Characteristics and clinical aspects of patients with spinal cord injury undergoing surgery / Caracterização e aspectos clínicos de pacientes com traumatismo raquimedular submetidos a cirurgia

ABSTRACT

ABSTRACT OBJECTIVE: To identify the characteristics of patients with spinal cord injury (SCI) undergoing surgery. METHODS: Previously, 321 patients with SCI were selected. Clinical and socio-demographic variables were collected. RESULTS: A total of 211 patients were submitted to surgery. Fall and injuries in the upper cervical and lumbosacral regions were associated with conservative treatment. Patients with lesions in the lower cervical spine, worse neurological status, and unstable injuries were associated with surgery. Individuals undergoing surgery were associated with complications after treatment. The authors assessed whether age influenced the characteristics of patients submitted to surgery. Subjects with <60 years of age were associated with motorcycle accidents and the morphologies of injury were fracture-dislocation. Elderly individuals were associated to fall, SCI in the lower cervical spine and the morphology of injury was listhesis. Subsequently, the authors analyzed the gender characteristics in these patients. Women who suffered car accidents were associated to surgery. Women were associated with paraparesis and the morphologic diagnosis was fracture-explosion, especially in the thoracolumbar transition and lumbosacral regions. Men who presented traumatic brain injury and thoracic trauma were related to surgery. These individuals had a worse neurological status and were associated to complications. Men and the cervical region were most affected, thereby, these subjects were analyzed separately (n= 92). The presence of complications increased the length of hospital stay. The simultaneous presence of morphological diagnosis, worst neurological status, tetraplegia, sensory, and motor alterations were associated with complications. Pneumonia and chest trauma were associated with mortality. CONCLUSION: These factors enable investments in prevention, rehabilitation, and treatment.

RESUMO

RESUMO OBJETIVO: Identificar as características de pacientes com traumatismo raquimedular (TRM) submetidos a cirurgia. MÉTODOS: Foram selecionados 321 pacientes com TRM. As variáveis clínicas e sociodemográficas foram coletadas. RESULTADOS: Foram submetidos a cirurgia 211 pacientes. A queda e as lesões nas regiões cervical superior e lombossacral foram associadas com tratamento conservador. Pacientes com lesões nas regiões cervical inferior, pior status neurológico e lesões instáveis foram associados com cirurgia. Indivíduos operados foram associados com complicações após tratamento. Posteriormente, os autores avaliaram se idade influenciava as características dos pacientes submetidos a cirurgia. Sujeitos com < 60 anos foram associados com acidente motociclístico e o diagnóstico de fratura-luxação. Subsequentemente, analisaram-se as características dos sexos nesses pacientes. Mulheres que sofreram acidente automobilístico foram associadas com cirurgia. Mulheres foram associadas com paraparesia e diagnóstico morfológico de fratura explosão, principalmente nas regiões de transição toracolombar e lombossacral. Homens que apresentaram traumatismo crânioencefálico e torácico foram relacionados a cirurgia. Esses indivíduos tiveram um pior status neurológico e foram associados à complicação. Homens e região cervical foram mais afetados; portanto, esses pacientes foram analisados isoladamente (n = 92). A presença de complicações aumentou a permanência hospitalar. A presença de diagnósticos morfológicos simultaneamente, pior status neurológico, tetraplegia, alteração sensório-motora foi associada com complicações. Pneumonia e traumatismo torácico foram associados com mortalidade. CONCLUSÃO: Esses fatores possibilitam investimentos em prevenção, reabilitação e tratamento.