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Timing of thoracolomber spine stabilization in trauma patients; impact on neurological outcome and clinical course. A real prospective (rct) randomized controlled study

  • Trauma Surgery
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Abstract

Objective

Optimal timing of stabilization for spinal injuries is discussed controversially. The goal of this study is to investigate the neurological recovery and its influencing factors in thoracolumbar spine fractures after surgical decompression and stabilization within 8 h of spinal cord injury versus surgery which is performed between 3 and 15 days.

Methods

Twenty-seven patients undergoing thoracolumbar stabilization with neurological deficit for an acute thoracolumbar spinal injury at the level of Th8-L2 vertebra at Selcuk University between March 2004 and December 2006 were recorded. Patients with neurological deficity and medically stable for surgery underwent immediate stabilization within 8 h defined as group I (n = 12) and patients underwent operation in 3–15 days after thoracolumbar injury were defined as group II (n = 15). Patients were assessed for neurologic deficit and improvement as defined by the scoring system of American spinal injury association (ASIA).

Results

In spite of comparable demographic data, patients in group I had a significantly shorter overall hospital and intensive care unit stay and had lesser systemic complications such as pneumonia and also exhibited better neurological improvement than group II (p < 0.05).

Conclusion

Early surgery may improve neurological recovery and decrease hospitalization time and also additional systemic complications in patients with thoracolomber spinal cord injuries. Thus early stabilization of thoracolumbar spine fractures within 8 h after trauma appears to be favorable.

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Authors and Affiliations

  1. Neurosurgery Department, Meram Faculty of Medicine, Selcuk University, A/5 Meram Akyokuş, 42080, Konya, Turkey

    Şahika Liva Cengiz, Erdal Kalkan, Kemal Ilik & Alper Basefer

  2. Emergency Department, Meram Faculty of Medicine, Selcuk University, Konya, Turkey

    Aysegul Bayir

Authors
  1. Şahika Liva Cengiz
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  2. Erdal Kalkan
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  3. Aysegul Bayir
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  4. Kemal Ilik
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  5. Alper Basefer
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Correspondence to Şahika Liva Cengiz.

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Cengiz, Ş.L., Kalkan, E., Bayir, A. et al. Timing of thoracolomber spine stabilization in trauma patients; impact on neurological outcome and clinical course. A real prospective (rct) randomized controlled study. Arch Orthop Trauma Surg 128, 959–966 (2008). https://doi.org/10.1007/s00402-007-0518-1

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  • DOI: https://doi.org/10.1007/s00402-007-0518-1

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