2018Russian journal of neurosurgeryOpen access

The timing in surgery of spinal trauma (a review)

А. А. Grin, Anton Kordonskiy, Ivan Lvov, A. K. Kaikov, А. В. Сытник, O. Yu. Bogdanova

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Abstract

The study objective is analyze the modern ideas about the influence of time factor on the treatment outcome of patients with spinal cord injury. Results. Experimental studies clearly demonstrate the effectiveness of early decompression. According to the results of meta-analyses, in patients who underwent early decompression of the cervical segment of spinal canal, the outcomes of treatment may be better compared with the treatment outcomes of patients who underwent delayed intervention. The benefit of early decompression of the thoracic and lumbar spinal cord is not statistically significant. The difference in the rate of intraand postoperative complications and lethality between early and late decompression groups is also statistically insignificant. Conclusion. Early decompression of the spinal canal and spinal stabilization (≤24 h) should be performed in a specialized hospital as fully as possible and as early as the severity of the patient condition allows.

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What this paper is about

The study objective is analyze the modern ideas about the influence of time factor on the treatment outcome of patients with spinal cord injury. Results. Experimental studies clearly demonstrate the effectiveness of early decompression. According to the results of meta-analyses, in patients who underwent early decompression of the cervical segment of spinal canal, the outcomes of treatment may be better compared with the treatment outcomes of patients who underwent delayed intervention. The benefit of early decompression of the thoracic and lumbar spinal cord is not statistically significant. The difference in the rate of intraand postoperative complications and lethality between early and late decompression groups is also statistically insignificant. Conclusion. Early decompression of the spinal canal and spinal stabilization (≤24 h) should be performed in a specialized hospital as fully as possible and as early as the severity of the patient condition allows.

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Available abstract

The study objective is analyze the modern ideas about the influence of time factor on the treatment outcome of patients with spinal cord injury. Results. Experimental studies clearly demonstrate the effectiveness of early decompression. According to the results of meta-analyses, in patients who underwent early decompression of the cervical segment of spinal canal, the outcomes of treatment may be better compared with the treatment outcomes of patients who underwent delayed intervention. The benefit of early decompression of the thoracic and lumbar spinal cord is not statistically significant. The difference in the rate of intraand postoperative complications and lethality between early and late decompression groups is also statistically insignificant. Conclusion. Early decompression of the spinal canal and spinal stabilization (≤24 h) should be performed in a specialized hospital as fully as possible and as early as the severity of the patient condition allows.

Key concepts: Medicine, Decompression, Surgery, Spinal cord, Surgical decompression, Spinal canal, Spinal decompression, Lumbar

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