Clin Orthop Surg.  2018 Dec;10(4):448-454. 10.4055/cios.2018.10.4.448.

The Importance of Early Surgical Decompression for Acute Traumatic Spinal Cord Injury

• Lee DY
• Park YJ
• Song SY
• Hwang SC
• Kim KT
• Kim DH

• KMID: 2426530
• DOI: http://doi.org/10.4055/cios.2018.10.4.448

Abstract

BACKGROUND
Traumatic spinal cord injury (SCI) is a tragic event that has a major impact on individuals and society as well as the healthcare system. The purpose of this study was to investigate the strength of association between surgical treatment timing and neurological improvement.
METHODS
Fifty-six patients with neurological impairment due to traumatic SCI were included in this study. From January 2013 to June 2017, all their medical records were reviewed. Initially, to identify the factors affecting the recovery of neurological deficit after an acute SCI, we performed univariate logistic regression analyses for various variables. Then, we performed a multivariate logistic regression analysis for variables that showed a p-value of < 0.2 in the univariate analyses. The Hosmer-Lemeshow test was used to determine the goodness of fit for the multivariate logistic regression model.
RESULTS
In the univariate analysis on the strength of associations between various factors and neurological improvement, the following factors had a p-value of < 0.2: surgical timing (early, < 8 hours; late, 8-24 hours; p = 0.033), completeness of SCI (complete/incomplete; p = 0.033), and smoking (p = 0.095). In the multivariate analysis, only two variables were significant: surgical timing (odds ratio [OR], 0.128; p = 0.004) and completeness of SCI (OR, 9.611; p = 0.009).
CONCLUSIONS
Early surgical decompression within 8 hours after traumatic SCI appeared to improve neurological recovery. Furthermore, incomplete SCI was more closely related to favorable neurological improvement than complete SCI. Therefore, we recommend early decompression as an effective treatment for traumatic SCI.

Keyword

Spine; Injury; Spinal cord injuries; Decompression

MeSH Terms

Decompression
Decompression, Surgical*
Delivery of Health Care
Humans
Logistic Models
Medical Records
Multivariate Analysis
Smoke
Smoking
Spinal Cord Injuries*
Spinal Cord*
Spine
Smoke

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