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  4. Role of Decompression in Late Presentation of Cervical Spinal Cord Disorders

Role of Decompression in Late Presentation of Cervical Spinal Cord Disorders

Asian Spine Journal, 2014 · DOI: 10.4184/asj.2014.8.2.183 · Published: April 1, 2014

Spinal Cord InjurySurgeryOrthopedics

Simple Explanation

This study investigates the effectiveness of surgical decompression in patients who present late with cervical spinal cord disorders. Often, in developing countries, patients arrive late for treatment due to various socioeconomic and infrastructural limitations. The research focuses on those patients who, due to unavoidable circumstances, present to medical facilities three months after the initial spinal cord injury. The study explores whether surgical decompression can still provide neurological benefits even when performed significantly after the initial injury, particularly in regions where delayed presentation is common.

Study Duration
2 Years
Participants
11 patients with cervical spinal cord compression
Evidence Level
Level III evidence, prospective study

Key Findings

  • 1
    Anterior cervical decompression with interbody fusion is effective in improving functional outcomes, even in late-presenting incomplete quadriplegic patients.
  • 2
    The use of anterior cervical plating minimizes the risk of graft failure and provides adequate stabilization.
  • 3
    Decompression, even in late reported cases, provides the best chance for a favorable outcome, especially in posttraumatic cases without cord transactions.

Research Summary

The study evaluated the neurologic outcome after anterior decompressive surgery in late neglected cases of mechanical cervical spinal cord disorder. It focused on patients admitted 3 months after spinal cord injury who underwent anterior decompression, interbody graft placement, and stabilization. Results showed that the anterior approach for cervical decompression allows for adequate decompression, offering the best chance even in late-reported cases, including posttraumatic scenarios. The use of anterior cervical plates reduces the chances of graft loosening or collapsing. The study concludes that anterior cervical decompression with interbody fusion improves functional outcomes in incomplete quadriplegic patients and minimizes graft failure when combined with anterior cervical plating.

Practical Implications

Surgical Intervention

Even in delayed presentation of cervical myelopathy, surgical decompression should be considered.

Plate Fixation

Anterior cervical plating should be used to minimize graft failure risk and ensure adequate stabilization.

Rehabilitation

Early mobilization and rehabilitation post-surgery can contribute to improved patient outcomes.

Study Limitations

  • 1
    Small sample size
  • 2
    Lack of a control group
  • 3
    Absence of randomization

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