压力之下 - 外伤性脊髓损伤手术时机的历史小故事。

IF 1.9 Q3 CLINICAL NEUROLOGY Brain & spine Pub Date : 2024-05-03 eCollection Date: 2024-01-01 DOI:10.1016/j.bas.2024.102825
Paula Valerie Ter Wengel, Florence Reith, Charlotte Y Adegeest, Michael G Fehlings, Brian K Kwon, W Peter Vandertop, Cumhur F Öner
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引用次数: 0

摘要

导言:一个世纪前,脊髓损伤(SCI)还不可避免地会导致致命的结果,尤其是对完全性脊髓损伤患者而言。纵观历史,尽管许多人认为无法改变脊髓损伤的灾难性后果,但人们一直在努力通过手术改变脊髓损伤患者的前景。时至今日,关于手术能否有效改善 SCI 患者神经功能预后的争论仍在继续,关于手术干预时机的讨论也在继续:材料和方法:叙述性文献综述:材料和方法:叙述性文献综述:纵观历史,人们曾多次尝试通过手术来改变 SCI 的病程,但结果却不尽相同。虽然研究表明手术时机与神经功能恢复之间存在潜在联系,但立即手术对个别病例的确切影响仍不明确。越来越明显的是,除了手术干预外,患者及其手术治疗的具体因素也会对神经功能的恢复产生重大影响:尽管越来越多的研究表明手术时机与神经功能预后可能存在关联,但紧急手术对个体的确切影响仍不确定。越来越明显的是,尽管进行了手术,但患者和治疗的特定因素也将在决定神经功能结果方面发挥作用。值得注意的是,正是这些因素影响了之前的研究结果以及我们对手术时机的看法。
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Under pressure - A historical vignette on surgical timing in traumatic spinal cord injury.

Introduction: It was not even a century ago when a spinal cord injury (SCI) would inevitably result in a fatal outcome, particularly for those with complete SCI. Throughout history, there have been extensive endeavours to change the prospects for SCI patients by performing surgery, even though many believed that there was no way to alter the catastrophic course of SCI. To this day, the debate regarding the efficacy of surgery in improving the neurological outcome for SCI patients persists, along with discussions about the timing of surgical intervention.

Research question: How have the historical surgical results shaped our perspective on the surgical treatment of SCI?

Material and methods: Narrative literature review.

Results: Throughout history there have been multiple surgical attempts to alter the course of SCI, with conflicting results. While studies suggest a potential link between timing of surgery and neurological recovery, the exact impact of immediate surgery on individual cases remains ambiguous. It is becoming more evident that, alongside surgical intervention, factors specific to both the patient and their surgical treatment will significantly influence neurological recovery.

Conclusion: Although a growing number of studies indicates a potential correlation of surgical timing and neurological outcome, the precise influence of urgent surgery on an individual basis remains uncertain. It is increasingly apparent that, despite surgery, patient- and treatment-specific factors will also play a role in determining the neurological outcome. Notably, these very factors have influenced the results in previous studies and our views concerning surgical timing.

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来源期刊
Brain & spine
Brain & spine Surgery
CiteScore
1.10
自引率
0.00%
发文量
0
审稿时长
71 days
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