胸腰椎TRM手术治疗后神经功能恢复

Q4 Medicine Coluna/ Columna Pub Date : 2023-04-17 DOI:10.1590/s1808-185120222201262526
Artur Henrique Soares da Silva Filho, Breno Teixeira Moreno, Guilherme Zanini Rocha, Pedro Augusto Rocha Torres, Rodrigo Silva Loque, Marcos Vinícios Roldão Porto
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引用次数: 0

摘要

摘要目的:通过对胸腰椎骨折患者在创伤后不到24小时、24 - 48小时和超过48小时内进行脊柱减压的随访,评估神经系统恢复情况。方法:收集2014年至2018年在贝洛奥里藏特一家大型公立医院就诊的脊髓损伤患者的数据,这些患者在最初治疗时出现神经功能障碍,并出现神经功能恢复。结果:41例脊髓损伤患者,平均年龄34岁。以胸椎骨折为主(65.9%),属于AO型脊柱C型(75%)。至于时间变量,约68%的患者在创伤后48小时以上接受手术治疗。我们观察到,在创伤后不到24小时内进行手术减压的患者和在创伤后超过48小时进行手术的患者在6个月的随访中显示出轻微的神经系统改善。但无统计学意义。值得注意的是,即使在分析该研究的41例患者时,无论手术间隔如何,也不可能在6个月的随访中观察到统计学上显着的神经学改善。结论:我们的研究不能证明早期手术时间小于24小时和超过48小时的患者之间存在显著差异。证据等级III;比较回顾性研究。
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NEUROLOGICAL RECOVERY AFTER SURGICAL TREATMENT IN PATIENTS WITH THORACOLUMBAR TRM
ABSTRACT Objective: Evaluate the neurological recovery with a follow-up of 06 (six) months in victims of thoracic and lumbar fractures who underwent spinal decompression in less than 24 hours, between 24 and 48 hours, and more than 48 hours after the trauma. Methods: Data were collected on patients seen at a large public hospital in Belo Horizonte, between 2014 and 2018, who were victims of SCI who presented with neurological deficits at initial care, and the neurological recovery presented. Results: 41 SCI patients were evaluated, whose mean age was 34 years. There was a predominance of thoracic spine fractures (65.9% of the cases) and classified as AO Spine type C (75%). Regarding the time variable, about 68% of the patients were submitted to surgical treatment more than 48 hours after the trauma. It was observed that both the patients submitted to surgical decompression within less than 24 hours, and those operated on more than 48 hours after the trauma showed a slight neurological improvement at the 6-month follow-up. However, no statistical significance was found. It is worth noting that even when analyzing the 41 patients of the study, regardless of the surgical interval, it was impossible to observe a statistically significant neurological improvement at the 6-month follow-up. Conclusion: Our study could not demonstrate significant differences between those patients who operated early in less than 24 hours and those who operated after more than 48 hours. Level of Evidence III; Comparative retrospective study.
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来源期刊
Coluna/ Columna
Coluna/ Columna Medicine-Surgery
CiteScore
0.40
自引率
0.00%
发文量
32
审稿时长
10 weeks
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