Early surgery for thoracolumbar spinal cord injury: initial experience from a developing spinal cord injury centre in India.

摘要: The spinal cord injury centre of Nizam's Institute Medical Sciences, Andhra Pradesh, India has been functioning now for 8 months and offers its services to the population 80 million in state. To date, 92 patients with a have treated; 51 had thoracolumbar injury. This report presents results management these patients. Preoperatively both CT MRI were performed radiological findings correlated outcome. Twenty five thoracic 26 lumber location. nine underwent surgical treatment (15 14 lumbar) others treated conservatively (10 12 lumbar). All operations carried out within 2 weeks following trauma, methylprednisolone therapy was instituted those who reached hospital early. Contraindications surgery included delay admission more than 3 focus sepsis, bedsores, generalised bone disorder such as osteopenia, medical illnesses. Transpedicular screw-plate fixation 27 patients, two decompressive laminectomy interlaminar wire fixation. Delayed decompression offered one patient relieve radiculopathy. Fracture-dislocation transection worst outcome, whilst wedge compression fracture oedema fared better. Operated cases shorter stay, complications immobilisation limited. Positive psychological influence mobilisation early acclimatisation altered style living their disability most significant outcomes surgery.