Indian Journal of Neurotrauma 2018; 15(01): 023-028
DOI: 10.1055/s-0038-1670529
Original Article
Thieme Medical and Scientific Publishers Private Ltd.

Results of Early Versus Delayed Decompression for Traumatic Cervical Spinal Cord Injury: A Single Center Prospective Study

Biswaranjan Nayak
1   Department of Neurosurgery, Apollo Hospital, Bhubaneswar, Odisha, India
,
Krishnamurthy B. H
1   Department of Neurosurgery, Apollo Hospital, Bhubaneswar, Odisha, India
,
Arun Kumar
1   Department of Neurosurgery, Apollo Hospital, Bhubaneswar, Odisha, India
,
Sushanta Kumar Patro
1   Department of Neurosurgery, Apollo Hospital, Bhubaneswar, Odisha, India
,
Prafulla Kumar Sahoo
1   Department of Neurosurgery, Apollo Hospital, Bhubaneswar, Odisha, India
,
Debabrat Biswal
1   Department of Neurosurgery, Apollo Hospital, Bhubaneswar, Odisha, India
,
Abhijeet Chandankhede
1   Department of Neurosurgery, Apollo Hospital, Bhubaneswar, Odisha, India
,
Balwant Singh
1   Department of Neurosurgery, Apollo Hospital, Bhubaneswar, Odisha, India
,
Himanshu Bhusana Nayak
1   Department of Neurosurgery, Apollo Hospital, Bhubaneswar, Odisha, India
,
Dhanwantari Shukla
1   Department of Neurosurgery, Apollo Hospital, Bhubaneswar, Odisha, India
› Author Affiliations
Funding No financial support of any other kind from anybody for this study was received.
Further Information

Publication History

Received: 04 July 2018

Accepted: 13 July 2018

Publication Date:
27 September 2018 (online)

Abstract

Objective This study was done with the aim to compare the clinical outcome and patient's quality of life between early (within 24 hours post-injury) versus delayed (after 24 hours to 7 days) surgically treated patients of acute cervical spinal cord injury. The current study was based on the hypothesis that early surgical decompression and fixations in acute cervical spinal cord trauma are safe and are associated with improved outcome as compared with delayed surgical decompression.

Methods A total of 54 patients were recruited and divided into early decompression surgery group A (operated within 24 hours of trauma; n = 25) and late/delayed decompression surgery group B (operated between 24 hours and 7 days of trauma; n = 29). The patients in both groups were followed up, and comparative differences noted in the neurological outcome, quality of life, and bony fusion.

Results The early surgery group had lesser postoperative complications. In group A, 54.17% patients had 1 American Spinal Injury Association Impairment Scale (AIS) grade improvement, while 29.17% experienced > 2 AIS grade improvement (p = 0.015). In group B, the neurological improvement was 50 and 21.43%, respectively (p = 0.003). There was a significant improvement in the postoperative quality of life scores in early surgery group.

Conclusion Early surgery in patients with acute cervical spinal cord injury should be considered strongly in view of the lesser complications, better neurological recovery, and reduced mortality.

 
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