Sacral fractures with neurological injury: is early decompression beneficial?
During a 6-year period, 177 patients with a displaced sacral fracture were treated at our level-one trauma centre. At the initial presentation, 13 patients demonstrated a neurological deficit as a result of their sacral fracture. Six patients underwent surgical decompression, and seven patients were managed without surgical decompression. All patients were re-assessed at an average follow-up of 27.1 (range 12-84) months using the modified SOFCOT Index and the SF-36. Patients undergoing surgical decompression had a significantly better neurological improvement as measured by the modified SOFCOT Index (p=0.014). Moreover, patients undergoing surgical decompression had a significantly better physical function than the patients that were managed without surgical decompression, as measured by the SF-36 (p=0.044). We therefore believe that patients undergoing surgical decompression achieve better neurological improvement and better functional results.
Zelle
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BA
Division of Orthopaedic Traumatology, Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Kaufmann Building, Suite 1011, 3471 Fifth Avenue, PA 15213, USA. zelleba@upmc.edu
Gruen
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GS
Hunt
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Speth
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D000293:Adolescent; D000328:Adult; D019299:Decompression, Surgical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012447:Sacrum; D013117:Spinal Cord Compression / Q000209:etiology* / Q000601:surgery*; D016103:Spinal Fractures / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome