Delayed anterior decompression in patients with spinal cord and cauda equina injuries of the thoracolumbar spine.
Forty-nine patients with complete and incomplete injuries of the spinal cord or cauda equina who had undergone anterior decompression at a minimum of 3 months after injury were examined. Follow-up was from 12 months to 19 years. Postoperative neurologic improvement occurred in 46.5% of patients with incomplete injuries. If the surgery was performed less than 2 years after injury, neurologic improvement occurred in 68% with an improvement in Frankel grade of 32%. Bladder function improved in 27% of patients and if operated on less than 2 years after injury improvement occurred in 43%. Conus medullaris decompression resulted in a 50% improvement. There was an 83% improvement in the pattern of pain after decompression. Of 23 patients with preoperative spasticity, 10 improved but 6 were worse after surgery.
Transfeldt
E E
EE
Twin Cities Scoliosis Spine Center, Minneapolis, Minnesota.
White
D
D
Bradford
D S
DS
Roche
B
B
D000328:Adult; D002420:Cauda Equina / Q000293:injuries*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007738:Kyphosis / Q000209:etiology; D008159:Lumbar Vertebrae / Q000293:injuries*; D008297:Male; D009128:Muscle Spasticity / Q000209:etiology; D010146:Pain / Q000209:etiology; D013119:Spinal Cord Injuries / Q000209:etiology / Q000601:surgery*; D016103:Spinal Fractures / Q000150:complications*; D013904:Thoracic Vertebrae / Q000293:injuries*; D013997:Time Factors; D001750:Urinary Bladder, Neurogenic / Q000209:etiology