gms | German Medical Science

72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

06.06. - 09.06.2021

Functional outcomes in individuals undergoing very early (< 5 h) and early (5-24 h) surgical decompression in traumatic cervical spinal cord injury – analysis of neurological improvement from the Austrian spinal cord injury study

Lässt sich bei cervicaler Rückenmarksverletzung durch eine chirurgische Dekompression innerhalb von 5 Stunden ein besseres neurologisches Outcome erzielen als innerhalb von 24 Stunden?

Meeting Abstract

  • presenting/speaker Georg Mattiassich - Unfallkrankenhaus Steiermark, Orthopädie und Traumatologie, Graz, Österreich
  • Iris Leister - Paracelsus Medizinische Universität Salzburg, Spinal Cord Injury and Tissue Regeneration Center Salzburg, Salzburg, Österreich
  • Thomas Haider - Medizinische Universität Wien, Orthopädie und Traumatologie, Wien, Österreich
  • Wolfgang Hitzl - Paracelsus Medizinische Universität Salzburg, Biostatistik und Forschungsbüro, Salzburg, Österreich
  • Thomas Freude - Paracelsus Medizinische Universität Salzburg, Spinal Cord Injury and Tissue Regeneration Center Salzburg, Salzburg, Österreich; Universitätsklinik Salzburg, Orthopädie und Traumatologie, Salzburg, Österreich
  • Herbert Resch - Paracelsus Medizinische Universität Salzburg, Spinal Cord Injury and Tissue Regeneration Center Salzburg, Salzburg, Österreich
  • Ludwig Aigner - Paracelsus Medizinische Universität Salzburg, Spinal Cord Injury and Tissue Regeneration Center Salzburg, Salzburg, Österreich
  • presenting/speaker Stephanie Aschauer-Wallner - Paracelsus Medizinische Universität Salzburg, Spinal Cord Injury and Tissue Regeneration Center Salzburg, Salzburg, Österreich; Universitätsklinik Salzburg, Orthopädie und Traumatologie, Salzburg, Österreich

Deutsche Gesellschaft für Neurochirurgie. 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie. sine loco [digital], 06.-09.06.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocV041

doi: 10.3205/21dgnc043, urn:nbn:de:0183-21dgnc0432

Published: June 4, 2021

© 2021 Mattiassich et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

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Objective: Our study aim was to assess the neurological outcomes of surgical decompression and stabilization within 5 and 24h after injury.

Methods: We performed a multi-center, retrospective cohort study in adolescents and adults 15-85 years of age presenting cervical spinal cord injury (CSCI) at one of 6 Austrian trauma centers participating in the Austrian Spinal Cord Injury Study (ASCIS). Neurological outcomes were measured using the American Spinal Injury Association Impairment Scale (AIS) grade according to the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) form after at least 6 months of follow-up (FU).

Results: Of the 49 enrolled patients with acute CSCI, 33 underwent surgical decompression within 5 h (mean 3.2 h ± 1.1 h; very early group) after injury, and 16 underwent surgical decompression between 5 and 24 h (mean 8.6 h ± 5.5 h; early group). Significant neurological improvement was observed among the entire study population between the preoperative assessment and the FU (p=0.0002). We identified a significant difference in the AIS grade at the last FU between the groups the using Jonckheere-Terpstra test for doubly ordered crosstabs (p = 0.011) and significantly different AIS improvement rates in the early group (p=0.018). Improvement by one AIS grade was observed in 31% and 42% of the patients in the early and very early groups, respectively (p=0.54). Improvement by two AIS grades was observed in 31% and 6% of the patients in the early and very early groups, respectively (p=0.03). Improvement by three AIS grades was observed in 6% and 3% of patients in the early and very early groups, respectively (p=1.0).

Conclusion: Decompression of the spinal cord within 24 h after SCI was associated with an improved neurological outcome. No additional neurological benefit was observed in patients who underwent decompression within 5h of injury.