Controversies in the Surgical Management of Spinal Cord Injuries

Traumatic spinal cord injury (SCI) affects over 200,000 people in the USA and is a major source of morbidity, mortality, and societal cost. Management of SCI includes several components. Acute management includes medical agents and surgical treatment that usually includes either all or a combination...

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Main Authors: Ahmed M. Raslan, Andrew N. Nemecek
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Neurology Research International
Online Access:http://dx.doi.org/10.1155/2012/417834
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author Ahmed M. Raslan
Andrew N. Nemecek
author_facet Ahmed M. Raslan
Andrew N. Nemecek
author_sort Ahmed M. Raslan
collection DOAJ
description Traumatic spinal cord injury (SCI) affects over 200,000 people in the USA and is a major source of morbidity, mortality, and societal cost. Management of SCI includes several components. Acute management includes medical agents and surgical treatment that usually includes either all or a combination of reduction, decompression, and stabilization. Physical therapy and rehabilitation and late onset SCI problems also play a role. A review of the literature in regard to surgical management of SCI patients in the acute setting was undertaken. The controversy surrounding whether reduction is safe, or not, and whether prereduction magnetic resonance (MR) imaging to rule out traumatic disc herniation is essential is discussed. The controversial role of timing of surgical intervention and the choice of surgical approach in acute, incomplete, and acute traumatic SCI patients are reviewed. Surgical treatment is an essential tool in management of SCI patients and the controversy surrounding the timing of surgery remains unresolved. Presurgical reduction is considered safe and essential in the management of SCI with loss of alignment, at least as an initial step in the overall care of a SCI patient. Future prospective collection of outcome data that would suffice as evidence-based is recommended and necessary.
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spelling doaj-art-52e2f5cefdf248aea5bd01bfba2f04b92025-02-03T01:27:26ZengWileyNeurology Research International2090-18522090-18602012-01-01201210.1155/2012/417834417834Controversies in the Surgical Management of Spinal Cord InjuriesAhmed M. Raslan0Andrew N. Nemecek1Department of Neurological Surgery, Oregon Health & Science University, Mail Code CH8N, Portland, OR 97239, USADepartment of Neurological Surgery, Oregon Health & Science University, Mail Code CH8N, Portland, OR 97239, USATraumatic spinal cord injury (SCI) affects over 200,000 people in the USA and is a major source of morbidity, mortality, and societal cost. Management of SCI includes several components. Acute management includes medical agents and surgical treatment that usually includes either all or a combination of reduction, decompression, and stabilization. Physical therapy and rehabilitation and late onset SCI problems also play a role. A review of the literature in regard to surgical management of SCI patients in the acute setting was undertaken. The controversy surrounding whether reduction is safe, or not, and whether prereduction magnetic resonance (MR) imaging to rule out traumatic disc herniation is essential is discussed. The controversial role of timing of surgical intervention and the choice of surgical approach in acute, incomplete, and acute traumatic SCI patients are reviewed. Surgical treatment is an essential tool in management of SCI patients and the controversy surrounding the timing of surgery remains unresolved. Presurgical reduction is considered safe and essential in the management of SCI with loss of alignment, at least as an initial step in the overall care of a SCI patient. Future prospective collection of outcome data that would suffice as evidence-based is recommended and necessary.http://dx.doi.org/10.1155/2012/417834
spellingShingle Ahmed M. Raslan
Andrew N. Nemecek
Controversies in the Surgical Management of Spinal Cord Injuries
Neurology Research International
title Controversies in the Surgical Management of Spinal Cord Injuries
title_full Controversies in the Surgical Management of Spinal Cord Injuries
title_fullStr Controversies in the Surgical Management of Spinal Cord Injuries
title_full_unstemmed Controversies in the Surgical Management of Spinal Cord Injuries
title_short Controversies in the Surgical Management of Spinal Cord Injuries
title_sort controversies in the surgical management of spinal cord injuries
url http://dx.doi.org/10.1155/2012/417834
work_keys_str_mv AT ahmedmraslan controversiesinthesurgicalmanagementofspinalcordinjuries
AT andrewnnemecek controversiesinthesurgicalmanagementofspinalcordinjuries