Spinal injuries with tetraplegia and paraplegia

Bedbrook, George M.

doi:10.1302/0301-620x.61b3.225332

Cited by 109 publications

(32 citation statements)

References 137 publications

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“…This point has been hotly debated on both sides, mostly on the basis of each author's personal experi ence. 19 far devised has been subjected to the rigor ous examination similar to that which was done for methylprednisolone and found to be superior to other operative procedures or to none at all. Although some investigators feel that neural damage is in fact caused by bony damage or dislocation, 6 7 it is important to remember that spinal cord injury can occur even in the absence of bony damage, particularly in older age groups, as has been pointed out by Hardy.…”

Section: Neurological Recoverymentioning

confidence: 99%

Operative and nonoperative management of spinal cord injury. A review

Donovan

1994

Spinal Cord

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Section: Neurological Recoverymentioning

confidence: 99%

Operative and nonoperative management of spinal cord injury. A review

Donovan

1994

Spinal Cord

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“…5,6 Various investigators have also reported spontaneous neurological recovery in the conservatively managed group. [7][8][9] Neurological deterioration following spinal surgery was observed in the past. This was because decompressive laminectomy was being performed without any stabilization of the cervical spine.…”

Section: Introductionmentioning

confidence: 99%

Neurological outcome in surgically treated patients with incomplete closed traumatic cervical spinal cord injury

et al. 2008

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Study design: Retrospective study based on a reference paper. Neurological outcome in patients who were managed surgically with closed traumatic cervical spine injury was evaluated using the ASIA motor scoring system and Frankel grading. Objectives: To assess the accuracy of motor charting and Frankel grading as tools to evaluate neurological outcome in closed traumatic cervical spine injury, and also to evaluate how the surgically treated patients fared in their neurological recovery by measurement tools as in the reference paper. Setting: National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, UK. Method: Fifty-seven patients were admitted within 2 days of the injury with closed traumatic cervical spine injuries (1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004). Thirty-seven (65%) met the inclusion criteria as per the referenced paper, that is, were treated surgically, were Frankel grade B and above and had at least 12 months follow up. The remaining 20 patients were not included as they did not meet the inclusion criteria. The breakdown of the 20 patients is given in Table 1. The mean recovery percentage (MRP) and mean deficit percentage (MDP) were calculated as per the referenced paper. Results: An evaluation of 37 patients surgically treated, who had follow up of at least 12 months, showed that preservation of pin prick below the level of lesion, and preservation of anal tone and perianal sensation were good prognostic indicators. There was no correlation between degree of encroachment of canal or the degree of kyphosis to MDP or MRP. The mean time from injury to mobilization was 7.6 days in 25 out of 37 patients. Twelve of the 37 patients had prolonged immobilization because of ITU stay or because they were initially treated conservatively. Three out of the 37 patients developed DVT/PE. Mean hospital stay was 6.4 months. Conclusion: The neurological outcome in surgically treated patients is comparable to the conservatively treated patients. The Frankel grading and ASIA motor charting combined is a powerful tool in assessing the neurological outcome in closed traumatic cervical spinal injured patients. Until now there has been no evidence to suggest that the obvious advantages of surgical management of closed cervical spine injuries (better alignment, easier manual handling and early mobilization) is traded for poorer neurological outcome.

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“…Anatomical reduction and neurological improvement was increased and there was a reduction in time to wheelchair mobilization, time for rehabilitation and of complications. Bedbrook (1979) cites several authors who advocate less surgical intervention.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of acute surgical intervention in traumatic paraplegia

Wilmot

Hall²

1986

Spinal Cord

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SummaryA retrospective study was conducted over a two-year perod of 95 consecutive admissions for traumatic paraplegia. The average age was 32 years. Seventy-two (76%) of these patients had acute surgical intervention. Fifty had Harrington rod placement with posterior fusion, 10 had additional laminectomy and one had rodding and anterior fusion. Seven laminectomies (alone) were performed at other hospitals.For those with rodding and/ or fusion, rehabilitation stay was 70 days;for those with no surgery, 81 days. This difference was not statistically significant. However, when days of acute medical/surgical and rehabilitation hospitalization were combined, those having spinal surgery of any kind had a significantly shorter stay than those not having surgery (95 vs. 136 days). Complications were significantly greater in the patients who underwent internal fixation surgery. The neurological condition did not appear to be jeopardized by rodding and fusion.

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Spinal injuries with tetraplegia and paraplegia

Cited by 109 publications

References 137 publications

Operative and nonoperative management of spinal cord injury. A review

Operative and nonoperative management of spinal cord injury. A review

Neurological outcome in surgically treated patients with incomplete closed traumatic cervical spinal cord injury

Evaluation of acute surgical intervention in traumatic paraplegia

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