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J Neurol Surg A Cent Eur Neurosurg 2023; 84(06): 570-577
DOI: 10.1055/a-1811-8201
Review Article

A Review of Strategies Associated with Surgical Decompression in Traumatic Spinal Cord Injury

Ying-Kang Zhu
1   Department of Orthopedics, The Fourth Affiliated Hospital, China Medical University, Shenyang, China
,
Fa-Tai Lu
1   Department of Orthopedics, The Fourth Affiliated Hospital, China Medical University, Shenyang, China
,
Guo-Dong Zhang
1   Department of Orthopedics, The Fourth Affiliated Hospital, China Medical University, Shenyang, China
,
Zun-Peng Liu
1   Department of Orthopedics, The Fourth Affiliated Hospital, China Medical University, Shenyang, China
› Institutsangaben
Funding This study was supported by the General program of Postdoctoral Science Foundation of China (2019M66166) and Liaoning Provincial Doctoral Start-up Foundation (20180540065) for the writing, polishing, and publication of the manuscript.
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Abstract

Traumatic spinal cord injury (TSCI) is frequent. Timely diagnosis and treatment have reduced the mortality, but the long-term recovery of neurologic functions remains ominous. After TSCI, tissue bleeding, edema, and adhesions lead to an increase in the intraspinal pressure, further causing the pathophysiologic processes of ischemia and hypoxia and eventually accelerating the cascade of secondary spinal cord injury. Timely surgery with appropriate decompression strategies can reduce that secondary injury. However, disagreement about the safety and effectiveness of decompression surgery and the timing of surgery still exists. The level and severity of spinal cord injury do have an impact on the timing of surgery; therefore, TSCI subpopulations may benefit from early surgery. Early surgery perhaps has little effect on recovery from complete TSCI but might be of benefit in patients with incomplete injury. Early decompression should be considered in patients with incomplete cervical TSCI. Patient age should not be used as an exclusion criterion for early surgery. The best time point for early surgery is although influenced by the shortest duration to thoroughly examine the patient's condition and stabilize the patient's state. After the patient's condition is fully evaluated, we can perform the surgical modality of emergency myelotomy and decompression. Therefore, a number of conditions should be considered, such as standardized decompression methods, indications and operation timing to ensure the effectiveness and safety of early surgical intervention, and promotion of the functional recovery of residual nerve tissue.

Keywords

TSCI - surgical decompression - surgical timing - functional recovery

Author Contributions

Y.Z. and Z.L. contributed to the study design, study performance, and preparation of the manuscript. Z.L. and Y.Z. contributed to literature analysis and interpretation, and preparation and revision of the manuscript. F.L. and G.Z. contributed to the study performance. All the authors read and approved the final manuscript.




Publikationsverlauf

Eingereicht: 29. Dezember 2021

Angenommen: 30. März 2022

Accepted Manuscript online:
30. März 2022

Artikel online veröffentlicht:
26. Juli 2023

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