McMaster University

McMaster University

Influence of Time on Motor Recovery & Hospital Stay in Spinal Cord Injury

We are pleased to share with you a recent publication in the Journal of Neurotrauma. This publication is entitled "The influence of time from injury to surgery on motor recovery and length of hospital stay in acute traumatic spinal cord injury: an observational Canadian cohort study."

Find the abstract below and click here to access the full-version of the article.

Dvorak MF1, Noonan V, Fallah N, Fisher CG, Finkelstein J, Kwon BK, Rivers CS, Ahn H, Paquet J, Tsai E, Townson A, Attabib N, Bailey C, Christie S, Drew B, Fourney DR, Fox R, Hurlbert RJ, Johnson MG, Linassi G, Parent S, Fehlings M. The influence of time from injury to surgery on motor recovery and length of hospital stay in acute traumatic spinal cord injury: an observational Canadian cohort study.J Neurotrauma. 2014 Oct 21. [Epub ahead of print]

Abstract

Objective:
To determine the influence of time from injury to surgery on neurological recovery and length of stay in an observational cohort of individuals with traumatic spinal cord injury.
Design:
We analyzed the baseline and follow-up motor scores of participants in the Rick Hansen Spinal Cord Injury Registry, to specifically assess the effect of early (less than 24 hours from injury) surgery on motor recovery and on length of stay.
Methods:
One thousand four hundred and ten patients who sustained acute traumatic spinal cord injuries with baseline AIS grades A, B, C, or D and were treated surgically were analyzed to determine the effect of the timing of surgery (24, 48, or 72 hours from injury) on motor recovery and length of stay. Depending upon the type of data available, we employed different types of generalized linear models, including multiple linear regression, gamma regression and negative binomial regression.
Results:
Individuals with incomplete AIS B, C, and D injuries from C2 to L2 demonstrated motor recovery improvement of an additional 6.3 motor points (SE=2.8 p<0.03) when they underwent surgical treatment within 24 hours from the time of injury, as compared to those who had surgery later than 24 hours post-injury. This beneficial effect of early surgery on motor recovery was not seen in the patients with AIS A complete SCI. AIS A and B patients who received early surgery experienced shorter hospital LOS.
Conclusion:
While the issues of when to perform surgery and what specific operation to perform remain controversial, this work provides evidence that for an incomplete acute traumatic spinal cord injury in the cervical, thoracic or thoracolumbar spine, surgery performed within 24 hours from injury improves motor neurological recovery. Early surgery also reduces LOS.

 

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