Early Surgical Decompression Ameliorates Dysfunction of Spinal Motor Neuron in Patients With Acute Traumatic Central Cord Syndrome: An Ambispective Cohort Analysis

STUDY DESIGN.An ambispective cohort analysis. OBJECTIVE.The aim of this study was to investigate the impact of early (≤2 weeks) versus delayed (>2 weeks) surgical intervention on the spinal motor neurons at and distal to injury site in acute traumatic central cord syndrome (ATCCS). SUMMARY OF BAC...

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Published in:Spine (Philadelphia, Pa. 1976) Pa. 1976), 2020-07, Vol.45 (14), p.E829-E838
Main Authors: Zheng, Chaojun, Yu, Qifeng, Shan, Xueli, Zhu, Yu, Lyu, Feizhou, Ma, Xiaosheng, Zhou, Shuyi, Jiang, Jianyuan
Format: Article
Language:English
Subjects:
Central Cord Syndrome - physiopathology
Central Cord Syndrome - surgery
Cohort Studies
Decompression, Surgical - adverse effects
Decompression, Surgical - statistics & numerical data
Humans
Motor Neurons - physiology
Spine - surgery
Time-to-Treatment - statistics & numerical data
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Summary:STUDY DESIGN.An ambispective cohort analysis. OBJECTIVE.The aim of this study was to investigate the impact of early (≤2 weeks) versus delayed (>2 weeks) surgical intervention on the spinal motor neurons at and distal to injury site in acute traumatic central cord syndrome (ATCCS). SUMMARY OF BACKGROUND DATA.Accumulating evidence demonstrated degeneration in distal lower motor neurons (LMNs) following spinal cord injury, and this secondary degeneration may exacerbate motor impairments and limit spontaneous motor recovery. However, few studies involved this pathological process in ATCCS. METHODS.Motor unit number estimation (MUNE) was performed on both abductor pollicis brevis (APB) and extensor digitorum brevis (EDB) in 69 ATCCS patients (early vs. delayed surgical-treatment29 vs. 35) and 42 healthy subjects. All patients were assessed by American spinal injury association and Medical Research Council scales. These examinations and disabilities of arm, shoulder, and hand (c) questionnaire were administered approximately 21 months after operation in 65 of these patients. RESULTS.Preoperatively, MUNE values were lower in cervical-innervated muscles of ATCCS patients than in those of controls, and reduced motor units were observed in lumbosacral-innervated muscles in ATCCS patients with preoperative duration over 6 months (P 
ISSN:0362-2436
1528-1159
DOI:10.1097/BRS.0000000000003447