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Controversies in the Surgical Management of Spinal Cord Injuries

Traumatic spinal cord injury (SCI) affects over 200,000 people in the USA and is a major source of morbidity, mortality, and societal cost. Management of SCI includes several components. Acute management includes medical agents and surgical treatment that usually includes either all or a combination...

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Detalles Bibliográficos
Autores principales: Raslan, Ahmed M., Nemecek, Andrew N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3361277/
https://www.ncbi.nlm.nih.gov/pubmed/22666586
http://dx.doi.org/10.1155/2012/417834
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author Raslan, Ahmed M.
Nemecek, Andrew N.
author_facet Raslan, Ahmed M.
Nemecek, Andrew N.
author_sort Raslan, Ahmed M.
collection PubMed
description Traumatic spinal cord injury (SCI) affects over 200,000 people in the USA and is a major source of morbidity, mortality, and societal cost. Management of SCI includes several components. Acute management includes medical agents and surgical treatment that usually includes either all or a combination of reduction, decompression, and stabilization. Physical therapy and rehabilitation and late onset SCI problems also play a role. A review of the literature in regard to surgical management of SCI patients in the acute setting was undertaken. The controversy surrounding whether reduction is safe, or not, and whether prereduction magnetic resonance (MR) imaging to rule out traumatic disc herniation is essential is discussed. The controversial role of timing of surgical intervention and the choice of surgical approach in acute, incomplete, and acute traumatic SCI patients are reviewed. Surgical treatment is an essential tool in management of SCI patients and the controversy surrounding the timing of surgery remains unresolved. Presurgical reduction is considered safe and essential in the management of SCI with loss of alignment, at least as an initial step in the overall care of a SCI patient. Future prospective collection of outcome data that would suffice as evidence-based is recommended and necessary.
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spelling pubmed-33612772012-06-04 Controversies in the Surgical Management of Spinal Cord Injuries Raslan, Ahmed M. Nemecek, Andrew N. Neurol Res Int Review Article Traumatic spinal cord injury (SCI) affects over 200,000 people in the USA and is a major source of morbidity, mortality, and societal cost. Management of SCI includes several components. Acute management includes medical agents and surgical treatment that usually includes either all or a combination of reduction, decompression, and stabilization. Physical therapy and rehabilitation and late onset SCI problems also play a role. A review of the literature in regard to surgical management of SCI patients in the acute setting was undertaken. The controversy surrounding whether reduction is safe, or not, and whether prereduction magnetic resonance (MR) imaging to rule out traumatic disc herniation is essential is discussed. The controversial role of timing of surgical intervention and the choice of surgical approach in acute, incomplete, and acute traumatic SCI patients are reviewed. Surgical treatment is an essential tool in management of SCI patients and the controversy surrounding the timing of surgery remains unresolved. Presurgical reduction is considered safe and essential in the management of SCI with loss of alignment, at least as an initial step in the overall care of a SCI patient. Future prospective collection of outcome data that would suffice as evidence-based is recommended and necessary. Hindawi Publishing Corporation 2012 2012-05-14 /pmc/articles/PMC3361277/ /pubmed/22666586 http://dx.doi.org/10.1155/2012/417834 Text en Copyright © 2012 A. M. Raslan and A. N. Nemecek. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Raslan, Ahmed M.
Nemecek, Andrew N.
Controversies in the Surgical Management of Spinal Cord Injuries
title Controversies in the Surgical Management of Spinal Cord Injuries
title_full Controversies in the Surgical Management of Spinal Cord Injuries
title_fullStr Controversies in the Surgical Management of Spinal Cord Injuries
title_full_unstemmed Controversies in the Surgical Management of Spinal Cord Injuries
title_short Controversies in the Surgical Management of Spinal Cord Injuries
title_sort controversies in the surgical management of spinal cord injuries
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3361277/
https://www.ncbi.nlm.nih.gov/pubmed/22666586
http://dx.doi.org/10.1155/2012/417834
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