scholarly journals Does surgical treatment within 4 hours after trauma have an influence on neurological remission in patients with acute spinal cord injury?

2016 ◽  
Vol Volume 12 ◽  
pp. 1339-1346 ◽  
Author(s):  
Bahram Biglari ◽  
Christopher Child ◽  
Timur Mert Yildirim ◽  
Tyler Swing ◽  
Tim Reitzel ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Surgical Treatment ◽  
Acute Spinal Cord Injury ◽  
Cord Injury

scholarly journals Application of intraoperative electrophysiological monitoring in vertebral canal decompression surgery for acute spinal cord injury

2020 ◽  
Vol 48 (6) ◽  
pp. 030006052092420
Author(s):  
Qun-Xi Li ◽  
Xiao-Jing Zhao ◽  
Xiang-Nan Li ◽  
Ai-Jun Fu ◽  
Yun-He Zhang ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Surgical Treatment ◽  
Evoked Potentials ◽  
Acute Spinal Cord Injury ◽  
Decompression Surgery ◽  
Vertebral Canal ◽  
Group I ◽  
Cord Injury ◽  
Joint Monitoring

Objective This study aimed to evaluate the joint monitoring of somatosensory evoked potentials (SEPs) and motor evoked potentials (MEPs) in vertebral canal decompression surgery for acute spinal cord injury. Methods Twenty-four patients, who were admitted to the hospital for the surgical treatment of spinal cord injury with SEP and MEP monitoring, were assigned to the intraoperative monitoring group (group I). In addition, 24 patients who were admitted to the hospital for the surgical treatment of spinal cord injury without SEP or MEP monitoring were assigned to the control group (group C). Results In group I, there were significant changes before and after decompression surgery in the P40 latency and amplitude, and in the latency of MEP in the abductor hallucis brevis (AHB), in patients with improved spinal nerve function following surgery. In contrast, there were no significant differences in the P40 latency or amplitude, or the latency of MEP in the AHB, in patients who showed no improvement after surgery. Conclusion In vertebral canal decompression surgery for acute spinal cord injury, the application of joint MEP and SEP monitoring can timely reflect changes in spinal cord function.

scholarly journals Surgical treatment for acute spinal cord injury study pilot study #2: evaluation of protocol for decompressive surgery within 8 hours of injury

1999 ◽  
Vol 6 (1) ◽  
pp. E5 ◽  
Author(s):  
Wai Pui Ng ◽  
Michael G. Fehlings ◽  
Brian Cuddy ◽  
Curtis Dickman ◽  
Mahmood Fazl ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Surgical Treatment ◽  
Pilot Study ◽  
Acute Spinal Cord Injury ◽  
Decompressive Surgery ◽  
Magnetic Resonance Imaging Examination ◽  
Major Public Health Problem ◽  
Cord Injury ◽  
Mean Time

Acute spinal cord injury (SCI) is a major public health problem for which there is still only limited treatment available. The National Acute Spinal Cord Injury Study-2 (NASCIS-2) and -3 clinical trials demonstrated that the use of acute pharmacotherapy with methylprednisolone can attenuate the secondary injury cascade if administered within 8 hours of acute SCI. However, no trial has been performed to examine whether acute surgical decompressive procedures within this critical 8-hour time window can improve patients' neurological outcome. The purpose of the current prospective Surgical Treatment for Acute Spinal Cord Injury Study (STASCIS) pilot study was to determine the feasibility of obtaining a radiological diagnosis of spinal canal compromise of 25% or more and to perform spinal cord (C3-T1) decompressive procedures by 8 hours postinjury. One of the following three decompressive methods was used: 1) traction alone; 2) traction and surgery; or 3) surgery alone. Twenty-six patients from eight North American centers were entered into the study between 1996 and 1997. Significant difficulties were encountered in many centers in performing immediate magnetic resonance imaging examination in patients with acute SCI. Fewer than 10% of acute cervical SCI patients could be enrolled into this protocol mainly because the combination of the required time for rescue, resuscitation, transport, imaging study, and surgical preparation exceeded the 8-hour injury-to-decompressive surgery window. Eleven patients underwent decompressive procedures initially by being placed in traction at a mean time of 10.9 hours postinjury. Those patients not undergoing this procedure underwent decompressive surgery at a mean time of 40.1 hours. However, the surgical decompressive procedure was completed within 12 hours in seven patients. As a result of these findings, several major changes have been made to the STASCIS protocol for early decompressive therapy.

Vasopressor support in managing acute spinal cord injury: current knowledge

2019 ◽  
Vol 63 (3) ◽  
Author(s):  
John K. Yue ◽  
Rachel E. Tsolinas ◽  
John F. Burke ◽  
Hansen Deng ◽  
Pavan S. Upadhyayula ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Current Knowledge ◽  
Acute Spinal Cord Injury ◽  
Vasopressor Support ◽  
Cord Injury

scholarly journals Role of melatonin in the dynamics of acute spinal cord injury in rats

2021 ◽  
Author(s):  
Jiaqi Bi ◽  
Jianxiong Shen ◽  
Chong Chen ◽  
Zheng Li ◽  
Haining Tan ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Acute Spinal Cord Injury ◽  
Cord Injury

“Proximalization is Advancement”—Zone 3 Frozen Elephant Trunk vs Zone 2 Frozen Elephant Trunk: A Literature Review

2021 ◽  
pp. 153857442110024
Author(s):  
Rozina Yasmin Choudhury ◽  
Kamran Basharat ◽  
Syeda Anum Zahra ◽  
Tien Tran ◽  
Lara Rimmer ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Surgical Treatment ◽  
Literature Review ◽  
Treatment Options ◽  
Frozen Elephant Trunk ◽  
Elephant Trunk ◽  
Descending Aorta ◽  
Cord Injury ◽  
Aortic Pathologies

Over the decades, the Frozen Elephant Trunk (FET) technique has gained immense popularity allowing simplified treatment of complex aortic pathologies. FET is frequently used to treat aortic conditions involving the distal aortic arch and the proximal descending aorta in a single stage. Surgical preference has recently changed from FET procedures being performed at Zone 3 to Zone 2. There are several advantages of Zone 2 FET over Zone 3 FET including reduction in spinal cord injury, visceral ischemia, neurological and cardiovascular sequelae. In addition, Zone 2 FET is a technically less complicated procedure. Literature on the comparison between Zone 3 and Zone 2 FET is scarce and primarily observational and anecdotal. Therefore, further research is warranted in this paradigm to substantiate current surgical treatment options for complex aortic pathologies. In this review, we explore literature surrounding FET and the reasons for the shift in surgical preference from Zone 3 to Zone 2.

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