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Posterior spinal decompression in adults with spinal cord injury without traumatic compromise of the spinal canal: what is the data? – Lumbar Spinal Stenosis

This article discusses the treatment options for spinal cord injury (SCI) and the need for laminectomy in improving neurological outcomes. The authors conducted a literature review of studies published between 2013 and 2023, focusing on patients with SCI and interventions such as laminectomy, laminoplasty, decompression, and duroplasty. The review included 6 observational studies, which showed that posterior spinal decompression techniques improved neurological outcomes in SCI patients with degenerative stenosis. However, the evidence for using laminectomy alone was lacking, and further research is needed. The article suggests that early decompression in SCI patients can be performed safely but should be supported by more high-quality evidence

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : top spinal clinic on Harley Street UK

Published article

CONCLUSION: Early decompression in SCI patients remains a reasonable practice option and can be performed safely, but no specific evidence supports the use of laminectomy alone. There is emerging evidence that intended durotomy followed by extended meningoplasty may improve the neurological outcome in patients suffering from SCI when meta-traumatic edema is apparent. However, the lack of high-quality evidence and results support the need for further research.

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Front Neurol. 2023 Sep 15;14:1220598. doi: 10.3389/fneur.2023.1220598. eCollection 2023.ABSTRACTBACKGROUND: Spinal cord injury (SCI) can be caused by a variety of factors and its severity can range from a mild concussion to a complete severing of the spinal cord. Τreatment depends on the type and severity of injury, the patient’s age and overall health. Reduction of,

Front Neurol. 2023 Sep 15;14:1220598. doi: 10.3389/fneur.2023.1220598. eCollection 2023.

ABSTRACT

BACKGROUND: Spinal cord injury (SCI) can be caused by a variety of factors and its severity can range from a mild concussion to a complete severing of the spinal cord. Τreatment depends on the type and severity of injury, the patient’s age and overall health. Reduction of dislocated or fractured vertebrae via closed manipulation or surgical procedures, fixation and removal of bony fragments and debris that compromise the spinal canal are indicated for decompression of the spinal cord and stabilization of the spine. However, when there is no obvious traumatic obstruction of spinal canal, the question arises as to whether laminectomy is needed to be performed to improve neurological outcome.

METHODS: A literature review covering all indexed studies published between 2013 and 2023 was performed using keywords to identify the patient group of interest (spinal cord injury, SCI, spinal cord trauma, cervical, thoracic, lumbar, thoracolumbar),central cord syndrome (CCS) and the interventions (laminectomy, laminoplasty, decompression, duroplasty).

RESULTS: This review includes6 observational studies investigating the outcome of posterior spinal decompression in patients suffering from spinal cord injury without traumatic spinal cord stenosis. Most patients already had degenerative stenosis. From a total of 202, 151 patients (74.7%) improved neurologically by at least one grade at ASIA scale, after being treated with either laminectomy, laminoplasty, duroplasty or a combination of these techniques.

CONCLUSION: Early decompression in SCI patients remains a reasonable practice option and can be performed safely, but no specific evidence supports the use of laminectomy alone. There is emerging evidence that intended durotomy followed by extended meningoplasty may improve the neurological outcome in patients suffering from SCI when meta-traumatic edema is apparent. However, the lack of high-quality evidence and results support the need for further research.

PMID:37789891 | PMC:PMC10543663 | DOI:10.3389/fneur.2023.1220598

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Posterior spinal decompression in adults with spinal cord injury without traumatic compromise of the spinal canal: what is the data?

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Front Neurol. 2023 Sep 15;14:1220598. doi: 10.3389/fneur.2023.1220598. eCollection 2023.ABSTRACTBACKGROUND: Spinal cord injury (SCI) can be caused by a variety of factors and its severity can range from a mild concussion to a complete severing of the spinal cord. Τreatment depends on the type and severity of injury, the patient's age and overall health. Reduction of
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