BACKGROUND/ OBJECTIVE: An assessment of neurological improvement after surgical intervention in the setting of traumatic conus medullaris injury (CMI). METHODS: A retrospective evaluation of a cohort of patients with a blunt traumatic CMI from T12 to L1. The neurologic and functional outcomes were recorded from the acute hospital admission to the most recent follow-up. Data collected included age, level of injury, neurologic examination according to the Frankel grading system and motor index score, and the mechanism and timing of CMI decompression. RESULTS: A total of 24 patients with a mean age of 27 years (men, 87%) were identified. The most common level of bony injury was L1, and the most frequent mechanism of injury was a motor vehicle crash. Before surgical intervention, 16 of 24 patients (66.7%) had a complete neurological deficit below the level of injury. The median interval from injury to surgery was 6 days (range, 7 hours to 390 days). Decompression, fusion, and adjunctive internal fixation were the most common surgical procedures. Median length of follow-up was 32 months after surgery. Improvement in spinal cord and bladder function was seen in 41.6% and 63.6% of patients, respectively. Root recovery was seen in 83.3% of patients. CONCLUSIONS: In the setting of CMI, no correlation between the timing of surgical decompression and motor improvement was identified. Root recovery was more predictable than spinal cord and bladder recovery.
BACKGROUND/ OBJECTIVE: An assessment of neurological improvement after surgical intervention in the setting of traumatic conus medullaris injury (CMI). METHODS: A retrospective evaluation of a cohort of patients with a blunt traumatic CMI from T12 to L1. The neurologic and functional outcomes were recorded from the acute hospital admission to the most recent follow-up. Data collected included age, level of injury, neurologic examination according to the Frankel grading system and motor index score, and the mechanism and timing of CMI decompression. RESULTS: A total of 24 patients with a mean age of 27 years (men, 87%) were identified. The most common level of bony injury was L1, and the most frequent mechanism of injury was a motor vehicle crash. Before surgical intervention, 16 of 24 patients (66.7%) had a complete neurological deficit below the level of injury. The median interval from injury to surgery was 6 days (range, 7 hours to 390 days). Decompression, fusion, and adjunctive internal fixation were the most common surgical procedures. Median length of follow-up was 32 months after surgery. Improvement in spinal cord and bladder function was seen in 41.6% and 63.6% of patients, respectively. Root recovery was seen in 83.3% of patients. CONCLUSIONS: In the setting of CMI, no correlation between the timing of surgical decompression and motor improvement was identified. Root recovery was more predictable than spinal cord and bladder recovery.
Authors: M Reinhold; C Knop; R Beisse; L Audigé; F Kandziora; A Pizanis; R Pranzl; E Gercek; M Schultheiss; A Weckbach; V Bühren; M Blauth Journal: Eur Spine J Date: 2010-05-25 Impact factor: 3.134
Authors: M Reinhold; C Knop; R Beisse; L Audigé; F Kandziora; A Pizanis; R Pranzl; E Gercek; M Schultheiss; A Weckbach; V Bühren; M Blauth Journal: Unfallchirurg Date: 2009-02 Impact factor: 1.000
Authors: Vafa Rahimi-Movaghar; Soheil Saadat; Mohammad R Rasouli; Sarah Ganji; Mayam Ghahramani; Mohammad-Reza Zarei; Alexander R Vaccaro Journal: J Spinal Cord Med Date: 2009 Impact factor: 1.985