Details

Autor(en) / Beteiligte

• Fan, Yu
• Zhou, Xi
• Wang, Hai
• Jiang, Pengxiang
• Cai, Siyi
• Zhang, Jianguo
• Liu, Yong

Titel

The timing of surgical intervention in the treatment of complete motor paralysis in patients with spinal metastasis

Ist Teil von

• European spine journal, 2016-12, Vol.25 (12), p.4060-4066

Ort / Verlag

Berlin/Heidelberg: Springer Berlin Heidelberg

Erscheinungsjahr

2016

Quelle

MEDLINE

Beschreibungen/Notizen

• Purpose The timing of surgical intervention is important for ambulatory patients with metastatic epidural spinal cord compression (MESCC), while limited studies have focused on non-ambulant patients. The aim of this study was to investigate the proper timing of surgical intervention for paraplegic patients with MESCC. Methods Forty-three non-ambulant patients with MESCC who underwent posterior decompression were retrospectively reviewed. The neurological outcomes for pre-operative Frankel B patients with different interval window were further compared. Results Neurologic deficit improved by at least 1 Frankel grade in 37 patients who underwent surgery within 72 h (86.0 %). Overall, 18 pre-operative Frankel B patients became ambulatory again with an interval of less than 48 h, 15 pre-operative Frankel B patients remained non-ambulatory post-operatively with an interval longer than 48 h besides one with an interval of 8 h ( P  < 0.001). All nine pre-operative Frankel A patients remained non-ambulatory even though the interval window was less than 24 h. Conclusion The timing of surgical intervention was key to predicting the post-operative outcome, and 48 h was suggested as the proper interval window for pre-operative Frankel B patients. These patients preserved sensory function which might be a predictor. And the sooner the surgery was performed, the better the result would be.