Recurrent Neurological Deterioration after Conservative Treatment for Acute Traumatic Central Cord Syndrome without Bony Injury: Seventeen Operative Case Reports

Jin, Wenjie; Sun, Xin; Shen, Kangping; Wang, Jia; Liu, Xing Zhen; Shang, Xiaoqiang; Tao, Hairong; Zhu, Tao

doi:10.1089/neu.2016.4706

Cited by 19 publications

(12 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The clinical manifestation of TCSS is that the symptoms of nerve damage in the upper limbs are more severe than in the lower limbs, and the dysfunction of the distal limbs is more severe than the proximal ones. In terms of sensory function, there is a sensory separation, that is, deep sensation and position sensation exist, and pain and temperature sensation absent [15], [16], [132]- [134]. These features of TCCS are of great significance for the diagnosis of cervical hyperextension injury.…”

Section: Discussionmentioning

confidence: 99%

“…For patients with severe initial neurological deficits, surgical treatment is more effective than conservative treatment [14]- [16]. Early surgery can relieve cervical spinal cord compression and restore the normal anatomical structure of the cervical spinal canal, thereby improving the treatment effect, shortening the length of hospital stay, reducing the occurrence of complications, and reducing the cost of treatment [16], [17]. Therefore, patients with cervical hyperextension injuries need to be diagnosed quickly and accurately and treated immediately.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Predicting Cervical Hyperextension Injury: A Covariance Guided Sine Cosine Support Vector Machine

et al. 2020

View full text Add to dashboard Cite

This study proposes an effective intelligent predictive model for prediction of cervical hyperextension injury. The prediction model is constructed by combing an improved sine cosine algorithm (SCA) with support vector machines (SVM), which is named COSCA-SVM. The core of the developed model is the COSCA method that combines the opposition-based learning mechanism and covariance mechanism to boost and recover the exploratory competence of SCA. The proposed COSCA approach is utilized to optimize the two critical parameters of the SVM, and it is also employed to catch the optimal feature subset. Based on the optimal parameter combination and feature subset, COSCA-SVM is able to make self-directed prediction of cervical hyperextension injury. The proposed COSCA was compared with other well-known and effective methods using 23 benchmark problems. Simulation results verify that the proposed COSCA is significantly superior to studied methods in dealing with majority of benchmark problems. Meanwhile, the proposed COSCA-SVM is compared with six other machine learning approaches considering a reallife dataset. Results have shown that the proposed COSCA-SVM can achieve better classification routine and higher stability on all four indicators. Therefore, we can expect that COSCA-SVM can be a promising building block for predicting cervical hyperextension injury.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Predicting Cervical Hyperextension Injury: A Covariance Guided Sine Cosine Support Vector Machine

et al. 2020

View full text Add to dashboard Cite

show abstract

“…29 For late neurologic deterioration after conservative treatment for CCS, Jin and colleagues suggested that patients could achieve a good neurologic outcome with spinal decompression. 30 As surgical and anesthetic techniques have improved, surgical decompression in patients with CCS has become safer and more effective. Yousefifard et al found that early spinal decompression surgery improved neurologic recovery and was associated with fewer postsurgical complications.…”

Section: Discussionmentioning

confidence: 99%

“…For 17 patients with secondary neurologic deterioration after conservative treatment for CCS, who had recovered to nearly normal neurologic status, Jin and colleagues suggested that cervical instability was responsible for the secondary deterioration, confirmed by a higher ratio of ruptures of anterior longitudinal ligament, posterior longitudinal ligament, and disks found during surgery. 30 Therefore, surgery with spinal cord decompression and spinal fixation may improve neurologic recovery and prevent further spinal cord damage and subsequent neurologic deterioration. 24 In this study, patients diagnosed with CCS, combined with evidence of radiologic compression and spinal instability, underwent diskectomy or cervical corpectomy plus bone graft for spinal fusion with anterior internal fixation in 65 cases and posterior decompression with pedicle screws instrumentation in 6 cases.…”

Section: Discussionmentioning

confidence: 99%

Effect of Surgical Intervention on Neurologic Recovery in Patients with Central Cord Syndrome

Zhao

Zhu

et al. 2020

J Neurol Surg A Cent Eur Neurosurg

View full text Add to dashboard Cite

To review the experience of managing central cord syndrome (CCS) surgically, we retrospectively reviewed 71 patients from October 2015 to April 2017. Deteriorating neurologic status with evidence of radiologic compression and spinal instability were absolute indications for surgery. The American Spinal and Injury Association (ASIA) motor scores (AMS) were recorded at the time of admission (aAMS), 3 days postoperatively (3dAMS), 1 month postoperatively(1mAMS), and at final follow-up (fAMS). Analysis of variance was performed to compare 3dAMS, 1mAMS, and fAMS. Surgery was successful in all 71 patients without re-injury of the spinal cord, infection, or other perioperative complications. The postoperative AMS at 3 days, 1 month, and at the final follow-up significantly improved over preoperative scores. ASIA sensory scores at fAMS were significantly better than 3dAMS and1mAMS scores. The ASIA motor and sensory scores at 1mAMS showed no significant improvements compared with the 3dAMS. Therefore, for patients diagnosed with CCS, combined with evidence of radiologic compression and spinal instability, surgery was beneficial in terms of gains in neurologic recovery.

show abstract

“…For these patients, conservative treatment is the main option, but problems such as a long treatment cycle, a high complication rate, high mortality, and long-term functional decline are common [4, 5]. Therefore, most clinicians prefer early surgical intervention [2].…”

Section: Introductionmentioning

confidence: 99%

Early and short-segment anterior spinal fusion for cervical spinal cord injury without fracture and dislocation can achieve more significant neurological recovery: a retrospective study based on the current medical system in southern China

et al. 2019

J Orthop Surg Res

View full text Add to dashboard Cite

ObjectiveThe purpose of this study was to investigate the effects of the number of fused segments, the timing of surgery and their interaction on the prognosis of patients with cervical spinal cord injury without fracture and dislocation (CSCIWFD), and to determine the appropriate time restrictions for early surgery in CSCIWFD patients based on the current diagnosis and treatment system in southern China.MethodsCSCIWFD patients who underwent anterior cervical decompression and internal fusion (ACDF) from January 2012 to June 2017 were selected. The patients were grouped according to the timing of surgery and the number of fused segments and evaluated based on their American Spinal Injury Association (ASIA) score, ASIA impairment scale, and Japanese Orthopaedic Association (JOA) score before and after surgery. SPSS22.0 software was used for the statistical analysis.ResultsThe ASIA score, JOA score, and ASIA impairment scale in all follow-ups were significantly higher than before surgery (p < 0.05). The ASIA and JOA scores at 6, 12, and 24 months after surgery of the patients who underwent ACDF within 72 h were significantly better than those of the patients who underwent ACDF after 72 h (p < 0.05). There were significant differences in postoperative ASIA and JOA scores at 12 and 24 months between the short-segment and three-segment fusion groups (p < 0.05). The results of the interaction between the surgical timing and the number of the fused segments showed that the postoperative ASIA and JOA scores at 6, 12, and 24 months were significantly higher in the patients who underwent early short-segment fusion than in those who underwent delayed short-segment fusion (p < 0.05). However, no statistically significant difference was found between early and delayed surgery in the patients who underwent three-segment fusion (p > 0.05).ConclusionACDF is safe and effective for the treatment of CSCIWFD. For patients with single- or double-segment injury, early (within 72 h) ACDF is associated with a more satisfactory prognosis. Due to the limitation of the small sample size, we cautiously recommend that 72 h can be used as a time limit for early surgery for CSCIWFD patients in regions where earlier surgery cannot be provided by the current diagnosis and treatment system.

show abstract

Recurrent Neurological Deterioration after Conservative Treatment for Acute Traumatic Central Cord Syndrome without Bony Injury: Seventeen Operative Case Reports

Cited by 19 publications

References 37 publications

Predicting Cervical Hyperextension Injury: A Covariance Guided Sine Cosine Support Vector Machine

Predicting Cervical Hyperextension Injury: A Covariance Guided Sine Cosine Support Vector Machine

Effect of Surgical Intervention on Neurologic Recovery in Patients with Central Cord Syndrome

Early and short-segment anterior spinal fusion for cervical spinal cord injury without fracture and dislocation can achieve more significant neurological recovery: a retrospective study based on the current medical system in southern China

Contact Info

Product

Resources

About