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Traumatic Spinal Cord Injury: Long-Term Motor, Sensory, and Urinary Outcomes

STUDY DESIGN: Retrospective study. PURPOSE: To evaluate how motor, sensory, and urinary outcomes of spinal cord injury (SCI) patients were influenced in the long term. OVERVIEW OF LITERATURE: SCI is a potentially disabling and devastating neurological outcome that can occur because of spinal column...

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Autores principales: Motiei-Langroudi, Rouzbeh, Sadeghian, Homa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Spine Surgery 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5481596/
https://www.ncbi.nlm.nih.gov/pubmed/28670409
http://dx.doi.org/10.4184/asj.2017.11.3.412
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author Motiei-Langroudi, Rouzbeh
Sadeghian, Homa
author_facet Motiei-Langroudi, Rouzbeh
Sadeghian, Homa
author_sort Motiei-Langroudi, Rouzbeh
collection PubMed
description STUDY DESIGN: Retrospective study. PURPOSE: To evaluate how motor, sensory, and urinary outcomes of spinal cord injury (SCI) patients were influenced in the long term. OVERVIEW OF LITERATURE: SCI is a potentially disabling and devastating neurological outcome that can occur because of spinal column fractures. Most studies have not evaluated or have failed to show the influence of different surgical approaches and other parameters on neurological recovery. METHODS: A thorough history regarding sensory, motor, and urinary complaints was taken from 103 patients with SCI due to vertebral fracture; patients were followed by a thorough neurological examination. Subsequently, all medical records of patients, including neurological state after trauma, trauma mechanism, treatment protocol, surgical protocol, and imaging findings, were evaluated. RESULTS: Of the 103 patients, 73.8% were survivors of a major earthquake and 26.2% were victims of vehicle accidents; 92.2% patients were surgically treated, while 7.8% underwent conservative management. The mean follow-up duration was 10.3 years. In follow-up visits, 67.0%, 12.6%, 13.6%, and 6.8% patients showed no, partial, substantial, and complete motor improvement, respectively; 68.0%, 26.2%, and 5.8% showed no, mild, and substantial sensory improvement, respectively; and 73.8%, 17.5%, and 8.7% showed no, substantial, and complete urinary improvement, respectively. Logistic regression analysis showed that sex, age at injury time, follow-up duration, trauma mechanism, and stem cell therapy had no effect on motor, sensory, and urinary improvement. Higher initial scores on the American Spinal Injury Association (ASIA) classification, lumbar fracture level, and performance of laminectomy improved motor outcome; higher initial ASIA scores improved urinary and sensory outcomes. CONCLUSIONS: The initial ASIA score is the most important factor for prognosticating motor, sensory, and urinary improvement in SCI patients. Lumbar (L3–L5) and thoracic (T1–T10) fractures have the best and worst prognosis, respectively, in terms of motor recovery. Laminectomy during surgery improves motor function.
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spelling pubmed-54815962017-06-30 Traumatic Spinal Cord Injury: Long-Term Motor, Sensory, and Urinary Outcomes Motiei-Langroudi, Rouzbeh Sadeghian, Homa Asian Spine J Clinical Study STUDY DESIGN: Retrospective study. PURPOSE: To evaluate how motor, sensory, and urinary outcomes of spinal cord injury (SCI) patients were influenced in the long term. OVERVIEW OF LITERATURE: SCI is a potentially disabling and devastating neurological outcome that can occur because of spinal column fractures. Most studies have not evaluated or have failed to show the influence of different surgical approaches and other parameters on neurological recovery. METHODS: A thorough history regarding sensory, motor, and urinary complaints was taken from 103 patients with SCI due to vertebral fracture; patients were followed by a thorough neurological examination. Subsequently, all medical records of patients, including neurological state after trauma, trauma mechanism, treatment protocol, surgical protocol, and imaging findings, were evaluated. RESULTS: Of the 103 patients, 73.8% were survivors of a major earthquake and 26.2% were victims of vehicle accidents; 92.2% patients were surgically treated, while 7.8% underwent conservative management. The mean follow-up duration was 10.3 years. In follow-up visits, 67.0%, 12.6%, 13.6%, and 6.8% patients showed no, partial, substantial, and complete motor improvement, respectively; 68.0%, 26.2%, and 5.8% showed no, mild, and substantial sensory improvement, respectively; and 73.8%, 17.5%, and 8.7% showed no, substantial, and complete urinary improvement, respectively. Logistic regression analysis showed that sex, age at injury time, follow-up duration, trauma mechanism, and stem cell therapy had no effect on motor, sensory, and urinary improvement. Higher initial scores on the American Spinal Injury Association (ASIA) classification, lumbar fracture level, and performance of laminectomy improved motor outcome; higher initial ASIA scores improved urinary and sensory outcomes. CONCLUSIONS: The initial ASIA score is the most important factor for prognosticating motor, sensory, and urinary improvement in SCI patients. Lumbar (L3–L5) and thoracic (T1–T10) fractures have the best and worst prognosis, respectively, in terms of motor recovery. Laminectomy during surgery improves motor function. Korean Society of Spine Surgery 2017-06 2017-06-15 /pmc/articles/PMC5481596/ /pubmed/28670409 http://dx.doi.org/10.4184/asj.2017.11.3.412 Text en Copyright © 2017 by Korean Society of Spine Surgery http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
Motiei-Langroudi, Rouzbeh
Sadeghian, Homa
Traumatic Spinal Cord Injury: Long-Term Motor, Sensory, and Urinary Outcomes
title Traumatic Spinal Cord Injury: Long-Term Motor, Sensory, and Urinary Outcomes
title_full Traumatic Spinal Cord Injury: Long-Term Motor, Sensory, and Urinary Outcomes
title_fullStr Traumatic Spinal Cord Injury: Long-Term Motor, Sensory, and Urinary Outcomes
title_full_unstemmed Traumatic Spinal Cord Injury: Long-Term Motor, Sensory, and Urinary Outcomes
title_short Traumatic Spinal Cord Injury: Long-Term Motor, Sensory, and Urinary Outcomes
title_sort traumatic spinal cord injury: long-term motor, sensory, and urinary outcomes
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5481596/
https://www.ncbi.nlm.nih.gov/pubmed/28670409
http://dx.doi.org/10.4184/asj.2017.11.3.412
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