engleski

Immediate decompression of spinal cord in a county hospital versus delayed decompression in spinal center

Background of the study .The role of early spinal cord decompression for the treatment of cervical spinal cord injury is controversial .Pilot study that evaluated protocol for decompressive surgery within 8 hours showed that the proposed trial is unfeasible.The aim of our study is comparison of time interval between injury and surgical decompression of the patient treated in nearest community hospital and the patients that were trasfered to the Level I trauma center in Croatia, a moderate-income country. Methods. Patients that sustained cervical spine fracture dislocation with total sensomotor deficit below injury level at admission in hospital were included in the study. Protocol group (No=12) patients were treated in County Hospital Pula Croatia.The control group was comprised of surgically treated patients in the Clinical Hospital for Traumatology, transported by car following initialy admition in the nearest community hospital . In protocol group X-ray and CT scan were performed while control group patients were evaluated by CT-myelography or MRI. Results. The average time from injury to the surgical decompression was significantly shorter in the protocol group. Among 12 protocol group patients 10 were men and 2 were women while in control group all 12 patients were men. Median (range, hours) from accident to surgery in protocol group was 6h (2 1/2- 9) while in control was 18 (10- 24).There were no neurological improvement in the control group while two patients in the protocol group recovered their neurological function. Conclusion. Our study showed that spinal cord decompression is possible inside the proposed 8 hours if decompression is performed in the nearest hospital.

spinal cord injury; decompression

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