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  4. Posterior Hybrid Technique for the Treatment of Traumatic Cervical Spinal Cord Injury with High Signal Intensity on T2WI

Posterior Hybrid Technique for the Treatment of Traumatic Cervical Spinal Cord Injury with High Signal Intensity on T2WI

Indian Journal of Orthopaedics, 2023 · DOI: 10.1007/s43465-023-00854-1 · Published: March 28, 2023

Spinal Cord InjurySurgeryOrthopedics

Simple Explanation

Cervical spinal cord injury without vertebral fracture or dislocation (CSCI) is a condition where neurological deficits occur in the spinal cord without any bone damage. This study compares two surgical techniques, posterior hybrid technique (PHT) and anterior decompression and fusion (ADF), for treating CSCI patients with high signal intensity on T2-weighted MRI (CSCIH). The study aimed to determine if PHT is an effective treatment option and whether it is superior to ADF in improving patients' health-related quality of life and preserving cervical range of motion.

Study Duration
January 2013 to January 2017
Participants
43 CSCIH cases with PHT and 46 CSCIH cases with ADF
Evidence Level
Not specified

Key Findings

  • 1
    Patients treated with PHT showed superior cervical range of motion (CRM) at the final follow-up compared to those treated with ADF.
  • 2
    The PHT group also exhibited greater improvements in the spinal canal area residual rate (SCARR) compared to the ADF group.
  • 3
    While both groups showed significant improvements in the cross-sectional area of the spinal cord and high signal intensity ratio, no significant differences were observed between the two groups.

Research Summary

This study compared the effectiveness of posterior hybrid technique (PHT) and anterior decompression and fusion (ADF) for treating traumatic cervical spinal cord injury with high signal intensity on T2WI (CSCIH). The PHT group demonstrated superior cervical range of motion (CRM) and spinal canal area residual rate (SCARR) compared to the ADF group at the final follow-up. The study concludes that PHT is as effective as ADF for treating CSCIH, with PHT showing superiority in improving patients’ long-term health-related quality of life and preserving CRM.

Practical Implications

Surgical Choice

PHT can be considered as an effective alternative to ADF for treating CSCIH, especially when long-term quality of life and cervical range of motion are prioritized.

Rehabilitation Strategies

Rehabilitation programs should focus on maximizing cervical range of motion, particularly for patients undergoing ADF, to address the limitations observed in this study.

Further Research

Larger, multi-center studies with longer follow-up periods are needed to validate these findings and explore the potential benefits of PHT in specific patient subgroups.

Study Limitations

  • 1
    Small sample size
  • 2
    Limited follow-up time
  • 3
    Single-center study

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