Angelica Alvarez Reyes , Sruti Bandlamuri , Travis M. Dumont , Venkat Ganapathy , R. John Hurlbert
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引用次数: 0
Abstract
Background
Guidelines for the management of acute spinal cord injury are based on a young age group suffering spinal fracture dislocations caused by high-impact trauma. The purpose of this study was to characterize our recent cervical spinal cord injury (cSCI) experience and compare it to this traditional demographic. We hypothesized that most cSCI patients now fall outside the scope of published guideline principles.
Methods
Cross-sectional cohort study. A detailed review was performed of cSCI patients admitted to our level 1 trauma institution over a 12-month period identifying demographics, injury types, and coded diagnoses cross-referenced from multiple archival systems
Results
Fifty-one patients with cSCI from blunt trauma were identified over the 1-year study period of which 82% did not have a spinal fracture or dislocation. cSCI patients without fracture/dislocation were older (mean age 62), had low-impact injuries (93%), and lower American Spinal Injury Association grades (98%). Patients with fracture/dislocation were younger (mean age 48), had high-impact injuries (77%), and higher American Spinal Injury Association grades (66%). Ninety-eight percent of our cSCI patients without fracture/dislocation presented with sensory and motor changes preferentially involving hands and arms in contrast to 11% of patients with fracture dislocation (P < 00001).
Conclusions
cSCI patients without fracture/dislocation now represent the large majority of spinal cord injuries at our level I trauma center. The demographic is most consistent with central cord syndrome, implicating unique pathophysiology and natural history. Extrapolation of management principles from previous guideline efforts is not intuitively generalizable to this patient population.
期刊介绍:
World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review.
The journal''s mission is to:
-To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care.
-To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide.
-To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients.
Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS