Ur Razaq Mohammad Naeem, Ali Bahadar, Khan Muhammad Zahid, Waqar Muhammad, Satar Abdul, Khan Muhammad Arif
Department of Orthopaedic, Ayub Teaching Hospital, Abbottabad, Pakistan.
Department of Orthopaedic & Spine Surgery, Hayatabad Medical Complex, Peshawar, Pakistan.
J Ayub Med Coll Abbottabad. 2018 Jan-Mar;30(1):58-63.
Spinal injuries are the most devastating injuries and affect every aspect of patients' lives. This may cause lifelong disability due to spinal cord injury. Recovery of neurological functions is highly desirable. Early or late surgical intervention is still debatable, but majority recommend early intervention. The result of late surgical intervention in term of neurological recovery is not clear. This study focuses on neurological recovery after late surgical intervention. The objective of this study was to assess neurological recovery in term of ASIA grading in patients with traumatic spinal cord injury.
This descriptive cross-sectional study was performed from June 2013 to June 2016. All patients treated for spinal trauma with spinal cord injury, operated after 24 hrs of injury were included in the study. Neurology was assessed according to ASIA scale preoperative and at 6 months. Data was analysed with the help of SPSS.
Total of 149 patients, 32 (21.5%) were female and 117 (78.5%) male were included. mean age was 32±13.11 years. Ninety-six (64.4%) patients presented with fall while 53 (35.6%) presented with motor vehicular accidents (MVA). according to AO comprehensive classification 76 (51.1%) patients were type C, 47 (31.5) were type B and 26 (17.4%) were type A. preoperative neurology was ASIA A 65 (43.6%), B12 (8.1%), C 59 (39.6%) and D 13 (8.7%). Mean delay in surgery was 3.6±1.8 days with minimum of 1 and maximum 14 days. ASIA grading on 6 months was ASIA "A" 61 (40.9%), B4 (2.7%), C 26 (17.4%), D 33 (22.1%) and E 25 (16.8%). the overall improvement in neurology was in 67 (45%) of patients. improvement by one grade was documented in 49 (32.9%) patients, by two grades in 17 (11.4%) and by three grades in one patient (.7%).
fall from height is a major cause of spine injuries in our set up followed by RTA. Preventive measures need to be instituted to lessen the devastating outcome.
脊柱损伤是最具毁灭性的损伤，会影响患者生活的方方面面。这可能会因脊髓损伤导致终身残疾。神经功能的恢复是非常令人期待的。早期或晚期手术干预仍存在争议，但大多数人建议早期干预。晚期手术干预在神经功能恢复方面的结果尚不清楚。本研究聚焦于晚期手术干预后的神经功能恢复。本研究的目的是根据美国脊髓损伤协会（ASIA）分级评估创伤性脊髓损伤患者的神经功能恢复情况。
本描述性横断面研究于2013年6月至2016年6月进行。所有因脊髓损伤接受脊柱创伤治疗且在受伤24小时后接受手术的患者均纳入本研究。术前及术后6个月根据ASIA量表评估神经功能。借助SPSS软件进行数据分析。
共纳入149例患者，其中女性32例（21.5%），男性117例（78.5%）。平均年龄为32±13.11岁。96例（64.4%）患者因跌倒受伤，53例（35.6%）患者因机动车事故（MVA）受伤。根据AO综合分类，76例（51.1%）患者为C型，47例（31.5%）为B型，26例（17.4%）为A型。术前神经功能分级为ASIA A级65例（43.6%），B级12例（8.1%），C级59例（39.6%），D级13例（8.7%）。手术平均延迟时间为3.6±1.8天，最短1天，最长14天。术后6个月的ASIA分级为ASIA“A”级61例（40.9%），B级4例（2.7%），C级26例（17.4%），D级33例（22.1%），E级25例（16.8%）。67例（45%）患者的神经功能总体有所改善。49例（32.9%）患者神经功能改善1级，17例（11.4%）患者改善2级，1例患者改善3级（0.7%）。
在我们的研究中，高处坠落是脊柱损伤后的主要原因，其次是道路交通事故（RTA）。需要采取预防措施以减轻这种毁灭性的后果。
