Short-term neurological and functional outcome of surgical intervention in spinal cord injuries: a single center prospective observational study

Abstract

Introduction: the management of an acute spinal cord injury remains controversial. The patient of acute spinal cord injury undergoes several phases of care beginning with the initial trauma management, surgical intervention, and perioperative medical management. The aim of this study was to evaluate the neurological and functional outcome of operative management of traumatic spinal cord injury patients admitted to a tertiary care centre in Northeast India. Methods: thirty patients with spinal cord injury admitted to a tertiary care centre from December 2019 to November 2021, and treated with instrumented stabilisation for spinal cord injury were evaluated until 6 months postoperatively. Patients were evaluated with validated neurological (American Spinal Injury Association scale) and functional outcome measures (Barthel index). Demographic details, mode of injury, morphology, patterns of fractures, neurological level, and management methods in the hospital were recorded and analysed using the Statistical Package for the Social Science (SPSS) version 27.0. Results: thoracolumbar spinal cord was more commonly injured with 16 (53.3%) patients compared to cervical spinal cord injury patients at 14 (46.7%). Eight patients had complete recovery, 7 patients had incomplete recovery and 15 patients had no recovery. At 6 months post-injury, 18 (60%) patients had favourable functional outcome. American Spinal Injury Association (ASIA) grade at admission was found to be significantly associated with the functional outcome. Conclusion: after surgery half of the patients had an improvement in their neurology, and functional outcome was favorable which suggests that surgery still holds the key to a better functional and rehabilitation outcome.