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

Abstract

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

Spinal Cord Injury: A Systematic Review of Current Treatment Options

“…The risks include aggravating secondary injury by hypotensive episodes or blood loss. Several studies point out that patients should be treated with early surgery if medically stable to do so [2,11]. Clinical benefits of early surgery possibly include shorter length of both ICU and overall hospital stay with fewer medical complications (such as pneumonia and DVT) [60].…”

“…This measurement considers not only the severity of injury, but also the accessibility of the medical system at stabilizing the patient and allowing them to proceed with rehabilitation. Of the 22 clinical studies identified in this review, nine Level III studies measured the length of stay [7,11,14,16,27,32,37,40,42,52]. Early surgical decompression was associated with a shorter hospital length of stay in eight studies [7,14,16,27,32,37,40,42] (although Guest et al [27] reported no p values), whereas the other only recorded the length of stay in the ICU [52].…”

“…We identified two Level II studies [11,62]. Vaccaro and others [62] studied 62 patients who presented with a spinal injury between C3 and T1.…”

“…These authors found no difference between groups with regard to the length of stay in the intensive care unit or inpatient rehabilitation and no difference with regard to the American Spinal Injury Association (ASIA) motor score. In contrast, Cengiz et al [11] studied 27 patients who sustained a traumatic SCI from T8 to L2. They defined early surgery as that occurring within 8 hours of injury and late surgery as that occurring from 3 to 15 days after surgery.…”

Spinal cord injury and its treatment: current management and experimental perspectives

“…Early surgery does not appear to be associated with an increased rate of complications [99]. However, clinical evidence for increased neurological recovery remains, at best, tenuous based on the existing trials [100][101][102][103][104].…”