Evaluation of the acute management of tetraplegia: conservative versus surgical treatment

Paraplegia
C Wilmot, K M Hall

Abstract

A retrospective study of 106 tetraplegic patients admitted consecutively to the Santa Clara Valley Medical Center (SCVMC) between August, 1981 and September, 1983 was conducted. The average age was 28; and 20 (19%) were female. The majority sustained their spinal cord injury in a motor vehicle accident (65%) or in a diving accident (19%). Forty-nine percent (52/106) of these patients had acute surgical intervention, and 63% (33/52) of these patients had this prior to admission to SCVMC. The majority (35/52) had posterior fusion alone. Twelve patients had an anterior fusion (11 at other hospitals) and four a laminectomy alone (three carried out at other hospitals). The length of rehabilitation stay was 133 days for those having surgery, and 119 days for non-surgical cases; statistically a non-significant difference. When acute medical/surgical hospitalisation and rehabilitation days were combined, those having surgery had a significantly longer stay (197 versus 153 days), but only when surgery was done other than at SCVMC. Complications occurred in 50/106 (47%) of the patients: 50% who had surgery and 44% who were treated conservatively. The most commonest complication was respiratory (43%), including 20% who had pneumonia. Comp...Continue Reading

References

Aug 1, 1979·The Journal of Bone and Joint Surgery. British Volume·G M Bedbrook

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Citations

Jan 11, 1991·Archives of Orthopaedic and Trauma Surgery·H JónssonW Rauschning
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May 1, 1990·The British Journal of Surgery·C H Tator
Aug 22, 2007·Journal of Orthopaedic Surgery·G S Sapkas, S A Papadakis

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