Inﬂuence of early extensive posterior decompression on hyponatremia and cardiopulmonary dysfunction after severe traumatic cervical spinal cord injury

Medicine, 2020 · DOI: http://dx.doi.org/10.1097/MD.0000000000021188 · Published: July 17, 2020

Simple Explanation

This study investigates how early surgery to relieve pressure on the spinal cord from the back of the neck affects complications like low sodium levels and heart/lung problems after severe spinal cord injuries in the neck. The study reviewed records of patients who had this surgery within 24 hours of their injury and looked at whether they developed these complications and how their spinal cord function improved. The findings suggest that this early surgery might help reduce these complications and improve recovery of spinal cord function.

Study Duration

January 2009 to January 2018

Participants

97 patients with severe traumatic cervical spinal cord injury

Evidence Level

Observational Study

Key Findings

1
Early expansive posterior decompression significantly reduces the incidence of hyponatremia, hypotension, and tracheotomy by promoting recovery of spinal cord function after severe tcSCI.
2
A significant increase in the rate of AIS one-grade conversion (80.4%) at discharge.
3
The incidence of hyponatremia (41.2%) and hypotension (13.4%) in tcSCI patients who underwent early extensive posterior decompression surgery was significantly lower than that in other studies.

Research Summary

This retrospective study analyzed the impact of early extensive posterior decompression on complications in patients with severe traumatic cervical spinal cord injury (tcSCI). The study found that early expansive posterior decompression significantly reduces the incidence of hyponatremia, hypotension, and tracheotomy by promoting recovery of spinal cord function. The results also showed a significant increase in the rate of AIS grade conversion at discharge, suggesting improved neurological recovery.

Practical Implications

Clinical Practice

Early extensive posterior decompression may be a beneficial surgical approach for managing severe tcSCI to reduce complications and improve neurological outcomes.

Future Research

Larger, prospective controlled studies are needed to validate these findings and compare different surgical approaches.

Patient Care

Awareness of potential complications like hyponatremia and hypotension is crucial in the acute management of tcSCI patients, and early intervention may improve outcomes.

Study Limitations

1
Lack of comparison between conservative treatment and surgical treatment.
2
The effects of drinking water, sodium intake and dexamethasone on blood sodium were not eliminated.
3
The inﬂuence of a history of hypertension and heart disease on BP and HR was not analyzed.

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