Optimal Timing of Surgical Decompression for Acute Traumatic Central Cord Syndrome
Abstract BACKGROUND: Traumatic central cord syndrome (TCCS) is an incomplete spinal cord injury defined by greater weakness in upper versus lower extremities, variable sensory loss, and variable bladder, bowel, and sexual dysfunction. The optimal timing of surgery for TCCS remains controversial. OBJ...
Uložené v:
| Vydané v: | Neurosurgery Ročník 77; číslo suppl_1; s. S15 - S32 |
|---|---|
| Hlavní autori: | , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | English Japanese |
| Vydavateľské údaje: |
Oxford University Press
01.10.2015
|
| Predmet: | |
| ISSN: | 0148-396X, 1524-4040 |
| On-line prístup: | Získať plný text |
| Tagy: |
Pridať tag
Žiadne tagy, Buďte prvý, kto otaguje tento záznam!
|
| Abstract | Abstract
BACKGROUND:
Traumatic central cord syndrome (TCCS) is an incomplete spinal cord injury defined by greater weakness in upper versus lower extremities, variable sensory loss, and variable bladder, bowel, and sexual dysfunction. The optimal timing of surgery for TCCS remains controversial.
OBJECTIVE:
To determine whether timing of surgery for TCCS predicts neurological outcomes, length of stay, and complications.
METHODS:
Five databases were searched through March 2015. Articles were appraised independently by 2 reviewers, and the evidence synthesized according to Grading of Recommendation Assessment, Development and Evaluation principles.
RESULTS:
Nine studies (3 prognostic, 5 therapeutic, 1 both) satisfied inclusion criteria. Low level evidence suggests that patients operated on <24 hours after injury exhibit significantly greater improvements in postoperative American Spinal Injury Association motor scores and the functional independence measure at 1 year than those operated on >24 hours after injury. Moderate evidence suggests that patients operated on <2 weeks after injury have a higher postoperative Japanese Orthopaedic Association score and recovery rate than those operated on >2 weeks after injury. There is insufficient evidence that lengths of hospital or intensive care unit stay differ between patients who undergo early versus delayed surgery. Furthermore, there is insufficient evidence that timing between injury and surgery predicts mortality rates or serious or minor adverse events.
CONCLUSION:
Surgery for TCCS <24 hours after injury appears safe and effective. Although there is insufficient evidence to provide a clear recommendation for early surgery (<24 hours), it is preferable to operate during the first hospital admission and <2 weeks after injury. |
|---|---|
| AbstractList | Abstract
BACKGROUND:
Traumatic central cord syndrome (TCCS) is an incomplete spinal cord injury defined by greater weakness in upper versus lower extremities, variable sensory loss, and variable bladder, bowel, and sexual dysfunction. The optimal timing of surgery for TCCS remains controversial.
OBJECTIVE:
To determine whether timing of surgery for TCCS predicts neurological outcomes, length of stay, and complications.
METHODS:
Five databases were searched through March 2015. Articles were appraised independently by 2 reviewers, and the evidence synthesized according to Grading of Recommendation Assessment, Development and Evaluation principles.
RESULTS:
Nine studies (3 prognostic, 5 therapeutic, 1 both) satisfied inclusion criteria. Low level evidence suggests that patients operated on <24 hours after injury exhibit significantly greater improvements in postoperative American Spinal Injury Association motor scores and the functional independence measure at 1 year than those operated on >24 hours after injury. Moderate evidence suggests that patients operated on <2 weeks after injury have a higher postoperative Japanese Orthopaedic Association score and recovery rate than those operated on >2 weeks after injury. There is insufficient evidence that lengths of hospital or intensive care unit stay differ between patients who undergo early versus delayed surgery. Furthermore, there is insufficient evidence that timing between injury and surgery predicts mortality rates or serious or minor adverse events.
CONCLUSION:
Surgery for TCCS <24 hours after injury appears safe and effective. Although there is insufficient evidence to provide a clear recommendation for early surgery (<24 hours), it is preferable to operate during the first hospital admission and <2 weeks after injury. |
| Author | Shamji, Mohammed F. Tetreault, Lindsay Vukas, Rachel R. Harrop, James S. Hilibrand, Alan S. Arnold, Paul M. Anderson, Karen K. Singh, Anoushka Fehlings, Michael G. Vaccaro, Alexander R. |
| Author_xml | – sequence: 1 givenname: Karen K. surname: Anderson fullname: Anderson, Karen K. email: kanderson3@kumc.edu organization: University of Kansas Medical Center, Department of Neurosurgery, Kansas City, Kansas – sequence: 2 givenname: Lindsay surname: Tetreault fullname: Tetreault, Lindsay organization: ‡University of Toronto, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada – sequence: 3 givenname: Mohammed F. surname: Shamji fullname: Shamji, Mohammed F. organization: §Toronto Western Hospital, Techna Research Institute, Department of Surgery, University of Toronto, Toronto, Ontario, Canada – sequence: 4 givenname: Anoushka surname: Singh fullname: Singh, Anoushka organization: ‖Toronto Western Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada – sequence: 5 givenname: Rachel R. surname: Vukas fullname: Vukas, Rachel R. organization: ¶University of Kansas Medical Center, A.R. Dykes Library of the Health Sciences, Kansas City, Kansas – sequence: 6 givenname: James S. surname: Harrop fullname: Harrop, James S. organization: #Departments of Neurological and Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania – sequence: 7 givenname: Michael G. surname: Fehlings fullname: Fehlings, Michael G. organization: University of Toronto, Department of Surgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada – sequence: 8 givenname: Alexander R. surname: Vaccaro fullname: Vaccaro, Alexander R. organization: ‡‡Department of Orthopaedic Surgery Thomas Jefferson University Hospital, Philadelphia, Pennsylvania – sequence: 9 givenname: Alan S. surname: Hilibrand fullname: Hilibrand, Alan S. organization: ‡‡Department of Orthopaedic Surgery Thomas Jefferson University Hospital, Philadelphia, Pennsylvania – sequence: 10 givenname: Paul M. surname: Arnold fullname: Arnold, Paul M. email: parnold@kumc.edu organization: University of Toronto, Department of Surgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada |
| BookMark | eNpdkEtqwzAYhEVJoUnaG3ShCzj5ZcmSvAxu-oDQQONAd0bP4BBbRrYXuX1d2kXpbAaGYWC-BZq1oXUIPRJYkTQV6_ftcQV_lTN-g-YkS1nCgMEMzYEwmdCcf96hRd-fAQhnQs7Rx74b6kZdcFk3dXvCwePDGE-1maInZ0LTRdf3dWixDxFvzDg4XEY1NmqoDS5cO8SpWYRo8eHa2hgad49uvbr07uHXl-j4vC2L12S3f3krNrvkTIDzRHrDcsGp4LkAbo0B7sBrTTPLtJRcaamspy6lTOQWeKZBUackk5m2niu6ROuf3TB2VRenF_FaEai-kVQTkuo_EvoFQZdWMw |
| ContentType | Journal Article |
| Copyright | Copyright © 2015 by the Congress of Neurological Surgeons 2015 |
| Copyright_xml | – notice: Copyright © 2015 by the Congress of Neurological Surgeons 2015 |
| DOI | 10.1227/NEU.0000000000000946 |
| DatabaseTitleList | |
| DeliveryMethod | fulltext_linktorsrc |
| EISSN | 1524-4040 |
| EndPage | S32 |
| ExternalDocumentID | 10.1227/NEU.0000000000000946 |
| GroupedDBID | --- .-D .Z2 01R 0R~ 123 1TH 354 3V. 40H 48X 4Q1 4Q2 4Q3 53G 5RE 5VS 71W 77Y 7O~ 7X7 88E 8FI 8FJ AAAAV AAAXR AAGIX AAHPQ AAIQE AAKAS AAPQZ AAQKA AARTV AASCR AASOK AASXQ AAVAP AAYEP ABASU ABDIG ABHFT ABJNI ABLJU ABOCM ABPPZ ABPTD ABUWG ABZAD ACDDN ACGFO ACGFS ACILI ACOAL ACUTJ ACWRI ACXJB ACXNZ ADBBV ADBIZ ADGZP ADHKW ADHPY ADRTK ADZCM AE3 AE6 AEETU AEMDU AENEX AENZO AETBJ AEWNT AFDTB AFFZL AFKRA AFOFC AFTRI AFUWQ AGINI AGINJ AHMBA AHOMT AHQNM AHVBC AIZYK AJNWD AJZMW ALIPV ALMA_UNASSIGNED_HOLDINGS AMNEI APIBT AWKKM BAYMD BCRHZ BENPR BOYCO BPHCQ BTRTY BYPQX C45 CCPQU CDBKE CS3 DAKXR E.X EBS EEVPB ENERS ERAAH EX3 F2K F2L F2M F2N F5P FCALG FECEO FL- FLUFQ FOEOM FOTVD FQBLK FYUFA GAUVT GJXCC H0~ H13 HLJTE HMCUK HZ~ IN~ JF7 JK3 JK8 K8S KD2 KMI KOP KSI KSN L-C L7B LMP M1P MHKGH N9A NOYVH NVLIB N~7 N~B O9- OAG OAH OBH ODA ODMLO OHH OL1 OLB OLG OLH OLU OLV OLY OLZ OVD OWU OWV OWW OWX OWY OWZ P2P PAFKI PEELM PSQYO RIG RLZ ROX ROZ RUSNO RXW S4R SJN TEORI TJX UKHRP V2I VVN W3M WOQ WOW X3V X3W XXN XYM YAYTL YCJ YFH YKOAZ YOC YXANX ZFV ZY1 |
| ID | FETCH-LOGICAL-j1066-8fc49763769706dcc06e0fbb35d4b886ab8adf3e23479d065b0a3ea8485bdf6a3 |
| ISSN | 0148-396X |
| IngestDate | Wed Sep 11 04:47:42 EDT 2024 |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | suppl_1 |
| Keywords | Incomplete spinal cord injury Central spinal cord syndrome Surgical decompression Systematic review Central cord syndrome Central cord injury syndrome Timing of surgery |
| Language | English Japanese |
| LinkModel | OpenURL |
| MergedId | FETCHMERGED-LOGICAL-j1066-8fc49763769706dcc06e0fbb35d4b886ab8adf3e23479d065b0a3ea8485bdf6a3 |
| ParticipantIDs | oup_primary_10_1227_NEU_0000000000000946 |
| PublicationCentury | 2000 |
| PublicationDate | 20151001 |
| PublicationDateYYYYMMDD | 2015-10-01 |
| PublicationDate_xml | – month: 10 year: 2015 text: 20151001 day: 01 |
| PublicationDecade | 2010 |
| PublicationTitle | Neurosurgery |
| PublicationYear | 2015 |
| Publisher | Oxford University Press |
| Publisher_xml | – name: Oxford University Press |
| SSID | ssj0016478 |
| Score | 2.1488483 |
| Snippet | Abstract
BACKGROUND:
Traumatic central cord syndrome (TCCS) is an incomplete spinal cord injury defined by greater weakness in upper versus lower extremities,... |
| SourceID | oup |
| SourceType | Publisher |
| StartPage | S15 |
| Title | Optimal Timing of Surgical Decompression for Acute Traumatic Central Cord Syndrome |
| Volume | 77 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| journalDatabaseRights | – providerCode: PRVPQU databaseName: Health Medical collection customDbUrl: eissn: 1524-4040 dateEnd: 20211231 omitProxy: false ssIdentifier: ssj0016478 issn: 0148-396X databaseCode: 7X7 dateStart: 20100101 isFulltext: true titleUrlDefault: https://search.proquest.com/healthcomplete providerName: ProQuest – providerCode: PRVPQU databaseName: ProQuest Central customDbUrl: eissn: 1524-4040 dateEnd: 20211231 omitProxy: false ssIdentifier: ssj0016478 issn: 0148-396X databaseCode: BENPR dateStart: 20100101 isFulltext: true titleUrlDefault: https://www.proquest.com/central providerName: ProQuest |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwtV3JTsMwELXKcuCCQIDY5QMHJBTIHvsIqAgJKIgA4hY5sa2ypahpqv4XP8g4dkIpCMGBHqIqaqzE8zoznrw3RmgnCynnjhLHeAEsULjNLBWGLCIglZMpYU7VSPvuPOp0yP09vWq13motzPA5ynMyGtHXfzU1nANjK-nsH8zdDAon4DsYHY5gdjj-yvCX4ARelOpe7ddVMZrjsm_8m1AMcs181QTDw0zxBCBglbp1qyn2gpvoQyL6TTeDqplHMaalrkoIvMrbG3HZ3tl-UxEQispePjcFgOKDtRN32ctjxSa46HVVBZ3vnTQXxnDzXU257JVF94mN1yecoGG6DX7SPU6UND1a7WcIEcm4YdeHla1u5FT7abPdi8ZjofY8TZwx1xtrWaiJ4rGumn4JEK6rXlF32re6cWX9of5EP26zQPrpgik040YBBVc6c9TuXF03L6-UfFczZ_WDGcUmjHTw3ThaWjmW1dwsoHmzHMGHGkaLqCXyJXRtIIQ1hHBP4hpC-BOEMEw6riCEGwhhAyGsIIRrCC2j25P2zfGpZfbesB4dyEItIjMfMlUIPzSyQ55ldihsmaZewP2UkJDB35hLT7hKicwhj01t5glGfBKkXIbMW0HTeS8XqwjbvrQjGQgSQLLrCkaFDH1IewkLbEEZX0O78PzJq-6ukqhVKUxVAlOVTE7V-u9_uoHmPtC4iaYH_VJsodlsOHgo-tvGZO-doW3d |
| linkProvider | ProQuest |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Optimal+Timing+of+Surgical+Decompression+for+Acute+Traumatic+Central+Cord+Syndrome&rft.jtitle=Neurosurgery&rft.au=Anderson%2C+Karen+K.&rft.au=Tetreault%2C+Lindsay&rft.au=Shamji%2C+Mohammed+F.&rft.au=Singh%2C+Anoushka&rft.date=2015-10-01&rft.pub=Oxford+University+Press&rft.issn=0148-396X&rft.eissn=1524-4040&rft.volume=77&rft.issue=suppl_1&rft.spage=S15&rft.epage=S32&rft_id=info:doi/10.1227%2FNEU.0000000000000946&rft.externalDocID=10.1227%2FNEU.0000000000000946 |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0148-396X&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0148-396X&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0148-396X&client=summon |