Effects of the time limit of surgical decompression on the prognosis of acute incomplete spinal cord injuries (a report of 67 cases)

Objective To investigate the effect of surgical decompression performed within different duration after the damage on nerve function recovery of the patients with acute incomplete spinal cord injury. Methods Data of 67 patients with lower cervical or upper thoracic vertebrae (C3-T12) fractures and dislocation complicated with spinal cord injury from Sep. 2000 to Sep. 2008 were retrospectively analyzed. Patients were divided into 3 groups according to the duration from trauma to surgical operation: Group A, received surgical treatment within 1d (≤24h) of trauma (n=18); Group B, received surgical treatment 1-3 days (24-72h) after trauma (n=35); and Group C, received surgical treatment 3-14 days (72-336h) after trauma (n=14). All the patients were followed-up for 1-3 years, and the pre- and post-operative neurological scores and classification were recorded according to the scoring standard of sensory and motor scores promulgated by American Spinal Injury Association (ASIA) and Frankel's system, then they were analyzed and compared statistically. Results No statistically significant difference of AISA scores and Frankel classification existed among the 3 groups before surgical treatment. After surgical treatment, all the AISA sensory and motor scores and Frankel classification were significantly higher than those of the 3 groups before surgical treatment (P0.01 or P0.05). The AISA sensory and motor scores were higher in group A than in group B and group C (P0.01 or P0.05), and also in group B than in group C (P0.01). The Frankel classification was higher in group A than in group B (P0.05) and group C (P0.01), while no statistically significant difference existed between group B and group C (P0.05). Conclusion Surgical decompression may have a definite therapeutic effect on the patients with acute incomplete spinal cord injury, and the earlier the procedure performed, the better the nerve function recovered.