A Study of Functional and Radiological Outcome in Anterior Cervical Discectomy and Fusion with Stabilization in Posttraumatic Acute Central Cord Syndrome
Background: Spinal injuries account for around 6% of overall trauma patients, of which cervical spine injuries contribute >50%. Central cord syndrome (CCS) is the most common subtype of incomplete spinal cord and accounts for around 15–25% of all cases. The aim of this study is to assess the func...
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| Language: | English |
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Jaypee Brothers Medical Publisher
2024-01-01
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| Series: | Journal of Orthopedics and Joint Surgery |
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| Online Access: | https://www.jojs.in/doi/JOJS/pdf/10.5005/jojs-10079-1135 |
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| author | Sivakumar Raju Sudeep K Velur Nagendra Vinoth Thangamani Bharat K Ramalingam Jeyashankaran D Abinav Annamalai |
| author_facet | Sivakumar Raju Sudeep K Velur Nagendra Vinoth Thangamani Bharat K Ramalingam Jeyashankaran D Abinav Annamalai |
| author_sort | Sivakumar Raju |
| collection | DOAJ |
| description | Background: Spinal injuries account for around 6% of overall trauma patients, of which cervical spine injuries contribute >50%. Central cord syndrome (CCS) is the most common subtype of incomplete spinal cord and accounts for around 15–25% of all cases. The aim of this study is to assess the functional and radiological outcomes of posttraumatic acute CCS treated with anterior cervical discectomy and fusion (ACDF) with stabilization.
Materials and methods: It is a prospective study done between October 2020 and September 2022 in the Department of Orthopaedics, Preethi Hospital. Our study consists of 23 patients with posttraumatic CCS treated with ACDF with stabilization. Neurological and functional outcomes were assessed using the modified Japanese Orthopedic Association (mJOA) scale, visual analog score (VAS), and American Spinal Injury Association (ASIA) score at regular intervals of 3 and 6 months and 1 and 2 years, respectively.
Results: Our study population comprised 19 males and four females with posttraumatic acute CCS. The average follow-up was 12–24 months. Out of 23 patients, 13 had single-level fusion, and 10 patients had double-level fusion surgery. In our study, preoperative (pre-op) mean VAS decreased from 7.6 ± 0.84 to 6.9 ± 1.6 postoperatively, and the mean mJOA score decreased from 8.2 ± 2.2 to 14.5 ± 2.0 postoperatively were statistically significant. On comparing pre-op and postoperative ASIA neurological grading, statistically significant improvement of ASIA grades. Radiological outcomes according to Bridwell's fusion criteria in computer tomography (CT) were also excellent.
Conclusion: To conclude, we recommended surgical decompression with ACDF as the current mode of treatment with excellent functional and radiological outcomes with long-term results for posttraumatic CCS. |
| format | Article |
| id | doaj-art-06ac5a4c93d04210a52464e4e2abc328 |
| institution | Kabale University |
| issn | 2582-7863 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Jaypee Brothers Medical Publisher |
| record_format | Article |
| series | Journal of Orthopedics and Joint Surgery |
| spelling | doaj-art-06ac5a4c93d04210a52464e4e2abc3282025-02-07T11:17:47ZengJaypee Brothers Medical PublisherJournal of Orthopedics and Joint Surgery2582-78632024-01-016111110.5005/jojs-10079-11351A Study of Functional and Radiological Outcome in Anterior Cervical Discectomy and Fusion with Stabilization in Posttraumatic Acute Central Cord SyndromeSivakumar Raju0Sudeep K Velur Nagendra1Vinoth Thangamani2https://orcid.org/0000-0002-7172-8045Bharat K Ramalingam Jeyashankaran3https://orcid.org/0009-0003-3100-8443D Abinav Annamalai4Department of Orthopaedics, Spine Surgery Unit, Preethi Hospital, Madurai, Tamil Nadu, IndiaDepartment of Orthopaedics, Spine Surgery Unit, Preethi Hospital, Madurai, Tamil Nadu, IndiaDepartment of Orthopaedics, Spine Surgery Unit, Preethi Hospital, Madurai, Tamil Nadu, IndiaDepartment of Orthopaedics, Spine Surgery Unit, Preethi Hospital, Madurai, Tamil Nadu, India, Phone: +91 9840746102Department of Orthopaedics, Preethi Hospital, Madurai, Tamil Nadu, IndiaBackground: Spinal injuries account for around 6% of overall trauma patients, of which cervical spine injuries contribute >50%. Central cord syndrome (CCS) is the most common subtype of incomplete spinal cord and accounts for around 15–25% of all cases. The aim of this study is to assess the functional and radiological outcomes of posttraumatic acute CCS treated with anterior cervical discectomy and fusion (ACDF) with stabilization. Materials and methods: It is a prospective study done between October 2020 and September 2022 in the Department of Orthopaedics, Preethi Hospital. Our study consists of 23 patients with posttraumatic CCS treated with ACDF with stabilization. Neurological and functional outcomes were assessed using the modified Japanese Orthopedic Association (mJOA) scale, visual analog score (VAS), and American Spinal Injury Association (ASIA) score at regular intervals of 3 and 6 months and 1 and 2 years, respectively. Results: Our study population comprised 19 males and four females with posttraumatic acute CCS. The average follow-up was 12–24 months. Out of 23 patients, 13 had single-level fusion, and 10 patients had double-level fusion surgery. In our study, preoperative (pre-op) mean VAS decreased from 7.6 ± 0.84 to 6.9 ± 1.6 postoperatively, and the mean mJOA score decreased from 8.2 ± 2.2 to 14.5 ± 2.0 postoperatively were statistically significant. On comparing pre-op and postoperative ASIA neurological grading, statistically significant improvement of ASIA grades. Radiological outcomes according to Bridwell's fusion criteria in computer tomography (CT) were also excellent. Conclusion: To conclude, we recommended surgical decompression with ACDF as the current mode of treatment with excellent functional and radiological outcomes with long-term results for posttraumatic CCS.https://www.jojs.in/doi/JOJS/pdf/10.5005/jojs-10079-1135anterior cervical discectomy and fusionamerican spinal injury association scorebridwell scorecentral cord syndromecervical spine injurymodified japanese orthopedic association scorevisual analog score |
| spellingShingle | Sivakumar Raju Sudeep K Velur Nagendra Vinoth Thangamani Bharat K Ramalingam Jeyashankaran D Abinav Annamalai A Study of Functional and Radiological Outcome in Anterior Cervical Discectomy and Fusion with Stabilization in Posttraumatic Acute Central Cord Syndrome Journal of Orthopedics and Joint Surgery anterior cervical discectomy and fusion american spinal injury association score bridwell score central cord syndrome cervical spine injury modified japanese orthopedic association score visual analog score |
| title | A Study of Functional and Radiological Outcome in Anterior Cervical Discectomy and Fusion with Stabilization in Posttraumatic Acute Central Cord Syndrome |
| title_full | A Study of Functional and Radiological Outcome in Anterior Cervical Discectomy and Fusion with Stabilization in Posttraumatic Acute Central Cord Syndrome |
| title_fullStr | A Study of Functional and Radiological Outcome in Anterior Cervical Discectomy and Fusion with Stabilization in Posttraumatic Acute Central Cord Syndrome |
| title_full_unstemmed | A Study of Functional and Radiological Outcome in Anterior Cervical Discectomy and Fusion with Stabilization in Posttraumatic Acute Central Cord Syndrome |
| title_short | A Study of Functional and Radiological Outcome in Anterior Cervical Discectomy and Fusion with Stabilization in Posttraumatic Acute Central Cord Syndrome |
| title_sort | study of functional and radiological outcome in anterior cervical discectomy and fusion with stabilization in posttraumatic acute central cord syndrome |
| topic | anterior cervical discectomy and fusion american spinal injury association score bridwell score central cord syndrome cervical spine injury modified japanese orthopedic association score visual analog score |
| url | https://www.jojs.in/doi/JOJS/pdf/10.5005/jojs-10079-1135 |
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