Timings of surgery for acute spinal injury

ABSTRACT

Early surgical management of spinal injury is commonly considered the treatment of choice for spinal injuries particularly cervical. Recently many reports do not agree strictly to criteria of emergency surgery. In our hospital this was chance study due to 15 km wide distance of fully equipped unit from casuality neuro surgical unit. It has been eventually delayed for few days until patient was other-wise stable and transportable to other unit. A retrospective study was undertaken to see the impact of this policy on the prognosis of neurological deficit postoperative complications and hospital stay. It included 27 patients undergoing surgery for spinal injuries from March-99 to Oct-2000 [21 months study]. Patients were divided into two groups. Group-A included 8 patients who were operated within 24 hours of admission and Group-B included 19[70.37 percent] patients operated during 1-2 weeks of trauma. In Group-A patients had grade power +3. In Group-B 16 patients has +3 power. In Group-A mortality was 3 [37.5 percent] and complication rate 5/8 [62.5 percent]. In Group-B morality was 2/19[10.52 percent] and complication rate 4/19 [21.05 percent]. The mean hospital stay was compared in both groups it was 9 days average in group-A while 19 days in group-B. This data concluded that circumstantial delay, initial refusal by relative or unsuitable environmental delay in surgery of spine is safe without worsening of neurological recovery and without increased rate of complications