Effects of durotomy versus myelotomy in the repair of spinal cord injury

Abstract

Current management for spinal cord injury aims to reduce secondary damage and recover sensation and movement. Acute spinal cord injury is often accompanied by spinal cord compartment syndrome. Decompression by durotomy and/or myelotomy attempts to relieve secondary damage by completelyrelieving the compression of the spinal cord, removing the necrotic tissue, decreasing edema, reducing hemorrhage, and improving blood circulation in the spinal cord. However, it is controversial whether durotomy and/or myelotomy after spinal cord injury are beneficial to neurological recovery. This review compares the clinical effects of durotomy with those of myelotomy in the treatment of spinal cord injury. We found that durotomy has been performed more than myelotomy in the clinic, and that durotomy may be safer and more effective than myelotomy. Durotomy performed in humans had positive effects on neurological function in 92.3% of studies in this review, while durotomy in animals had positive effects on neurological function in 83.3% of studies. Myelotomy procedures were effective in 80% of animal studies, but only one clinical study of myelotomy has reported positive results, of motor and sensory improvement, in humans. However, a number of new animal studies have reported that durotomy and myelotomy are ineffective for spinal cord injury. More clinical data, in the form of a randomized controlled study, are needed to understand the effectiveness of durotomy and myelotomy.

Care needs of adults with spinal trauma in the prehospital and hospital setting from the perspective of patient care team: A qualitative research

“…Finally, surgical intervention should be performed at the earliest opportunity and within 3 days after the injury, which is a golden time for neurological recovery. [ 69 70 71 72 ] The results of the present study are also in agreement with these results.…”

[Retracted] Detection and Analysis of Perfusion Pressure through Measuring Oxygen Saturation and Requirement of Dural Incision Decompression after Laminectomy

“…The occurrence of SCCS after SCI is common and leads to poor prognosis. Dural incision and duroplasty are designed to alleviate the symptoms of this SCCS [ 5 , 7 ]. With the control of SCCS and the reduction of secondary damage, patients may have better nerve recovery.…”

Significance of spinal cord perfusion pressure following spinal cord injury: A systematic scoping review

“…The full data extraction table for all 73 included articles is provided on the Open Science Framework. These articles consisted 34 original research articles, 6 , 8 , 9 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 13 conference abstracts, 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 13 literature reviews, 24 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 4 systematic reviews, 5 , 13 , 14 , 15 4 letters to the editor, 76 , 77 , ...…”