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| ZHU Dezhou,GAO Jie,LI Lianhua.Prognostic factors of surgical treatment for acute traumatic central cord syndrome[J].Chinese Journal of Spine and Spinal Cord,2018,(11):975-981. |
| Prognostic factors of surgical treatment for acute traumatic central cord syndrome |
| Received:August 16, 2018 Revised:October 20, 2018 |
| English Keywords:Acute traumatic central cord syndrome Cervical surgery Prognosis Spinal cord injury |
| Fund:军队医学科研计划创新工程专项（项目编号：16CXZ002） |
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| English Abstract: |
| 【Abstract】 Objectives: To investigate the effectiveness of surgical treatment of acute traumatic central cord syndrome(ATCCS), and to analyze the factors of affecting postoperative spinal cord function recovery. Methods: Totally 53 patients with ATCCS who underwent orthopedic surgical treatment in our hospital from 2015 to 2017 were reviewed, including age, gender, pathological signs, intrinsic muscle strength of hand at admission, paravertebral soft tissue injury, the length of high signal in spinal cord, maximum canal compromise(MCC), maximum spinal cord compression(MSCC), the interval from injury to surgery, surgical approach, the ASIA score(motor, sensory) and JOA score at admission and the final follow-up. The factors of affecting postoperative spinal cord function recovery were analyzed. Results: In the cohort of 53 patients, the mean age was 55.57±9.68 years, 39 patients were males(74%), 14 patients were females(26%). The average interval from injury to surgery was 6.85±5.39 days. 19 cases underwent anterior surgery, 34 cases underwent posterior surgery. The results showed that the old age(61.14±7.55 vs 53.56±9.65 years old), the intrinsic muscle strength of hand was poor(5.43±5.95 vs 9.49±4.99 points), pathological signs were positive(positive/negative)(10/4 vs 15/24 cases), the T2-weighted MR showed paravertebral soft tissue injury(8/6 vs 9/30 cases) and long length of high signal in spinal cord(25.87±13.85mm vs 18.08±10.68mm) were the main factors for poor prognosis(P<0.05). And gender(29/10 vs 10/4 cases), MCC[(43.18±10.96)% vs (49.14±7.94)%], MSCC[(26.75±10.81)% vs (28.67±9.59)%], admission ASIA motor score(74.18±22.78 vs 60.00±22.35 points), admission ASIA sensory score(101.38±8.93 vs 93.14±16.38 points), the interval from injury to surgery(7.51±5.87 vs 5.00±3.23 points), surgical approach(15/24 vs 4/10 cases) had no significant effect on prognosis(P>0.05). Conclusions: Surgical treatment is safe and effective for ATCCS. Advanced age, positive pathology, low intrinsic muscle strength of hand at admission, injured paravertebral soft tissue and long high signal length in spinal cord indicate that the spinal cord function recovery is poor after operation. |
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