Neurologic outcome of early versus late surgery for cervical spinal cord injury.

Authors

• A R Vaccaro
• R J Daugherty
• T P Sheehan
• S J Dante
• J M Cotler
• R A Balderston
• G J Herbison
• B E Northrup

Publication/Presentation Date

11-15-1997

Abstract

STUDY DESIGN: A prospective analysis evaluating neurologic outcome after early versus late surgery for cervical spinal cord trauma.

OBJECTIVES: The study was conducted to determine whether neurologic and functional outcome is improved in traumatic cervical spinal cord-injured patients (C3-T1, American Spinal Injury Association grades A-D) who had early surgery (< 72 hours after spinal cord injury) compared with those patients who had late surgery (>5 days after spinal cord injury).

SUMMARY OF BACKGROUND DATA: There is considerable controversy as to the appropriate timing of surgical decompression and stabilization for cervical spinal cord trauma. There have been numerous retrospective studies, but no prospective studies, to determine whether neurologic outcome is best after early versus late surgical treatment for cervical spinal cord injury.

METHODS: Patients meeting appropriate inclusion criteria were randomized to an early (< 72 hours after spinal cord injury) or late (>5 days after spinal cord injury) surgical treatment protocol. The neurologic and functional outcomes were recorded from the acute hospital admission to the most recent follow-up.

RESULTS: Comparison of the two groups showed no significant difference in length of acute postoperative intensive care stay, length of inpatient rehabilitation, or improvement in American Spinal Injury Association grade or motor score between early (mean, 1.8 days) versus late (mean, 16.8 days) surgery.

CONCLUSIONS: The results of this study reveal no significant neurologic benefit when cervical spinal cord decompression after trauma is performed less than 72 hours after injury (mean, 1.8 days) as opposed to waiting longer than 5 days (mean, 16.8 days).

Volume

22

Issue

22

First Page

2609

Last Page

2613

ISSN

0362-2436

Published In/Presented At

Vaccaro, A. R., Daugherty, R. J., Sheehan, T. P., Dante, S. J., Cotler, J. M., Balderston, R. A., Herbison, G. J., & Northrup, B. E. (1997). Neurologic outcome of early versus late surgery for cervical spinal cord injury. Spine, 22(22), 2609–2613. https://doi.org/10.1097/00007632-199711150-00006

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

9399445

Department(s)

Administration and Leadership

Document Type

Article