@article{JSS4157,
author = {José Ramírez-Villaescusa and Jesús López-Torres Hidalgo and David Ruiz-Picazo and Antonio Martin-Benlloch and Pedro Torres-Lozano and Eloy Portero-Martinez},
title = {The impact of urgent intervention on the neurologic recovery in patients with thoracolumbar fractures},
journal = {Journal of Spine Surgery},
volume = {4},
number = {2},
year = {2018},
keywords = {},
abstract = {Background: We carried out an observational longitudinal retrospective study between 2000 and 2009 in 28 patients who underwent surgery for unstable vertebral fractures with neurologic deficits.
Methods: For the statistical analysis, we used the Chi2-test to compare proportions in independent groups and the exact Fisher test and the Wilcoxon test for repeated measures, and we compared the mean values using the Mann-Whitney U test at a significance level of P8 h), and neurologic status using the American Spinal Injury Association (ASIA) Impairment Scale at baseline and at the end of follow-up were assessed. We tested the ASIA score improvement at the end of follow-up using multiple regression analysis, adjusted by variables such as ISS, timing of intervention, location, approach and type of fracture.
Results: Twenty-eight patients were included in the analysis. Of the total, 11 (39.2%) underwent surgery urgently (≤8 h) and 17 (60.8%) in >8 h. The mean difference in the neurologic improvement in all patients was 0.97 (95% CI, 0.51–1.42) and was statistically significant (P=0.001). The mean difference in the neurologic improvement in patients with incomplete lesions was 1.59 (95% CI, 1.01–2.17, P=0.001). In these patients, the mean improvement for those intervened in less than 8 h was 1.73 compared to those operated on after more than 8 h (mean improve 0.47) with a difference statistically significant (P=0.007).
Conclusions: Urgent surgery was associated with neurologic improvement in patients with spinal cord injury (SCI). This improvement was mainly observed in patients with an incomplete lesion.},
issn = {2414-4630}, url = {https://jss.amegroups.org/article/view/4157}
}