International Journal of Clinical and Experimental Medical Sciences

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

Received: 06 December 2016    Accepted: 26 December 2016    Published: 17 January 2017
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Abstract

Purpose. 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 2а), 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 2а 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 2с – 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.

DOI 10.11648/j.ijcems.20160206.13
Published in International Journal of Clinical and Experimental Medical Sciences (Volume 2, Issue 6, November 2016)
Page(s) 110-116
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Spinal Cord Injury, Secondary Injury, Spinal Cord Decompression

References
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[2] Aki T, Toya S (1984) Experimental study on changes of the spinal-evoked potential and circulatory dynamics following spinal cord compression and decompression. Spine 9: 800-809.
[3] Bohlman НН, Bahniuk Е, Raskulinecz G, et al. (1979) Mechanical factors affecting recovery from incomplete cervical spinal cord injury: a preliminary report. Johns Hopkins Med J 145: 115-125.
[4] Tarlov IM (1954) Spinal cord compression studies, 111: Time limits for recovery after gradual compression in dogs. AMA Arch Neurol Psychiatry 71: 588-597.
[5] Tarlov IM (1955) Spinal cord injuries: early treatment. Surg Clin North Am 35: 591-607.
[6] Yoshida H, Okada Y, Maruiwa H, et al. (2003) Synaptic blockade plays a major role in the neural disturbance of experimental spinal cord compression. J Neurotrauma 20: 1365-1376.
[7] Shields СB, Zhang YP, Shields LB, et al. (2005) The therapeutic window for spinal cord decompression in a rat spinal cord injury model. J Neurosurg Spine 3: 302-307.
[8] Guttmann L, Harri P (1963) Initial treatment of traumatic paraplegia and tetraplegia. Edinburgh, UK: Royal College of Surgeons 80-92.
[9] Guttmann L (1976) Spinal Cord Injuries: Comprehensive Management and Research. Oxford: Blackwell 354.
[10] Bedbrook GM, Sakae T (1982) A review of cervical spine injuries with neuro-logical dysfunction. Paraplegia 20: 321-333.
[11] Wilmot CB, Hall KM (1986) Evaluation of the acute management of tetraplegia: conservative versus surgical treatment. Paraplegia 24: 148-153.
[12] Marshall LF, Knowlton S, Garfin SR, et al. (1987) Deterioration following spinal cord injury. A multicenter study. J Neurosurg 66: 400-404.
[13] Tsymbalyuk VI, Nevodnik VI, Salkov NN (2013) Secondary injures of spinal cord under the action of long-term compression in the presence of the injury of spinal column and spinal cord in the cervical part. Ukrainian Neurosurgical Journal 4: 54-59.
[14] Salkov M, Tsymbaliuk V, Dzyak L, et al. (2015) New concept of pathogenesis of impaired circulation in traumatic cervical spinal cord injury and its impact on disease severity: Case series of four patients. Eur. Spine in press.
[15] Salkov M, Zozylia N, Tsymbaliuk V, et al. (2015) New Concept of the Development of Brainstem Ischemia in the Setting of Occlusions of the Vertebral Arteries and Radicular and Medullary Arteries in the Presence of the Cervical Spinal Injury. Brain Disord Ther 4: 193.
[16] Salkov M, Tsymbaliuk V, Dzyak L (2015) The Method of Multilevel Decompression of Thoracic Spine with the Durotomy and the Local Administration of Cortexin in the Setting in Intradural Space in the Patients with Spinal Cord Injury. Int J Neurorehabilitation 2: 173.
[17] Salkov МM (2015) Experience in the use of pneumatic high-speed drill in spinal trauma surgery. Ukrainian Neurosurgical Journal 5 (2): 84-88.
[18] Sal'kov NN, D. V. Ovcharenko DV (2014) Case report of an indirect spine and spinal cord injury. Zhurnal "Voprosy nejrokhirurgii imeni N. N. Burdenko" 78 (3): 49-52.
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Author Information
  • Department of Spinal Surgery of Communal Institution ?Dnipropetrovsk Regional Clinical Hospital Named After l.l. Mechnikov?, Dnipropetrovsk, Ukraine

  • Department of the Restorative Neurosurgery ?The Institute of Neurosurgery Named After A.P.Romodanov? Kiev, Ukraine

  • Department of the Neurology with Neurosurgery ?Dnepropetrovsk Medical Academy?, Dnipropetrovsk, Ukraine

  • Department of the Neurology with Neurosurgery ?Odessa Medical University?, Odessa, Ukraine

  • Department of Spinal Surgery of Communal Institution ?Dnipropetrovsk Regional Clinical Hospital Named After l.l. Mechnikov?, Dnipropetrovsk, Ukraine

  • Department of the Neurology with Neurosurgery ?Dnepropetrovsk Medical Academy?, Dnipropetrovsk, Ukraine

  • Department of Neurosurgery of Communal Institution ?2nd City Hospital of Krivoy Rog?, Krivoy Rog, Ukraine

  • Department of Spinal Surgery of Communal Institution ?Dnipropetrovsk Regional Clinical Hospital Named After l.l. Mechnikov?, Dnipropetrovsk, Ukraine

  • Faculty of Medicine, Charles University in Prague, Prague, Czech Republic

Cite This Article
  • APA Style

    Mykola Salkov, Vitaliy Tsymbaliuk, Lydmila Dzyak, Anatoly Son, German Titov, et al. (2017). Analysis of Results of the Surgical Treatment of the Spinal Cord Injury (Step by Step). International Journal of Clinical and Experimental Medical Sciences, 2(6), 110-116. https://doi.org/10.11648/j.ijcems.20160206.13

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    ACS Style

    Mykola Salkov; Vitaliy Tsymbaliuk; Lydmila Dzyak; Anatoly Son; German Titov, et al. Analysis of Results of the Surgical Treatment of the Spinal Cord Injury (Step by Step). Int. J. Clin. Exp. Med. Sci. 2017, 2(6), 110-116. doi: 10.11648/j.ijcems.20160206.13

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    AMA Style

    Mykola Salkov, Vitaliy Tsymbaliuk, Lydmila Dzyak, Anatoly Son, German Titov, et al. Analysis of Results of the Surgical Treatment of the Spinal Cord Injury (Step by Step). Int J Clin Exp Med Sci. 2017;2(6):110-116. doi: 10.11648/j.ijcems.20160206.13

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  • @article{10.11648/j.ijcems.20160206.13,
      author = {Mykola Salkov and Vitaliy Tsymbaliuk and Lydmila Dzyak and Anatoly Son and German Titov and Alexander Rodinsky and Andrey Botvinnikov and Nataly Zozylia and Margaryta Salkova},
      title = {Analysis of Results of the Surgical Treatment of the Spinal Cord Injury (Step by Step)},
      journal = {International Journal of Clinical and Experimental Medical Sciences},
      volume = {2},
      number = {6},
      pages = {110-116},
      doi = {10.11648/j.ijcems.20160206.13},
      url = {https://doi.org/10.11648/j.ijcems.20160206.13},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ijcems.20160206.13},
      abstract = {Purpose. 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 2а), 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 2а 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 2с – 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.},
     year = {2017}
    }
    

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  • TY  - JOUR
    T1  - Analysis of Results of the Surgical Treatment of the Spinal Cord Injury (Step by Step)
    AU  - Mykola Salkov
    AU  - Vitaliy Tsymbaliuk
    AU  - Lydmila Dzyak
    AU  - Anatoly Son
    AU  - German Titov
    AU  - Alexander Rodinsky
    AU  - Andrey Botvinnikov
    AU  - Nataly Zozylia
    AU  - Margaryta Salkova
    Y1  - 2017/01/17
    PY  - 2017
    N1  - https://doi.org/10.11648/j.ijcems.20160206.13
    DO  - 10.11648/j.ijcems.20160206.13
    T2  - International Journal of Clinical and Experimental Medical Sciences
    JF  - International Journal of Clinical and Experimental Medical Sciences
    JO  - International Journal of Clinical and Experimental Medical Sciences
    SP  - 110
    EP  - 116
    PB  - Science Publishing Group
    SN  - 2469-8032
    UR  - https://doi.org/10.11648/j.ijcems.20160206.13
    AB  - Purpose. 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 2а), 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 2а 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 2с – 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.
    VL  - 2
    IS  - 6
    ER  - 

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