Effectiveness of different surgical methods in the treatment of acute central cord syndrome without fractures and dislocations of the cervical spine

Journal of Back and Musculoskeletal Rehabilitation, 2023 · DOI: 10.3233/BMR-210377 · Published: January 1, 2023

Simple Explanation

This study evaluates two surgical methods for treating acute central cord syndrome (ACCS) without fractures or dislocations: anterior cervical discectomy and fusion, and posterior cervical laminectomy. Patients with ACCS were divided into two groups, each receiving one of the surgical treatments, and their outcomes were compared based on ASIA classification and motor scores. The study found that both surgical methods improved ASIA classification, motor scores, and sensory scores, suggesting that the choice of method should depend on the patient's specific condition.

Study Duration

7 years (May 2012 to October 2019)

Participants

164 patients with ACCS without fracture or dislocation

Evidence Level

Not specified

Key Findings

1
Both anterior cervical discectomy and fusion and posterior cervical laminectomy significantly improved ASIA classification, motor scores, and sensory scores in ACCS patients.
2
No significant differences were found in ASIA classification and motor scores between the two surgical groups at admission (P > 0.05).
3
One year after surgery, the ASIA motor scores and sensory scores were not statistically significant between the two groups (P > 0.05).

Research Summary

The study aimed to evaluate the effectiveness of anterior cervical discectomy and fusion versus posterior cervical laminectomy in treating acute central cord syndrome (ACCS) without fractures or dislocations. The results indicated that both surgical methods led to significant improvements in ASIA classification, motor scores, and sensory scores, with no significant differences between the two groups one year after surgery. The conclusion suggests that the choice of surgical method should be based on the individual patient's condition, as both approaches can effectively improve neurological outcomes.

Practical Implications

Personalized Treatment Approach

Surgeons should consider individual patient conditions when selecting between anterior cervical discectomy and fusion and posterior cervical laminectomy for ACCS.

Early Surgical Intervention

Early surgical intervention can improve outcomes for ACCS patients by reducing spinal cord edema and improving blood circulation.

Comprehensive Patient Assessment

Thorough patient assessment, including imaging and clinical evaluation, is crucial for determining the most appropriate surgical strategy.

Study Limitations

1
The study lacks detailed analysis of postoperative complications.
2
The sample size is relatively small, limiting the generalizability of the findings.
3
Elderly patients were not included in the study, restricting applicability to older populations.

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