AI Summary & Key Takeaways
AI InsightIn this study, the American Spinal Cord Injury Association (ASIA) scale wasused to evaluate the neurologic status of the patients and neurologic evaluation was performedbefore and after surgery according to the criteria proposed by the Japanese OrthopedicAssociation (JOA).Results: The review indicated that there were chiefly 3 groups of preexisting factors asfollows: (1) Type I(20%): disc herniation or segmental instability. (2) Type II(52%):obviousdecrease or even disappearance of the storing space of spinal canal, including congenitalspinal canal stenosis, multi-segmental cervical spondylosis, ossification of the posteriorlongitudinal ligament (OPLL) (3) Type III(28%): decrease of the storing space of spinal canalcombined with segmental instability or disc herniation .The postoperative follow-ups for thesurgical treatment showed that neurologic status had been improved significantly in more than80% of the patients with SCIWORET and the mean recovery rate with the JOA score was57.9% in Type I, 51.5% in Type II and 48.2% in Type III.Conclusions: Classification for SCIWORET according to preexisting factors may be used asa basic guidance for surgical decision-making and good outcomes can be achieved.
📌 3 Key Takeaways
Abstract
Objective: To evaluate retrospectively the preexisting factors, classification andcorresponding surgical treatments for spinal cord injury without radiologic evidence of trauma(SCIWORET).Methods: Seventy-five patients with SCIWORET were reviewed to analyze theirdemographic information, mechanisms of injury, neurologic status, imaging manifestation,and surgical management along with outcome. Classification for SCIWORET was proposedand unique aspects of this classification system along with surgical management and outcomewas discussed. In this study, the American Spinal Cord Injury Association (ASIA) scale wasused to evaluate the neurologic status of the patients and neurologic evaluation was performedbefore and after surgery according to the criteria proposed by the Japanese OrthopedicAssociation (JOA).Results: The review indicated that there were chiefly 3 groups of preexisting factors asfollows: (1) Type I(20%): disc herniation or segmental instability. (2) Type II(52%):obviousdecrease or even disappearance of the storing space of spinal canal, including congenitalspinal canal stenosis, multi-segmental cervical spondylosis, ossification of the posteriorlongitudinal ligament (OPLL) (3) Type III(28%): decrease of the storing space of spinal canalcombined with segmental instability or disc herniation .The postoperative follow-ups for thesurgical treatment showed that neurologic status had been improved significantly in more than80% of the patients with SCIWORET and the mean recovery rate with the JOA score was57.9% in Type I, 51.5% in Type II and 48.2% in Type III.Conclusions: Classification for SCIWORET according to preexisting factors may be used asa basic guidance for surgical decision-making and good outcomes can be achieved.
Özet
Amaç: Retrospektif olarak radyolojik kanıt olmaksızın servikal spinal kord yaralanmasının(SCIWORET) öncelikli etmenleri, sınıflandırması ve eşdeğerli cerrahi tedavilerideğerlendirmek.Yöntemler: SCIWORET tanılı 75 hasta demografik bilgileri, yaralanma mekanizmaları,nörolojik durumları, görüntüleme ve cerrahi yönetimi sonuçları açılarından analiz edilerekderlendi. SCIWORET için sınıflandırma cerrahi yönetim ve sonuçları yönü ile özgünsınıflandırma sistemi tartışıldı. Bu çalışmada Amerikan Spinal Kord Yaralanma Derneğinin(ASIA) skalası ve cerrahi öncesi ve sonrası nörolojik değerlendirme için de Japon OrtopediBirliğinin (JOA) önerdiği kriterler kullanıldı.Sonuçlar: Bu çalışma temelde 3 grup öncelikli faktörün mevcudiyetini gösterdi: (1) Tip I(%20) : Disk fıtıklaşması ve segmental instabilite. (2) Tip II (%52): Posterior LongitidunalLigaman Kalsifikasyonu (OPLL), multisegmental servikal spondiloz, kongenital spinal stenozdahil spinal kanalın yedekleme aralığının kaybolması ya da belirgin derecede azalması. (3)Tip III (%28): Spinal kanalın yedekleme aralığının kaybı yanı sıra segmental instabilite veyadisk fıtıklaşması. Cerrahi tedavinin postoperative izleminde SCIWORET hastalarının%80inden fazlasında nörolojik durumun önemli ölçüde düzeldiği ve ortalama şifa oranınınJOA skoruna gore Tip I için %57,9, Tip II için % 51,5 ve Tip III için ise %48,2 olduğunugösterdi.Yargı: Öncelikli faktörlere göre bir temel kılavuz olarak SCIWORET sınıflaması cerrahikarar verme ve iyi sonuçlar elde etmede bir temel kılavuz olarak kullanılabilir.