Timing of thoracolomber spine stabilization in trauma patients; impact on neurological outcome and clinical course. A real prospective (rct) randomized controlled study

Objective Optimal timing of stabilization for spinal injuries is discussed controversially. The goal of this study is to investigate the neurological recovery and its influencing factors in thoracolumbar spine fractures after surgical decompression and stabilization within 8 h of spinal cord injury...

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Bibliographic Details
Published in:Archives of orthopaedic and trauma surgery 2008-09, Vol.128 (9), p.959-966
Main Authors: Cengiz, Şahika Liva, Kalkan, Erdal, Bayir, Aysegul, Ilik, Kemal, Basefer, Alper
Format: Article
Language:English
Subjects:
Adult
Decompression, Surgical
Female
Humans
Length of Stay
Lumbar Vertebrae - injuries
Lumbar Vertebrae - surgery
Male
Medicine
Medicine & Public Health
Middle Aged
Neurologic Examination
Orthopedics
Outcome and Process Assessment (Health Care)
Postoperative Complications
Prospective Studies
Recovery of Function
Spinal cord injuries
Spinal Fractures - surgery
Surgery
Thoracic Vertebrae - injuries
Thoracic Vertebrae - surgery
Time Factors
Trauma
Trauma Surgery
Young Adult
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Summary:Objective Optimal timing of stabilization for spinal injuries is discussed controversially. The goal of this study is to investigate the neurological recovery and its influencing factors in thoracolumbar spine fractures after surgical decompression and stabilization within 8 h of spinal cord injury versus surgery which is performed between 3 and 15 days. Methods Twenty-seven patients undergoing thoracolumbar stabilization with neurological deficit for an acute thoracolumbar spinal injury at the level of Th8-L2 vertebra at Selcuk University between March 2004 and December 2006 were recorded. Patients with neurological deficity and medically stable for surgery underwent immediate stabilization within 8 h defined as group I ( n  = 12) and patients underwent operation in 3–15 days after thoracolumbar injury were defined as group II ( n  = 15). Patients were assessed for neurologic deficit and improvement as defined by the scoring system of American spinal injury association (ASIA). Results In spite of comparable demographic data, patients in group I had a significantly shorter overall hospital and intensive care unit stay and had lesser systemic complications such as pneumonia and also exhibited better neurological improvement than group II ( p  
ISSN:0936-8051
1434-3916
DOI:10.1007/s00402-007-0518-1