engleski

Neurodecompression of Quadriplegic Patients with Cervical Fracture Dislocation Performed within 8 Hours in County Hospital

Background: Experimental and clinical evidence suggest early neurodecompression of spinal cord injury patients, but fewer than 10% patients are treated within first 8 hours. Authors organized neurotrauma service in area with summertime increase in traffic intensity and number of straight head divers. Material and Methods: From September 1997 to December 2001, twelve quadriplegic patients with cervical fracture dislocation were surgically treated in County hospital Pula, Croatia. Injury-to-surgery time intervals were noted. Neurological findings at admission was graded according to ASIA classification. Results: At admission 10 patients were classified as ASIA A and 2 as ASIA B. Injury-to-surgery mean &plusmn ; ; ; SD time was 5.75&plusmn ; ; ; 1.16 hours. One patient died, one patient was lost for follow-up, and 7 patients are chairbound. One patient classified as ASIA A at admission recovered motor function greater than M3 and can walk with crutches. Two patients classified as ASIA B at admission returned to their premorbid job. Conclusion: Our data suggest that in local hospitals neurodecompression can be performed inside 8 hours in much than 10% of patients, with resultant improvement of motor recovery. Exact neurological deficit in first hours couldn be covered by spinal shock, definitive quadriplegia could not be predicted, and urgent neurodecompression could not be considered as unhelpful in patients classified as ASIA A at admission.

spinal cord injury; quadriplegic patients; neurodecompression; early surgical procedure; cervical region

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