and society. Therefore, detecting the best treatment is of major importance and spine decompressive plays a critical role in its treatment. As the time of performing the surgery is a great discrepancy, this study was designed to compare the neurological outcomes, rate of complications and duration of hospitalization in early and late surgeries in acute spinal injury.
 Subjects & Methods: In this non-randomized clinical trial, 30 patients with spinal injury referred to Emdadi center in Mashhad in 2011 were included. Fifteen patients were operated within 24 hours of the trauma and the rest of the patients were operated after 24 hours. Patients were also assessed using a checklist regarding the duration of hospitalization, rate of complications and neurological improvement, 3 and 6 months after the operation. The results were compared between 2 groups using independent t, Mann-Whitney and Chi-square tests.
Results: In early surgery, duration of hospitalization (P=0.031) was significantly less and neurological improvement and rate of various complications were similar to the late surgery. Age, gender, location of an injury in spine and existence of additional trauma were similar between 2 groups and did not affect the study outcomes.
Conclusion: Early decompressive surgery reduces the duration of hospitalization in patients with spinal injury, however, does not affect the neurological improvement and rate of complications. Nevertheless, it should be considered in all patients.

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