Early durotomy with duroplasty for severe adult spinal cord injury without radiographic abnormality: a novel concept and method of surgical decompression

• DOI: 10.1007/s00586-019-06091-1
• Publication Date: 2019-08-22T14:02:35Z
• Authors: Fengzhao Zhu; Sheng Yao; Zhengwei Ren; Dionne Telemacque; Yanzhen Qu; Kaifang Chen; Fan Yang; Lian Zeng; Xiaodong Guo
• Keywords: Spinal cord compression

Treatment options for adult spinal cord injury without radiographic abnormality (ASCIWORA) varied. Compression of ASCIWORA may more likely result from lesions such as edema and hemorrhage or contusion. This study aimed to explore the clinical effect early durotomy with duroplasty decompression in treatment severe ASCIWORA. Data 16 patients who underwent ( < 72 h) posterior laminectomy followed by June 2015 January 2017 were retrospectively analyzed. Patients' prognosis was analyzed American Spinal Injury Association Impairment Scale (AIS) grades scores. In 3 patients, intraspinal pressure (ISP) continuously monitored 1 week. Cervical magnetic resonance imaging (MRI) revealed 9 suspected contusion 7 cases. Pathological manifestations found during operation consistent preoperative MRI findings. Of cases, AIS grade improved 2 11 case. The scores at last follow-up significantly higher than There a high level ISP after laminectomy, whereas continued decrease steadily durotomy. Durotomy helps thoroughly decompress improve cerebrospinal fluid circulation pathological investigation can be used evaluate predict patients. monitoring is an effective method evaluating intramedullary decompression. These slides retrieved under Electronic Supplementary Material.