Article
Transverse spinal cord syndrom due to intraspinal space occupying lesion
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Authors
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Yvonne Mondorf
- Nordstadtkrankenhaus, Neurochirurgie, Hannover, Deutschland
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Armando Santillana
- Nordstadtkrankenhaus, Neurochirurgie, Hannover, Deutschland
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Michael Robert Gaab
- Nordstadtkrankenhaus Klinikum Region Hannover, Neurochirurgische Klinik und Poliklinik, Hannover, Deutschland
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Joachim Oertel
- Universitätsmedizin Mainz, Neurochirurgische Klinik und Poliklinik, Mainz, Deutschland
| Published: | May 17, 2010 |
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Outline
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Introduction: Transverse spinal cord syndrome could have different causes and etiologies. It is always connected with wide spread neurological symptoms caused by a compression of the myelon. The aim of the treatment should always be a decompression of the myelon.
Materials and methods: Between January 2003 und December 2007, 118 neurosurgical operative procedures were performed in 118 patients suffering from a transverse spinal cord syndrome. All patients were retrospectively followed. Special attention was paid to presurgical clinical status, the imaging, postsurgical clinical status and postoperative imaging where the postoperative decompression of the myelon is shown.
Results: A surgical procedure was performed in 118 patients (63 male, 55 female, mean age 62 years [range 22 years to 91 years]). Transverse spinal cord syndrome was caused by trauma in 19 (16.1%) patients, by tumor in 66 (55.9%) patients, by infection in nine (7.6%) patients, by intraspinal hemorrhage in eight (6.8%) patients and caused by any other reason like pathological fractures in 15 (12.7%) patients. In 32 (27.1%) cases the myelon compression was found in the cervical spine, in 67 (56.8%) cases the myelon compression was found in the thoracic spine and in 19 (16.1%) cases the myelon compression was found in the lumbar spine. There was no procedure-related morbidity and no procedure related mortality. After surgery the patients improved clinically in 84 (69.5%) cases. A Twelve patients (10.2%) died because of their severe underlying pathology. The duration from the beginning of neurological symptoms to performing decompression surgery was less than 24 hours in 37 (31.4%) cases, less than 72 hours in 19 (16.1%) cases and more than 72 hours in 62 (52.5%) cases.
Conclusion: Transverse spinal cord syndrome could have different causes but a myelon compression because of a space occupying pathology is very often found. A decompression surgery should always be performed, even if the duration of the time between the beginning of neurological symptoms and surgery would be longer than 72 hours.
