Surgical intervention combined with weight-bearing walking training promotes recovery in patients with chronic spinal cord injury: a randomized controlled study

Neural Regeneration Research, 2024 · DOI: https://doi.org/10.4103/NRR.NRR-D-23-01198 · Published: January 31, 2024

Spinal Cord Injury Surgery Rehabilitation

Simple Explanation

This study investigates whether surgery combined with weight-bearing walking training can help patients with chronic spinal cord injuries recover. The surgical intervention aimed to detether the spinal cord, restore cerebrospinal fluid flow, and reduce spinal cord compression. The study found that surgery plus walking training led to more improvement, reduced spasticity, and faster recovery of bowel and bladder function compared to walking training alone.

Study Duration

12 months

Participants

30 patients with chronic complete thoracic spinal cord injury

Evidence Level

Level 1, Randomized Controlled Trial

Key Findings

1
Surgical intervention plus weight-bearing walking training was associated with a higher incidence of American Spinal Injury Association Impairment Scale improvement.
2
Surgery combined with weight-bearing walking training resulted in reduced spasticity in patients with chronic spinal cord injury.
3
Surgical intervention combined with rehabilitation led to more rapid bowel and bladder functional recovery than weight-bearing walking training alone.

Research Summary

This randomized controlled trial evaluated the efficacy of surgical intervention combined with weight-bearing walking training in patients with chronic complete thoracic spinal cord injury. The study found that surgery plus weight-bearing walking training led to a higher incidence of ASIA Impairment Scale improvement, reduced spasticity, and faster bowel and bladder functional recovery. The authors conclude that surgery combined with rehabilitation appears to have a role in the treatment of chronic spinal cord injury patients, particularly those with T7-T11 injuries.

Practical Implications

Clinical Practice

Surgical intervention alongside rehabilitation may be a viable treatment option for chronic SCI patients, especially those with specific MRI abnormalities.

Future Research

Larger-scale studies are needed to replicate these findings and evaluate the long-term benefits of surgical intervention and intensive rehabilitation.

Patient Selection

MRI assessment is crucial for determining the suitability of surgical intervention, with specific abnormalities favoring intervention and others contraindicating it.

Study Limitations

1
Relatively small sample size
2
Clinical neurological deterioration before surgery was not required for enrollment.
3
Most changes occurred within 2 to 3 months; perhaps a shorter program would be effective.

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