Analysis of Results of the Surgical Treatment of the Spinal Cord Injury (Step by Step)

摘要

Substantiation of the reasonable period of the surgical intervention with due account for the analysis of the surgical treatment. Methods. The research is based on the follow-up of 200 patients with spinal cord injury. In accordance with the goal of this research, all patients with spinal cord injury were allocated to four clinical groups according to the period of surgical intervention: within the first 24 hours after the injury (Group 2a), during the first 2 - 3 days (Group 2b), after 4 - 6 days (Group 2c) and over 6 days (Group 1). Results. Temporal factor is substantiated by the morphological examinations, which revealed inconvertibility of the secondary injury of spinal cord in case of its long-term compression between 7 - 8 days. Group 2a demonstrated (surgical intervention was performed within the first 24 hours after the injury) the best results in respect of neurological recovery, namely 66,7%. In Group 2b the treatment efficiency was 58,4% and in group 2c - 51,4%. The control group demonstrated the lowest percent of neurological recovery, namely 11%. All patients had the spinal cord compression due to fractures and fractures - dislocations vertebrae. In the course of the treatment we used modern methods decompression and stabilization of spinal column, as well as pharmacological treatment. Conclusions. Spinal cord injury under the action of the long-term compression of vessels of spinal cord and matter of spinal cord is followed by the progressive secondary injuries and consequently by irreversible changes in the structure of the spinal cord, which can be revealed on the 7 - 8 day after the injury. The first six days is the most effective period for the performance of the decompression and stabilization operations in the presence of the spinal cord injury.